Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.
Fort HealthCare, Fort Atkinson, Wisconsin.
J Am Acad Dermatol. 2019 Jan;80(1):60-69.e2. doi: 10.1016/j.jaad.2018.05.040. Epub 2018 Jun 1.
The optimal long-term dosing strategy for adalimumab (ADA) in hidradenitis suppurativa/acne inversa (HS) was evaluated by pooling the results of the PIONEER phase 3 trials and an open-label extension (OLE) study.
To assess the response to and tolerability of long-term administration of ADA in HS.
The durations of the PIONEER I/II periods A, B, and OLE were 12, 24, and 52 or more weeks, respectively. Patients who entered the OLE and received ADA (40 mg every week continuously) and responders plus partial responders (PRRs) were evaluated. Primary efficacy assessments included measurement of HS clinical response (HiSCR), lesion counts, skin pain, and Dermatology Life Quality Index (DLQI). Treatment-emergent adverse events were assessed.
At week 12, 52.3% of those receiving ADA weekly and 73.0% of PRRs achieved HiSCR. Achievement of HiSCR was maintained through week 168 in 52.3% of patients who received ADA weekly and 57.1% of PRRs. Sustained improvement in lesion counts, skin pain, and DLQI score were also observed. The safety profile throughout the OLE was similar to the profiles observed in the PIONEER studies.
The OLE was uncontrolled.
Continuous weekly dosing with ADA, 40 mg, is a reasonable treatment option for long-term control of moderate-to-severe HS.
通过汇总 PIONEER 三期试验和开放标签扩展(OLE)研究的结果,评估阿达木单抗(ADA)在化脓性汗腺炎/反向痤疮(HS)中的最佳长期给药方案。
评估 ADA 在 HS 中的长期给药的应答和耐受性。
PIONEER I/II 期 A、B 和 OLE 阶段的持续时间分别为 12、24 和 52 周或更长时间。评估进入 OLE 并接受 ADA(每周 40mg 持续使用)和完全应答者(PRRs)的患者。主要疗效评估包括 HS 临床应答(HiSCR)、皮损计数、皮肤疼痛和皮肤病生活质量指数(DLQI)的测量。评估治疗出现的不良事件。
接受 ADA 每周治疗的患者中有 52.3%,PRRs 中有 73.0%在第 12 周达到 HiSCR。接受 ADA 每周治疗的患者中有 52.3%,PRRs 中有 57.1%在第 168 周维持 HiSCR。皮损计数、皮肤疼痛和 DLQI 评分也持续改善。OLE 期间的安全性概况与 PIONEER 研究中观察到的概况相似。
OLE 为非对照研究。
每周连续给予 ADA 40mg,是中重度 HS 长期控制的合理治疗选择。