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本文引用的文献

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Long-term safety of tofacitinib for the treatment of rheumatoid arthritis up to 8.5 years: integrated analysis of data from the global clinical trials.托法替布治疗类风湿关节炎长达8.5年的长期安全性:来自全球临床试验数据的综合分析
Ann Rheum Dis. 2017 Jul;76(7):1253-1262. doi: 10.1136/annrheumdis-2016-210457. Epub 2017 Jan 31.
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Efficacy and safety of tofacitinib in patients with active rheumatoid arthritis: review of key Phase 2 studies.托法替布治疗活动性类风湿关节炎患者的疗效与安全性:关键2期研究综述
Int J Rheum Dis. 2016 Dec;19(12):1216-1225. doi: 10.1111/1756-185X.12901. Epub 2016 Jul 25.
3
Tuberculosis and other opportunistic infections in tofacitinib-treated patients with rheumatoid arthritis.托法替布治疗的类风湿关节炎患者中的结核病及其他机会性感染。
Ann Rheum Dis. 2016 Jun;75(6):1133-8. doi: 10.1136/annrheumdis-2015-207319. Epub 2015 Aug 28.
4
Tofacitinib, an oral Janus kinase inhibitor: analysis of malignancies across the rheumatoid arthritis clinical development programme.托法替布,一种口服的Janus激酶抑制剂:类风湿关节炎临床研发项目中恶性肿瘤的分析
Ann Rheum Dis. 2016 May;75(5):831-41. doi: 10.1136/annrheumdis-2014-205847. Epub 2015 Apr 22.
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Herpes zoster and tofacitinib therapy in patients with rheumatoid arthritis.带状疱疹和托法替尼治疗类风湿关节炎患者。
Arthritis Rheumatol. 2014 Oct;66(10):2675-84. doi: 10.1002/art.38745.
6
Tofacitinib versus methotrexate in rheumatoid arthritis.托法替布与甲氨蝶呤治疗类风湿关节炎的疗效比较。
N Engl J Med. 2014 Jun 19;370(25):2377-86. doi: 10.1056/NEJMoa1310476.
7
Safety and efficacy of tofacitinib, an oral janus kinase inhibitor, for the treatment of rheumatoid arthritis in open-label, longterm extension studies.托法替布(一种口服的Janus激酶抑制剂)在开放性长期扩展研究中治疗类风湿关节炎的安全性和有效性。
J Rheumatol. 2014 May;41(5):837-52. doi: 10.3899/jrheum.130683. Epub 2014 Apr 1.
8
Tofacitinib in combination with nonbiologic disease-modifying antirheumatic drugs in patients with active rheumatoid arthritis: a randomized trial.托法替布联合非生物性疾病修正抗风湿药物治疗活动期类风湿关节炎患者的随机试验。
Ann Intern Med. 2013 Aug 20;159(4):253-61. doi: 10.7326/0003-4819-159-4-201308200-00006.
9
Safety of biologics approved for treating rheumatoid arthritis: analysis of spontaneous reports of adverse events.治疗类风湿关节炎的生物制剂的安全性:不良事件自发报告分析。
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10
Tofacitinib (CP-690,550) in patients with rheumatoid arthritis receiving methotrexate: twelve-month data from a twenty-four-month phase III randomized radiographic study.托法替布(CP-690,550)用于接受甲氨蝶呤治疗的类风湿关节炎患者:一项为期24个月的III期随机影像学研究的12个月数据。
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全球托法替布治疗类风湿关节炎的3年上市后监测经验

Worldwide, 3-Year, Post-Marketing Surveillance Experience with Tofacitinib in Rheumatoid Arthritis.

作者信息

Cohen Stanley, Curtis Jeffrey R, DeMasi Ryan, Chen Yan, Fan Haiyun, Soonasra Arif, Fleischmann Roy

机构信息

Metroplex Clinical Research Center, Dallas, TX, USA.

University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Rheumatol Ther. 2018 Jun;5(1):283-291. doi: 10.1007/s40744-018-0097-3. Epub 2018 Feb 22.

DOI:10.1007/s40744-018-0097-3
PMID:29470834
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5935628/
Abstract

INTRODUCTION

Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting.

METHODS

Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily.

RESULTS

During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders.

CONCLUSIONS

Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance.

FUNDING

Pfizer Inc.

摘要

引言

上市后监测(PMS)是新药获批后监测不良事件(AE)的一个组成部分。托法替布是一种用于治疗类风湿关节炎(RA)的口服Janus激酶抑制剂。开展了一项上市后监测报告分析,以评估托法替布在上市后环境中的安全性。

方法

分析了2012年11月6日(托法替布首次上市许可)至2015年11月5日期间辉瑞安全数据库中收到的全球托法替布上市后监测数据。对感兴趣的严重不良事件(SAE)进行了审查,并通过将SAE的数量除以估计的100患者年暴露量来计算报告率(RR)。患者暴露量是根据全球估计销售额和托法替布5毫克每日两次的估计每日用药方案计算的。

结果

在3年报告期内,自批准以来全球托法替布的上市后暴露量估计为34223患者年。共收到9291份病例报告(82.9%为非严重报告),报告了25417例不良事件、102例死亡病例和4352例严重不良事件。根据监管活动医学词典系统器官分类,感兴趣的严重不良事件的报告率(每100患者年)分别为:感染2.57、胃肠道疾病0.91、呼吸系统疾病0.60、肿瘤0.45、心脏疾病0.43、肝胆疾病0.12。

结论

尽管这些数据存在局限性,但与托法替布类风湿关节炎临床开发项目中确定的安全性概况相比,在这一现实世界环境中未发现新的安全风险。通过托法替布开发项目和上市后监测确定的任何风险将继续通过药物警戒监测进行监测。

资助

辉瑞公司