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观察性队列研究中 CT-P13 治疗免疫介导性炎症性疾病患者的上市后汇总安全性分析。

Post-Marketing Pooled Safety Analysis for CT-P13 Treatment of Patients with Immune-Mediated Inflammatory Diseases in Observational Cohort Studies.

机构信息

CELLTRION, Inc., 19F, IBS Building, 263 Central-ro, Yeonsu-gu, Incheon, Republic of Korea.

出版信息

BioDrugs. 2020 Aug;34(4):513-528. doi: 10.1007/s40259-020-00421-2.

Abstract

BACKGROUND

At EU marketing authorisation, safety data for CT-P13 (biosimilar infliximab) were limited, particularly in some indications, and uncommon adverse events (AEs) could not be evaluated among relatively small analysis populations.

OBJECTIVES

Our objective was to investigate the overall safety profile and incidence rate of AEs of special interest (AESIs), including serious infections and tuberculosis, in CT-P13-treated patients.

METHODS

Data were pooled from six observational studies representing authorised indications of CT-P13 (ankylosing spondylitis, rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, adult and paediatric Crohn's disease and ulcerative colitis). Patients were analysed by indication and treatment (patients who received CT-P13 or those who switched from reference infliximab to CT-P13 ≤ 6 months prior to enrolment or during the study).

RESULTS

Overall, 4393 patients were included (n = 3677 CT-P13 group; n = 716 switched group); 64.03% of patients had inflammatory bowel disease and 6.31% of patients were antidrug antibody positive. Overall, 32.94% and 9.58% of patients experienced treatment-emergent AEs (TEAEs) and treatment-emergent serious AEs, respectively. Across indications, TEAEs were more frequent with CT-P13 than with the switched group. Infections including tuberculosis were the most frequent serious AESI overall (2.48%) and by treatment group or indication. In total, 14 patients (0.32%) reported active tuberculosis. Overall incidence rates per 100 patient-years (95% confidence interval) were 3.40 (2.788-4.096) for serious infections including tuberculosis and 0.44 (0.238-0.732) for active tuberculosis. Infusion-related reactions were the second most frequent AESI following infection including tuberculosis.

CONCLUSION

The CT-P13 safety profile appears consistent with previous studies for CT-P13 and reference infliximab, supporting the favourable risk/benefit balance for CT-P13 treatment.

摘要

背景

在欧盟获得上市许可时,关于 CT-P13(英夫利昔单抗生物类似药)的安全性数据有限,特别是在某些适应证中,且在相对较小的分析人群中无法评估罕见不良反应(AE)。

目的

我们旨在研究 CT-P13 治疗患者的总体安全性概况和特殊关注的不良反应(SAEIs)发生率,包括严重感染和结核病。

方法

数据来自 6 项观察性研究的汇总,这些研究代表了 CT-P13 的已批准适应证(强直性脊柱炎、类风湿关节炎、银屑病关节炎、斑块状银屑病、成人和儿童克罗恩病和溃疡性结肠炎)。根据适应证和治疗对患者进行分析(接受 CT-P13 治疗的患者,或在入组前≤6 个月或在研究期间从参照英夫利昔单抗转换为 CT-P13 的患者)。

结果

共纳入 4393 例患者(n=3677 例 CT-P13 组;n=716 例转换组);64.03%的患者患有炎症性肠病,6.31%的患者存在抗药物抗体阳性。总体而言,32.94%和 9.58%的患者分别出现治疗中出现的 AE(TEAE)和治疗中出现的严重 AE。在所有适应证中,CT-P13 组的 TEAE 发生率高于转换组。感染包括结核病是总体上最常见的严重 SAEI(2.48%),且无论治疗组或适应证均如此。共有 14 例患者(0.32%)报告患有活动性结核病。每 100 患者-年(95%置信区间)的严重感染(包括结核病)和活动性结核病的总发生率分别为 3.40(2.788-4.096)和 0.44(0.238-0.732)。继感染(包括结核病)之后,输注相关反应是第二常见的 SAEI。

结论

CT-P13 的安全性概况与 CT-P13 和参照英夫利昔单抗的先前研究一致,支持 CT-P13 治疗的有利风险/获益平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64ad/7223987/60c35ad91929/40259_2020_421_Fig1_HTML.jpg

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