Bessette Louis, Haraoui Boulos, Chow Andrew, Fortin Isabelle, Dixit Sanjay, Khraishi Majed, Haaland Derek, Elmoufti Sami, Staelens Fabienne, Bogatyreva Irina, Syrotuik Jerry, Shaikh Saeed
Department of Medicine, Laval University, 2705, Laurier Boulevard, Québec City, Québec, Canada.
Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
Ther Adv Musculoskelet Dis. 2019 Mar 5;11:1759720X19831151. doi: 10.1177/1759720X19831151. eCollection 2019.
The aim of this study was to assess the real-world effectiveness and safety of certolizumab pegol (CZP) in rheumatoid arthritis (RA) patients, and the impact on patients' productivity, pain, and fatigue, in Canadian practice.
FαsT-CAN, a 2-year prospective, observational study, evaluated CZP use in Canadian adults with moderate to severe, active RA. The primary objective was to assess the proportion of patients achieving 28-joint Disease Activity Scores (DAS28) <2.6 at Week 104. Secondary and additional endpoints assessed the improvements in Patients' Assessment of Arthritis Pain (PtAAP), fatigue, Health Assessment Questionnaire-Disability Index (HAQ-DI), and the proportion of patients achieving minimal clinically important differences (MCID) in HAQ-DI. Validated arthritis-specific Work Productivity Surveys (WPS-RA) assessed the RA-associated impact on productivity. Incidence of CZP-related treatment-emergent adverse events (TEAEs) was reported for patients receiving ⩾1 dose of CZP (safety set).
The full analysis set (baseline DAS28 ⩾ 2.6, ⩾1 dose of CZP and ⩾1 valid post-baseline DAS28 measurement) included 451 of the 546 patients recruited into the study; a total of 229/451 (50.8%) patients completed Week 104. At Week 104, 90/451 (20.0%) patients achieved DAS28 < 2.6. Rapid improvements in disease activity, pain, and fatigue were observed. At Week 104, 66.2% of patients achieved HAQ-DI MCID. Patients employed at Week 104, reported reduced absenteeism, and improved productivity. CZP-related TEAEs were consistent with the known CZP safety profile.
CZP was an effective RA treatment in Canadian practice, and no new CZP-related safety signals were identified. The improvements in household and workplace productivity are the first observations in a real-world Canadian setting.
本研究旨在评估聚乙二醇化赛妥珠单抗(CZP)在加拿大类风湿关节炎(RA)患者实际应用中的有效性、安全性,以及对患者工作效率、疼痛和疲劳的影响。
FαsT-CAN是一项为期2年的前瞻性观察性研究,评估了加拿大中重度活动性RA成年患者使用CZP的情况。主要目标是评估在第104周时达到28个关节疾病活动评分(DAS28)<2.6的患者比例。次要和附加终点评估了患者关节炎疼痛评估(PtAAP)、疲劳、健康评估问卷残疾指数(HAQ-DI)的改善情况,以及在HAQ-DI中达到最小临床重要差异(MCID)的患者比例。经过验证的关节炎特异性工作效率调查(WPS-RA)评估了RA对工作效率的影响。报告了接受≥1剂CZP(安全组)患者中与CZP相关的治疗中出现的不良事件(TEAE)的发生率。
完整分析集(基线DAS28≥2.6、≥1剂CZP且≥1次有效的基线后DAS28测量值)包括纳入研究的546例患者中的451例;共有229/451(50.8%)例患者完成了第104周的研究。在第104周时,90/451(20.0%)例患者达到DAS28<2.6。观察到疾病活动、疼痛和疲劳迅速改善。在第104周时,66.2%的患者达到HAQ-DI MCID。在第104周工作的患者报告旷工减少,工作效率提高。与CZP相关的TEAE与已知的CZP安全性特征一致。
在加拿大的实际应用中,CZP是一种有效的RA治疗药物,未发现新的与CZP相关的安全信号。家庭和工作场所工作效率的提高是在加拿大实际环境中的首次观察结果。