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培塞利珠单抗治疗慢性斑块状银屑病:来自两项 3 期、多中心、随机、双盲、安慰剂对照研究(CIMPASI-1 和 CIMPASI-2)的 48 周结果。

Certolizumab pegol for the treatment of chronic plaque psoriasis: Results through 48 weeks from 2 phase 3, multicenter, randomized, double-blinded, placebo-controlled studies (CIMPASI-1 and CIMPASI-2).

机构信息

New York Medical College at Metropolitan Hospital, New York, New York.

Oregon Medical Research Center, Portland, Oregon.

出版信息

J Am Acad Dermatol. 2018 Aug;79(2):302-314.e6. doi: 10.1016/j.jaad.2018.04.012. Epub 2018 Apr 13.

Abstract

BACKGROUND

Certolizumab pegol, the only Fc-free, PEGylated anti-tumor necrosis factor biologic, demonstrated clinically meaningful improvements suggestive of a positive risk-benefit balance in phase 2 studies in adults with moderate-to-severe chronic plaque psoriasis.

OBJECTIVE

Assess certolizumab efficacy and safety versus placebo in phase 3 studies.

METHODS

Patients with moderate-to-severe chronic plaque psoriasis were randomized 2:2:1 to certolizumab 400 mg, certolizumab 200 mg, or placebo every 2 weeks. At week 16, certolizumab-treated patients achieving a 50% reduction in Psoriasis Area and Severity Index continued treatment through week 48. Coprimary endpoints were week 16 responder rates, defined as a 75% reduction in Psoriasis Area and Severity Index and Physician's Global Assessment 0/1 (clear/almost clear) and ≥2-point improvement. Safety was assessed by treatment-emergent adverse events.

RESULTS

Week-16 endpoints were significantly greater for both doses of certolizumab versus placebo, and the responses were maintained through week 48. For most measures, improvement was numerically greater for certolizumab 400 mg. No unexpected safety signals were identified.

LIMITATION

There was no active comparator.

CONCLUSION

Treatment with either certolizumab 400 mg or 200 mg every 2 weeks was associated with significant and clinically meaningful improvements in moderate-to-severe psoriasis. The 400-mg dose could provide additional clinical benefit. The safety profile was consistent with the therapeutic class.

摘要

背景

唯一一种无 Fc 段、聚乙二醇化的抗肿瘤坏死因子生物制剂,培塞利珠单抗在中重度慢性斑块型银屑病成人患者的 2 期研究中显示出有临床意义的改善,提示其具有积极的风险效益平衡。

目的

评估培塞利珠单抗在 3 期研究中的疗效和安全性。

方法

中重度慢性斑块型银屑病患者按 2:2:1 的比例随机分配至培塞利珠单抗 400mg、培塞利珠单抗 200mg 或安慰剂组,每 2 周给药 1 次。在第 16 周,达到 75%的银屑病面积和严重程度指数(PASI)改善且医师全球评估(PGA)为 0/1(清除/几乎清除)和改善≥2 分的培塞利珠单抗治疗患者继续治疗至第 48 周。主要终点为第 16 周应答率,定义为 PASI75 和 PGA0/1 且改善≥2 分。通过治疗出现的不良事件评估安全性。

结果

与安慰剂相比,两种剂量的培塞利珠单抗在第 16 周的终点均显著更高,且应答在第 48 周得到维持。对于大多数指标,培塞利珠单抗 400mg 的改善程度更高。未发现新的安全性信号。

局限性

无活性对照。

结论

每 2 周给予培塞利珠单抗 400mg 或 200mg 治疗与中重度银屑病的显著和有临床意义的改善相关。400mg 剂量可能提供额外的临床获益。安全性特征与治疗类别一致。

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