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一项单臂、开放标签研究,旨在评估采用无血清、高产量生产工艺制造的依那西普用于类风湿性关节炎患者时的免疫原性、安全性及疗效。

A single-arm, open-label study to assess the immunogenicity, safety, and efficacy of etanercept manufactured using the serum-free, high-capacity manufacturing process administered to patients with rheumatoid arthritis.

作者信息

Polák Pavol, Peric Porin, Louw Ingrid, Gaylord Stefanie M, Williams Theresa, Becker Jean-Claude, Pedersen Ron, Korth-Bradley Joan, Vlahos Bonnie

机构信息

Out-patient Rheumatology Clinic, Zilina, Slovakia.

Clinical Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.

出版信息

Eur J Rheumatol. 2019 Jan;6(1):23-28. doi: 10.5152/eurjrheum.2018.18078.

Abstract

OBJECTIVE

To evaluate the immunogenicity, safety, and efficacy of etanercept (ETN) manufactured using the serum-free, high-capacity manufacturing (SFHCM) process in patients with rheumatoid arthritis (RA).

METHODS

In this global, multicenter, open-label, single-arm study (NCT02378506), 187 adult patients with moderate to severe RA received ETN 50 mg once weekly for 24 weeks manufactured using the SFHCM process. Immunogenicity (presence of antidrug antibodies (ADAs) and neutralizing antibodies (NAbs)) was assessed at 12 and 24 weeks. Safety and efficacy were evaluated at 4, 12, and 24 weeks.

RESULTS

Eight (4.5%) patients tested positive for ADA, and there were no NAbs detected at any time throughout the study. Ninety (48.1%) patients reported treatment-emergent adverse events (AEs), of which 27 (14.4%) reported injection-site reactions, and 43 (23.0%) reported infections. The majority of AEs were mild or moderate in severity, and the drug was well tolerated. Throughout the duration of the study (week 4 to week 24), there was a progressive increase in the American College of Rheumatology (ACR)-defined responses (ACR20: 55.9%-82.0%, ACR50: 16.1%-57.8%, and ACR70: 3.2%-26.7%) from baseline and the proportion of patients achieving low disease activity and remission, with a corresponding decrease in measures of disease activity.

CONCLUSION

The immunogenicity, safety, and efficacy of ETN manufactured using the SFHCM process were similar to the current approved ETN formulation. ClinicalTrials.gov registration: NCT02378506.

摘要

目的

评估采用无血清、高产量生产工艺(SFHCM)制造的依那西普(ETN)在类风湿关节炎(RA)患者中的免疫原性、安全性和疗效。

方法

在这项全球多中心、开放标签、单臂研究(NCT02378506)中,187例中重度RA成年患者接受了采用SFHCM工艺制造的ETN,每周一次,每次50mg,共24周。在第12周和第24周评估免疫原性(抗药物抗体(ADA)和中和抗体(NAb)的存在情况)。在第4周、第12周和第24周评估安全性和疗效。

结果

8例(4.5%)患者ADA检测呈阳性,在整个研究过程中的任何时间均未检测到NAb。90例(48.1%)患者报告了治疗中出现的不良事件(AE),其中27例(14.4%)报告了注射部位反应,43例(23.0%)报告了感染。大多数AE的严重程度为轻度或中度,该药物耐受性良好。在整个研究期间(第4周到第24周),美国风湿病学会(ACR)定义的反应(ACR20:55.9%-82.0%,ACR50:16.1%-57.8%,ACR70:3.2%-26.7%)从基线开始逐渐增加,达到低疾病活动度和缓解的患者比例增加,同时疾病活动度指标相应下降。

结论

采用SFHCM工艺制造的ETN的免疫原性、安全性和疗效与目前批准的ETN制剂相似。ClinicalTrials.gov注册号:NCT02378506。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f67/6459335/5598e4c577de/EJR-6-1-23-g01.jpg

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