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一项长期、干预性、开放性标签扩展研究,评估托珠单抗治疗完成全球、国际性 CHERISH 试验的波兰和俄罗斯多关节型幼年特发性关节炎患者的安全性。

Long-term, interventional, open-label extension study evaluating the safety of tocilizumab treatment in patients with polyarticular-course juvenile idiopathic arthritis from Poland and Russia who completed the global, international CHERISH trial.

机构信息

Department of Pediatric Pulmonology and Rheumatology, Medical University of Lublin, Gębali 6 Street, 20-093, Lublin, Poland.

Department of Pediatric Neurology and Rheumatology, St. Louis Children's Hospital, Cracow, Poland.

出版信息

Clin Rheumatol. 2018 Jul;37(7):1807-1816. doi: 10.1007/s10067-018-4071-9. Epub 2018 Apr 13.

DOI:10.1007/s10067-018-4071-9
PMID:29654485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6006189/
Abstract

Efficacy and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, were demonstrated in juvenile idiopathic arthritis (JIA) with polyarticular course (pJIA) in the CHERISH trial. This observational, III phase study evaluated long-term treatment of TCZ in pJIA patients was conducted by members of the Pediatric Rheumatology International Trials Organization (PRINTO) from Poland and Russia. Forty-one patients, who had completed the CHERISH core study (104 weeks), were extensionally treated with TCZ (8 mg/kg, intravenous infusion every 4 weeks). Total treatment time was from 131 to 193 weeks. The long-term safety (the primary endpoint) and efficacy were evaluated. All patients achieved ACR70 response in the core study and continued to achieve at least ACR50 response up to week 24 of this study. The safety population comprised 46.41 patient-years (PY). Rates per 100 PY of adverse (AEs) and serious events (SAEs) were 181.0 and 6.46, respectively. Pharyngitis and respiratory tract infections were the most common AEs. Except one AE (severe neutropenia), all others were classified as mild (24.4%) or moderate (29.3%). The incidence of SAEs was low (7.3%). No new safety findings were observed. The safety profile of over 2.5-year treatment with TCZ is consistent with the pre-marketing CHERISH clinical trial. Presented data and continued efficacy response support the use of TCZ in pJIA. EUDRACT No: 2011-001607-12. https://clinicaltrials.gov/ct2/show/study/NCT01575769?term=ML27783.

摘要

托珠单抗(TCZ)是一种白细胞介素-6 受体抑制剂,在多关节型幼年特发性关节炎(pJIA)的 CHERISH 试验中已证实其疗效和安全性。这项观察性、III 期研究评估了 TCZ 在波兰和俄罗斯儿童风湿病国际试验组织(PRINTO)成员中治疗 pJIA 患者的长期治疗效果。41 名完成 CHERISH 核心研究(104 周)的患者接受 TCZ(8mg/kg,每 4 周静脉输注一次)扩展治疗。总治疗时间为 131 至 193 周。评估了长期安全性(主要终点)和疗效。所有患者在核心研究中均达到 ACR70 缓解,并在本研究第 24 周继续达到至少 ACR50 缓解。安全性人群包括 46.41 患者年(PY)。每 100PY 的不良事件(AE)和严重事件(SAE)发生率分别为 181.0 和 6.46。咽炎和呼吸道感染是最常见的 AE。除 1 例 AE(严重中性粒细胞减少症)外,其他均为轻度(24.4%)或中度(29.3%)。SAE 的发生率较低(7.3%)。未观察到新的安全性发现。超过 2.5 年 TCZ 治疗的安全性概况与上市前的 CHERISH 临床试验一致。目前的数据和持续的疗效反应支持 TCZ 在 pJIA 中的应用。EUDART 编号:2011-001607-12。https://clinicaltrials.gov/ct2/show/study/NCT01575769?term=ML27783。

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本文引用的文献

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Comparison of treatment response, remission rate and drug adherence in polyarticular juvenile idiopathic arthritis patients treated with etanercept, adalimumab or tocilizumab.用依那西普、阿达木单抗或托珠单抗治疗的多关节型幼年特发性关节炎患者的治疗反应、缓解率及药物依从性比较。
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The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort.当代治疗方案管理下的儿童青少年特发性关节炎的结局:REACCh-Out 队列研究结果。
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