Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
Central Dermatology and Saint Louis University School of Medicine, St Louis, Missouri.
J Am Acad Dermatol. 2021 Feb;84(2):398-407. doi: 10.1016/j.jaad.2020.09.047. Epub 2020 Sep 19.
Data for the effect of metabolic syndrome (MetS) on the efficacy and safety of biologic agents for psoriasis treatment are limited.
To evaluate long-term tildrakizumab efficacy, drug survival, and safety in patients with psoriasis by baseline MetS status.
Post hoc analyses of up to 3 years of efficacy data and 5 years of safety data from the phase 3, double-blind, randomized controlled reSURFACE 1 and 2 trial (NCT01722331 and NCT01729754) base and extension studies were conducted for patients receiving continuous tildrakizumab 100 or 200 mg.
Of 338 (n = 124/214 in reSURFACE 1/2) and 307 (n = 147/160 in reSURFACE 1/2) patients continuously receiving tildrakizumab 100 and 200 mg, respectively, throughout the studies, 26/44 (21%/21%) and 34/30 (23%/19%) met MetS criteria. Proportions of patients who achieved a 75% improvement in the Psoriasis Area and Severity Index (PASI) in reSURFACE 1/2 were generally comparable among those with versus without MetS at week 52 (tildrakizumab 100 mg, 85%/86% vs 86%/94%; tildrakizumab 200 mg, 76%/87% vs 76%/87%) and through week 148. Results were similar for responders with 90% and 100% improvement in the PASI. Tildrakizumab's safety profile did not vary by MetS status.
Small sample size and post hoc analysis limit interpretation.
Long-term tildrakizumab efficacy and safety were comparable between patients with and without MetS.
代谢综合征(MetS)对银屑病生物制剂治疗疗效和安全性的数据有限。
评估基线 MetS 状态对银屑病患者接受 tilrakizumab 长期疗效、药物存续率和安全性的影响。
对 3 期、双盲、随机对照 reSURFACE 1 和 2 试验(NCT01722331 和 NCT01729754)的疗效数据和 5 年安全性数据进行了事后分析,这些数据来自基础和扩展研究,共纳入接受连续 tilrakizumab 100mg 或 200mg 治疗的患者。
在连续接受 tilrakizumab 100mg 和 200mg 治疗的 338 例(reSURFACE 1/2 各 124 例和 214 例)和 307 例(reSURFACE 1/2 各 147 例和 160 例)患者中,分别有 26/44(21%/21%)和 34/30(23%/19%)符合 MetS 标准。在 reSURFACE 1/2 中,第 52 周(tilrakizumab 100mg:85%/86% vs 86%/94%;tilrakizumab 200mg:76%/87% vs 76%/87%)和第 148 周时,有 MetS 的患者与无 MetS 的患者相比,达到银屑病面积和严重性指数(PASI)75%改善的患者比例大致相当。PASI 改善 90%和 100%的患者中,也得出了类似的结果。MetS 状态不影响 tilrakizumab 的安全性。
样本量小且为事后分析,限制了结论的解释。
长期 tilrakizumab 的疗效和安全性在 MetS 患者与非 MetS 患者中相当。