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阿达木单抗在日本克罗恩病患者中的长期安全性和有效性:一项真实世界研究的3年结果

Long-term safety and effectiveness of adalimumab in Japanese patients with Crohn's disease: 3-year results from a real-world study.

作者信息

Hisamatsu Tadakazu, Suzuki Yasuo, Kobayashi Mariko, Hagiwara Takashi, Kawaberi Takeshi, Ogata Haruhiko, Matsui Toshiyuki, Watanabe Mamoru, Hibi Toshifumi

机构信息

Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.

Inflammatory Bowel Disease Center, Toho University, Sakura Medical Centre, Sakura, Japan.

出版信息

Intest Res. 2021 Oct;19(4):408-418. doi: 10.5217/ir.2020.00025. Epub 2020 Nov 20.

Abstract

BACKGROUND/AIMS: Crohn's disease is a chronic disorder; therefore, it is essential to investigate long-term safety and efficacy of treatments. This study assessed the safety and effectiveness of adalimumab for up to 3 years in Japanese patients with Crohn's disease in real-world settings.

METHODS

This was a multicenter, single-cohort, observational study of patients with Crohn's disease. Safety assessments included incidence of adverse drug reactions. Effectiveness assessments included clinical remission, mucosal healing, and Work Productivity and Activity Impairment (WPAI).

RESULTS

The safety and effectiveness analysis populations comprised 389 and 310 patients, respectively. Mean (standard deviation) exposure to adalimumab in the safety analysis population was 793.4 (402.8) days, with a 58.1% retention rate. A total of 105 patients (27.0%) and 43 patients (11.1%) experienced adverse drug reactions and serious adverse drug reactions, respectively, with no patient reporting tuberculosis or hepatitis B. Infections and serious infections were reported in 37 patients (9.5%) and 17 patients (4.4%), respectively. Malignancy was reported as an adverse drug reaction in 2 patients (0.5%). Remission rate increased from 37.8% (98/259) at baseline to 73.9% (167/226) at week 4 and remained > 70% over 3 years. Proportion of patients without mucosal ulcerations increased from 2.7% (2/73) at baseline to 42.3% (11/26) between years > 2 to ≤ 3. WPAI improvement started at 4 weeks, with the overall work impairment score improving from 42.7 (n = 102) at baseline to 26.9 (n = 84) at 4 weeks.

CONCLUSIONS

Results from this study confirm the long-term safety and effectiveness of adalimumab treatment in Japanese patients with Crohn's disease in the real-world setting.

摘要

背景/目的:克罗恩病是一种慢性疾病,因此,研究治疗方法的长期安全性和有效性至关重要。本研究评估了阿达木单抗在日本克罗恩病患者现实环境中长达3年的安全性和有效性。

方法

这是一项针对克罗恩病患者的多中心、单队列观察性研究。安全性评估包括药物不良反应的发生率。有效性评估包括临床缓解、黏膜愈合以及工作效率和活动障碍(WPAI)。

结果

安全性和有效性分析人群分别包括389例和310例患者。安全性分析人群中阿达木单抗的平均(标准差)暴露时间为793.4(402.8)天,保留率为58.1%。分别有105例患者(27.0%)和43例患者(11.1%)发生药物不良反应和严重药物不良反应,无患者报告结核病或乙型肝炎。分别有37例患者(9.5%)和17例患者(4.4%)报告发生感染和严重感染。有2例患者(0.5%)报告恶性肿瘤为药物不良反应。缓解率从基线时的37.8%(98/259)增至第4周时的73.9%(167/226),并在3年期间保持>70%。无黏膜溃疡的患者比例从基线时的2.7%(2/73)增至第2年至≤3年期间的42.3%(11/26)。WPAI改善始于第4周,总体工作障碍评分从基线时的42.7(n = 102)改善至第4周时的26.9(n = 84)。

结论

本研究结果证实了阿达木单抗治疗日本克罗恩病患者在现实环境中的长期安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b54d/8566837/bdf2859dbe3c/ir-2020-00025f1.jpg

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