Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, South Korea.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Rheumatol Int. 2018 Dec;38(12):2233-2242. doi: 10.1007/s00296-018-4159-1. Epub 2018 Sep 18.
To evaluate the efficacy and safety of infliximab biosimilar CT-P13 in patients with active Takayasu arteritis (TAK). In this single-center open-label trial, patients with active TAK received CT-P13 at a starting dose of 5 mg/kg at weeks 0, 2, 6, and then every 8 weeks up to week 46. They were followed up until week 54. From week 14 to week 46, patients with inadequate response received increased dose of CT-P13 by 1.5 mg/kg. Concomitant prednisolone was allowed ≤ 10 mg/day. The primary efficacy end point was the achievement of partial or complete remission at week 30. All patients underwent positron emission tomography-computed tomography (PET-CT) at baseline and week 30. Twelve patients with TAK received CT-P13; one patient with protocol violation was excluded from analysis. Nine (81.8%) patients had taken concomitant prednisolone with median dose of 5.0 mg/day. At week 30, three (27.3%) patients achieved complete remission and six (54.5%) patients achieved partial remission. Statistically significant improvements in modified Indian Takayasu Clinical Activity Score (ITAS2010), ITAS-A, and serum levels of erythrocyte sedimentation rate and C-reactive protein were seen at week 30 from baseline. PET parameters were significantly reduced from baseline to week 30, including maximum standardized uptake value, target-to-vein ratio, target-to-liver ratio, and PET Vascular Activity Score. There were no serious adverse events. Treatment with CT-P13 may lead to improvement in clinical, radiographic, and serological activities with lower glucocorticoid requirement in TAK.Trial registration number NCT02457585.
评估英夫利昔单抗生物类似药 CT-P13 治疗活动期大动脉炎(TAK)患者的疗效和安全性。在这项单中心、开放标签试验中,活动期 TAK 患者接受 CT-P13 起始剂量 5mg/kg,分别于第 0、2、6 周给药,之后每 8 周给药 1 次,持续至第 46 周。患者随访至第 54 周。从第 14 周到第 46 周,如果患者应答不足,则增加 CT-P13 剂量 1.5mg/kg。允许同时使用泼尼松龙≤10mg/天。主要疗效终点是第 30 周时达到部分或完全缓解。所有患者在基线和第 30 周时均接受正电子发射断层扫描-计算机断层扫描(PET-CT)检查。12 例 TAK 患者接受 CT-P13 治疗;1 例因违反方案而被排除分析。9 例(81.8%)患者同时使用泼尼松龙,中位剂量为 5.0mg/天。第 30 周时,3 例(27.3%)患者达到完全缓解,6 例(54.5%)患者达到部分缓解。与基线相比,第 30 周时改良印度大动脉炎临床活动评分(ITAS2010)、ITAS-A 以及红细胞沉降率和 C 反应蛋白的血清水平均显著改善。与基线相比,第 30 周时 PET 参数显著降低,包括最大标准化摄取值、靶静脉比、靶肝比和 PET 血管活动评分。无严重不良事件。CT-P13 治疗可能会导致 TAK 患者的临床、影像学和血清学活动得到改善,且需要的糖皮质激素剂量降低。试验注册号 NCT02457585。