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尼达尼布治疗系统性硬化症相关间质性肺疾病患者:SENSCIS 试验的日本人群分析。

Nintedanib in patients with systemic sclerosis-associated interstitial lung disease: A Japanese population analysis of the SENSCIS trial.

机构信息

Department of Allergy and Rheumatology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan.

出版信息

Mod Rheumatol. 2021 Jan;31(1):141-150. doi: 10.1080/14397595.2020.1751402. Epub 2020 Apr 23.

Abstract

OBJECTIVE

We examined the efficacy and safety of nintedanib in Japanese patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) in the global Safety and Efficacy of Nintedanib in Systemic Sclerosis (SENSCIS) trial.

METHODS

Randomised patients received oral nintedanib 150 mg ( = 34) twice daily or placebo ( = 36) until the last patient reached 52 weeks of treatment (up to 100 weeks). Data were analysed using a subgroup analysis model with Japanese and non-Japanese patients as subgroup variables.

RESULTS

In Japanese patients, the adjusted annual rate of forced vital capacity (FVC) decline over 52 weeks was -86.2 mL/year (nintedanib) and -90.9 mL/year (placebo); treatment difference, 4.67 mL/year (95% confidence interval, -103.28, 112.63). Treatment effect heterogeneity between Japanese and non-Japanese patients was not detected (treatment-by-visit-by-subgroup interaction;  = .49). FVC decline was smaller for nintedanib versus placebo through 100 weeks in Japanese patients. The most commonly reported adverse events with nintedanib were gastrointestinal and liver disorder events; most were mild-to-moderate in severity.

CONCLUSION

In both Japanese and non-Japanese patients with SSc-ILD, nintedanib slowed the progression of ILD, with no heterogeneity detected between the subgroups. The safety profile for nintedanib in Japanese patients was similar to that observed in patients with idiopathic pulmonary fibrosis (ClinicalTrials.gov: NCT02597933).

摘要

目的

我们在全球 Safety and Efficacy of Nintedanib in Systemic Sclerosis(SENSCIS)试验中,研究了尼达尼布在日本系统性硬化症相关间质性肺病(SSc-ILD)患者中的疗效和安全性。

方法

随机分配的患者接受尼达尼布 150mg 口服,每日两次( = 34)或安慰剂( = 36),直至最后一名患者达到 52 周的治疗(最长 100 周)。使用包含日本和非日本患者作为亚组变量的亚组分析模型进行数据分析。

结果

在日本患者中,52 周时用力肺活量(FVC)的调整年下降率为 -86.2 mL/年(尼达尼布)和 -90.9 mL/年(安慰剂);治疗差异为 4.67 mL/年(95%置信区间,-103.28,112.63)。未检测到日本和非日本患者之间的治疗效果异质性(治疗-访视-亚组相互作用; = .49)。在日本患者中,尼达尼布治疗直至 100 周时 FVC 下降较安慰剂小。尼达尼布最常见的不良反应是胃肠道和肝脏疾病事件;大多数为轻到中度。

结论

在日本和非日本 SSc-ILD 患者中,尼达尼布减缓了ILD 的进展,亚组之间未检测到异质性。尼达尼布在日本患者中的安全性特征与特发性肺纤维化患者观察到的相似(ClinicalTrials.gov:NCT02597933)。

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