Salford Royal NHS Foundation Trust, The University of Manchester, National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom.
SKiN Centre for Dermatology, Peterborough, Ontario, Canada.
J Am Acad Dermatol. 2020 May;82(5):1138-1149. doi: 10.1016/j.jaad.2019.12.038. Epub 2019 Dec 26.
Cumulative clinical improvement and speed of improvement are important to psoriasis patients.
Compare cumulative benefits of biologics over 12 to 16 weeks in the treatment of moderate to severe psoriasis.
A systematic literature review identified phase III trial data on Psoriasis Area and Severity Index (PASI) responses for biologics during 12 and 16 weeks of treatment. Cumulative clinical benefit, measured by the area under the curve for PASI ≥75% improvement (PASI 75), ≥90% improvement (PASI 90), and 100% improvement (PASI 100), was compared using the network meta-analysis and Bayesian methodology on the relative probability of achieving percentage of maximum area under the curve.
Among biologics approved for psoriasis treatment, anti-interleukin-17 biologics demonstrated consistently greater cumulative clinical benefits on PASI 75, PASI 90, and PASI 100 over the 12- or 16-week period than anti-interleukin-23 and other biologics. For biologics with 12-week data, ixekizumab and brodalumab showed greater cumulative benefits for PASI 75, PASI 90, and PASI 100 than secukinumab, followed by guselkumab, infliximab, adalimumab, ustekinumab, and etanercept. Ixekizumab showed greater cumulative benefits than all other biologics reporting 16-week data.
Recently approved biologics were not included.
Ixekizumab (at 12 weeks and 16 weeks) and brodalumab (at 12 weeks) had greater cumulative clinical benefit than all of other biologics studied.
累积临床疗效和疗效改善速度对银屑病患者很重要。
比较生物制剂在治疗中重度银屑病的 12 至 16 周治疗期间的累积获益。
系统文献回顾确定了生物制剂在 12 和 16 周治疗期间的银屑病面积和严重程度指数（PASI）应答的 III 期试验数据。使用网络荟萃分析和贝叶斯方法，根据实现最大曲线下面积百分比的相对概率，比较 PASI 改善 75%（PASI 75）、90%（PASI 90）和 100%（PASI 100）的累积临床获益，通过曲线下面积评估。
在批准用于银屑病治疗的生物制剂中，抗白细胞介素-17 生物制剂在 12 或 16 周治疗期间，在 PASI 75、PASI 90 和 PASI 100 方面表现出一致更大的累积临床获益，而抗白细胞介素-23 生物制剂和其他生物制剂则不然。对于具有 12 周数据的生物制剂，依奇珠单抗和布罗达umab 在 PASI 75、PASI 90 和 PASI 100 方面的累积获益均大于司库奇尤单抗，其次是古塞库单抗、英夫利昔单抗、阿达木单抗、乌司奴单抗和依那西普。依奇珠单抗在 16 周数据报告中显示出比所有其他生物制剂更大的累积获益。
最近批准的生物制剂未包括在内。
依奇珠单抗（12 周和 16 周）和布罗达umab（12 周）比研究中的所有其他生物制剂具有更大的累积临床获益。
