Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.
Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.
RMD Open. 2019 Jan 22;5(1):e000779. doi: 10.1136/rmdopen-2018-000779. eCollection 2019.
Psoriatic arthritis is a chronic inflammatory disease that affects the musculoskeletal system. It can include arthritis, spondylitis, dactylitis and enthesitis, and is strongly associated with the presence of psoriasis. The introduction of biological therapies as a treatment option has brought a significant improvement in disease control for patients with psoriatic arthritis. Here, we aimed to detect emerging differences in demographic and clinical characteristics of the psoriatic arthritis patient study population since the introduction of biologicals. We hypothesised that evolving views on control of disease activity and increased experience in the management of psoriatic arthritis have affected the patient population considered for clinical trials and that this may serve as a proxy for changes in clinical practice.
We systematically searched for and selected 12 phase II and phase III trials and divided them into three treatment periods based on different time periods and working mechanisms of the particular biologicals. We made a selection of patient and disease parameters for which data were available in all three periods, calculated those data per period and looked for statistically significant differences between the treatment periods.
Statistical analysis showed significant differences in patient characteristics, disease characteristics, disease activity, disease effects and use of prior treatments between the patient populations of the three periods.
This study shows a clear evolution of the patient population considered for clinical trials since the introduction of biologicals. Further research is needed to see if those changes can be detected in the daily clinical practice.
银屑病关节炎是一种影响肌肉骨骼系统的慢性炎症性疾病。它可能包括关节炎、脊柱炎、指(趾)炎和附着点炎,并且与银屑病的存在密切相关。生物疗法作为一种治疗选择的引入,为银屑病关节炎患者的疾病控制带来了显著改善。在这里,我们旨在检测自生物制剂引入以来,银屑病关节炎患者研究人群的人口统计学和临床特征方面出现的新差异。我们假设,对疾病活动控制的观点不断发展,以及在银屑病关节炎管理方面经验的增加,影响了考虑进行临床试验的患者人群,这可能是临床实践变化的一个指标。
我们系统地搜索并选择了 12 项 2 期和 3 期试验,并根据特定生物制剂的不同时间段和工作机制将其分为三个治疗期。我们选择了在所有三个时期都有数据的患者和疾病参数,计算了每个时期的数据,并寻找治疗期之间的统计学显著差异。
统计分析显示,三个时期的患者人群在患者特征、疾病特征、疾病活动度、疾病影响和先前治疗的使用方面存在显著差异。
这项研究表明,自生物制剂引入以来,考虑进行临床试验的患者人群发生了明显的演变。需要进一步研究,以了解这些变化是否可以在日常临床实践中检测到。