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特发性包涵体肌炎中双羟苯丙氨酸(BYM338)的长期安全性和耐受性。

Long-term safety and tolerability of bimagrumab (BYM338) in sporadic inclusion body myositis.

机构信息

From the Neuromuscular Research Center (K.S.), Phoenix, AZ; Department of Neurology (T.I.C., A.A.A), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Novartis Institutes for BioMedical Research (B.S., D.L.), Basel, Switzerland; Novartis Healthcare Pvt Ltd (H.A.), Hyderabad, India; Novartis Pharma AG (L.B.T), Basel, Switzerland. Dr. Cochrane is now at Biogen Inc, Cambridge, MA. Dr. Sloth is now at Novo Nordisk, Copenhagen, Denmark.

出版信息

Neurology. 2020 Oct 6;95(14):e1971-e1978. doi: 10.1212/WNL.0000000000010417. Epub 2020 Jul 20.

Abstract

OBJECTIVE

To assess the long-term safety and tolerability and to monitor benefits of extended use of bimagrumab in individuals with sporadic inclusion body myositis (sIBM) who completed a single-dose core study.

METHODS

In this multicenter, open-label extension study, 10 adults received bimagrumab 10 mg/kg IV every 4 weeks up to 2 years (104 weeks). Safety (primary endpoint) was assessed by recording adverse events (AEs). Clinical benefits were assessed by changes from baseline in thigh muscle volume (TMV), lean body mass (LBM), 6-minute walk distance (6MWD), handgrip, and quadriceps strength.

RESULTS

Participants had a mean age of 70.1 (SD 10.4) years. All participants (n = 10) discontinued the treatment due to early termination of the study (n = 7) or AEs (n = 3; myocardial infarction, esophageal carcinoma, and dementia, none of which were treatment related). The most common AEs were muscle spasms and falls (both 9 of 10, 90%), followed by diarrhea (6 of 10, 60%) and acne and skin eruption (both 5 of 10, 50%). At weeks 8 and 16, mean TMV increased from baseline by 4.1% (SD 4.3%) and 4.5% (SD 6.3%). Mean LBM increased from baseline and was sustained at 6.9% (SD 3.9%) at week 76. Means of 6MWD showed a progressive decline from baseline to week 76, during which there was a modest numerical increase in handgrip strength and no significant changes in quadriceps strength.

CONCLUSIONS

Long-term treatment up to 2 years with bimagrumab had a good safety profile and was well tolerated in individuals with sIBM. An increase in muscle mass was noted on a group level; however, there was no evidence of clinical improvement.

CLINICALTRIALSGOV IDENTIFIER

NCT02250443.

CLASSIFICATION OF EVIDENCE

This study provides Class IV evidence that for patients with sIBM, long-term bimagrumab treatment was safe and well tolerated and did not lead to functional improvement.

摘要

目的

评估在完成单次核心研究的散发性包涵体肌炎(sIBM)个体中,延长使用比马鲁单抗的长期安全性和耐受性,并监测其获益。

方法

在这项多中心、开放性扩展研究中,10 名成年人接受每 4 周静脉注射 10mg/kg 的比马鲁单抗,最长可达 2 年(104 周)。通过记录不良事件(AE)评估安全性(主要终点)。通过大腿肌肉量(TMV)、瘦体重(LBM)、6 分钟步行距离(6MWD)、握力和股四头肌力量从基线的变化评估临床获益。

结果

参与者的平均年龄为 70.1(SD 10.4)岁。由于研究提前终止(n=7)或 AE(n=3;心肌梗死、食管癌和痴呆,均与治疗无关),所有参与者(n=10)均停止治疗。最常见的 AE 是肌肉痉挛和跌倒(均为 10 例中的 9 例,90%),其次是腹泻(10 例中的 6 例,60%)和痤疮和皮疹(均为 10 例中的 5 例,50%)。在第 8 周和第 16 周,TMV 从基线平均增加 4.1%(SD 4.3%)和 4.5%(SD 6.3%)。LBM 从基线增加,在第 76 周时保持 6.9%(SD 3.9%)的水平。6MWD 的平均值从基线呈下降趋势,直至第 76 周,在此期间,握力略有增加,股四头肌力量无明显变化。

结论

在 sIBM 患者中,长达 2 年的比马鲁单抗长期治疗具有良好的安全性和耐受性。肌肉量增加在群体水平上是显著的;然而,没有证据表明临床有改善。

临床试验.gov 标识符:NCT02250443。

证据分类

这项研究提供了 IV 级证据,表明对于 sIBM 患者,长期比马鲁单抗治疗是安全且耐受良好的,并且不会导致功能改善。

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