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在欧洲的真实临床实践中,12 个月的培塞利珠单抗治疗对轴性脊柱关节炎的疗效和安全性。

Effectiveness and safety of 12-month certolizumab pegol treatment for axial spondyloarthritis in real-world clinical practice in Europe.

机构信息

Rheumazentrum Ruhrgebiet Herne, Ruhr-University, Bochum.

Hannover Medical School, Hannover Medical School, Hanover, Germany.

出版信息

Rheumatology (Oxford). 2021 Jan 5;60(1):113-124. doi: 10.1093/rheumatology/keaa181.

Abstract

OBJECTIVES

The efficacy and safety of certolizumab pegol (CZP), an Fc-free, PEGylated anti-TNF, in axial spondyloarthritis (axSpA) has been established in clinical trial settings. We report CZP effectiveness and safety in European clinical practice in patients with axSpA, including radiographic (r-) and non-radiographic (nr-) axSpA.

METHODS

CIMAX (NCT02354105), a European non-interventional multicentre prospective study, observed CZP treatment response and safety over 12 months in a real-world axSpA cohort. The primary outcome was change from baseline in BASDAI to week 52, with additional outcomes pertaining to effectiveness and safety. Patients who received ≥1 dose CZP were followed up for adverse events, and those with baseline and ≥1 post-baseline BASDAI assessment were included in effectiveness analyses.

RESULTS

A total of 672 patients (r-axSpA: 469; nr-axSpA: 201; unconfirmed diagnosis: 2) from 101 sites received ≥1 dose of CZP, of whom 564 (r-axSpA: 384; nr-axSpA: 179; unconfirmed: 1) were included in the effectiveness analyses. The mean baseline BASDAI was 6.1 in the overall axSpA population and r-axSpA and nr-axSpA subpopulations. At week 52, the mean (s.d.) change in BASDAI was -2.9 (2.3; n = 439); for r-axSpA and nr-axSpA, it was -2.9 (2.2; n = 301) and -2.8 (2.4; n = 137), respectively (P <0.0001 for all). Similar improvements were seen across other axSpA disease measures. In total, 37.9% (255/672) patients experienced adverse events, and 1.8% (12/672) experienced ≥1 serious adverse events.

CONCLUSION

Improvements observed in signs and symptoms of axSpA following one year of CZP treatment in real-world clinical practice were similar to those from previous randomized clinical trials, with no new safety concerns.

摘要

目的

在临床试验环境中,已证实无 Fc 段且聚乙二醇化的抗 TNF 药物 certolizumab pegol(CZP)对轴性脊柱关节炎(axSpA)有效且安全。我们报告了 CZP 在包括放射学(r-)和非放射学(nr-)axSpA 在内的欧洲临床实践中的有效性和安全性。

方法

CIMAX(NCT02354105)是一项欧洲非干预性多中心前瞻性研究,观察了 CZP 在真实世界 axSpA 队列中治疗 12 个月的反应和安全性。主要结局是从基线到第 52 周 BASDAI 的变化,其他结局与有效性和安全性相关。对接受至少 1 剂 CZP 的患者进行不良反应随访,对基线和至少 1 次基线后 BASDAI 评估的患者进行有效性分析。

结果

共 101 个研究点的 672 名患者(r-axSpA:469 名;nr-axSpA:201 名;未确诊:2 名)接受了至少 1 剂 CZP,其中 564 名(r-axSpA:384 名;nr-axSpA:179 名;未确诊:1 名)被纳入有效性分析。总体 axSpA 人群以及 r-axSpA 和 nr-axSpA 亚群的基线平均 BASDAI 为 6.1。在第 52 周,BASDAI 的平均(标准差)变化为-2.9(2.3;n=439);r-axSpA 和 nr-axSpA 分别为-2.9(2.2;n=301)和-2.8(2.4;n=137)(均<0.0001)。在其他 axSpA 疾病指标中也观察到了相似的改善。总体而言,37.9%(255/672)的患者出现不良反应,1.8%(12/672)的患者出现≥1 例严重不良反应。

结论

在真实世界临床实践中,接受 CZP 治疗一年后 axSpA 的体征和症状得到改善,与之前的随机临床试验相似,没有新的安全性问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cf9/7785316/2c7aeb61142e/keaa181f1.jpg

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