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皮下注射替扎尼定治疗膝关节或髋关节中度至重度骨关节炎患者的疗效起始和维持:一项 16 周剂量滴定研究。

Onset and maintenance of efficacy of subcutaneous tanezumab in patients with moderate to severe osteoarthritis of the knee or hip: A 16-week dose-titration study.

机构信息

Northwestern University Feinberg School of Medicine, 710 N Lake Shore Drive, Room 1020, Chicago, IL 60611, United States.

Northwest Clinical Research Center, Bellevue, WA, United States.

出版信息

Semin Arthritis Rheum. 2020 Jun;50(3):387-393. doi: 10.1016/j.semarthrit.2020.03.004. Epub 2020 Mar 19.

Abstract

OBJECTIVE

To examine the onset and maintenance of efficacy of subcutaneous tanezumab for pain relief and functional improvement in difficult-to-treat patients with moderate-to-severe osteoarthritis (OA) in a 16-week dose-titration study (NCT02697773).

METHODS

Patients were randomized to placebo (placebo group) or tanezumab 2.5 mg at baseline and week 8 (tanezumab 2.5 mg group), or tanezumab 2.5 mg at baseline and tanezumab 5 mg at week 8 (tanezumab 2.5/5 mg group). Analyses included change from baseline in average daily index joint pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Physical Function, and treatment responses (WOMAC Pain improvement criteria and Outcome Measures in Rheumatology-Osteoarthritis Research Society International [OMERACT-OARSI] criteria).

RESULTS

The 696 patients received placebo (n = 232), tanezumab 2.5 mg (n = 231), or tanezumab 2.5/5 mg (n = 233). Average daily index joint pain was statistically significantly improved within the first week (day 3-5) with tanezumab 2.5 mg compared with placebo. On first post-randomization WOMAC measurement (week 2), both tanezumab groups had statistically significant improvements compared with placebo in WOMAC Pain and Physical Function, and more tanezumab-treated patients achieved treatment response criteria (≥30%, ≥50%, or ≥70% reduction in WOMAC Pain or OMERACT-OARSI response). Efficacy was generally maintained throughout the 16-week treatment period.

CONCLUSION

Subcutaneous tanezumab provided statistically significant improvements compared with placebo in average daily index joint pain within the first week and WOMAC Pain and Physical Function (week 2) that were generally maintained throughout the 16-week treatment period. Tanezumab 5 mg provided only modest additional efficacy over tanezumab 2.5 mg.

摘要

目的

在一项 16 周剂量滴定研究(NCT02697773)中,考察皮下注射替纳珠单抗治疗中重度骨关节炎(OA)的难治性患者的疼痛缓解和功能改善的起效和维持时间。

方法

患者随机分为安慰剂(安慰剂组)或替纳珠单抗 2.5mg 基线和第 8 周(替纳珠单抗 2.5mg 组),或替纳珠单抗 2.5mg 基线和第 8 周替纳珠单抗 5mg(替纳珠单抗 2.5/5mg 组)。分析包括从基线平均每日指数关节疼痛和西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)疼痛和身体功能的变化,以及治疗反应(WOMAC 疼痛改善标准和骨关节炎研究协会国际 [OMERACT-OARSI] 标准)。

结果

696 例患者接受安慰剂(n=232)、替纳珠单抗 2.5mg(n=231)或替纳珠单抗 2.5/5mg(n=233)。与安慰剂相比,替纳珠单抗 2.5mg 在治疗的第一周(第 3-5 天)内,平均每日指数关节疼痛有统计学意义上的改善。在第一次随机后 WOMAC 测量(第 2 周)时,与安慰剂相比,替纳珠单抗组在 WOMAC 疼痛和身体功能方面均有统计学意义的改善,更多接受替纳珠单抗治疗的患者达到治疗反应标准(WOMAC 疼痛降低≥30%、≥50%或≥70%,或 OMERACT-OARSI 反应)。疗效在整个 16 周治疗期间基本保持不变。

结论

与安慰剂相比,替纳珠单抗在治疗的第一周内平均每日指数关节疼痛以及 WOMAC 疼痛和身体功能(第 2 周)方面均有统计学意义的改善,且在整个 16 周治疗期间基本保持不变。替纳珠单抗 5mg 与替纳珠单抗 2.5mg 相比仅略有额外疗效。

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