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阿达木单抗生物类似药 SDZ-ADL 治疗类风湿关节炎、银屑病或银屑病关节炎患者:两项 III 期研究(ADMYRA 和 ADACCESS)患者报告结局测量结果。

Treatment with SDZ-ADL, an Adalimumab Biosimilar, in Patients with Rheumatoid Arthritis, Psoriasis, or Psoriatic Arthritis: Results of Patient-Reported Outcome Measures from Two Phase III Studies (ADMYRA and ADACCESS).

机构信息

Oregon Medical Research Center, 9495 Locust St., Suite G, Portland, OR, 97223, USA.

Central Dermatology, St Louis, MO, USA.

出版信息

BioDrugs. 2021 Mar;35(2):229-238. doi: 10.1007/s40259-021-00470-1. Epub 2021 Mar 2.

DOI:10.1007/s40259-021-00470-1
PMID:33651341
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7952364/
Abstract

BACKGROUND

SDZ-ADL (GP2017; Sandoz GmbH, Austria) is an EMA-/FDA-approved adalimumab biosimilar. The effect of SDZ-ADL on quality of life (QoL) and patient-reported outcomes (PROs) was assessed as part of two phase III studies, one in patients with moderate-to-severe chronic plaque psoriasis (PsO; ADACCESS) and the other in patients with rheumatoid arthritis (RA; ADMYRA). Additionally, ADACCESS included patients with psoriatic arthritis (PsA).

METHODS

ADACCESS included 465 patients with PsO, whereas ADMYRA included 353 patients with RA. Both studies evaluated and confirmed equivalent efficacy, similar safety, and immunogenicity of SDZ-ADL with reference adalimumab (ref-ADL). A third of patients underwent multiple (four) treatment switches between study treatments starting at Week 17 (ADACCESS); all patients switched from ref-ADL to SDZ-ADL at Week 24 (ADMYRA). Assessed PROs included Dermatology Life Quality Index (DLQI) and EuroQol five-dimension health status questionnaire (EQ-5D-5L) in ADACCESS, Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue) score in ADMYRA, and Health Assessment Questionnaire-Disability Index (HAQ-DI) in both studies.

RESULTS

In both studies, baseline scores for all PRO assessments were comparable between the two treatment groups. In ADACCESS, mean DLQI decreased from baseline in both groups, and the mean (standard deviation [SD]) percent reductions from baseline in DLQI were comparable between groups at Week 17 (SDZ-ADL, - 64.5 [80.3]; ref-ADL, - 70.6 [41.7]), which were sustained after the switch at Week 51 ('continued SDZ-ADL,' - 79.7 [36.2]; 'continued ref-ADL,' - 80.8 [44.6]; 'switched to SDZ-ADL,' - 70.7 [32.2]; 'switched to ref-ADL,' - 69.3 [49.6]). In ADACCESS, the proportion of patients with an EQ-5D-5L score of 1 (no problems) increased from baseline for all five dimensions in all treatment groups and was comparable between treatment groups at Week 51. In ADACCESS, in patients with PsA at baseline, mean (SD) HAQ-DI scores decreased from baseline in both treatment groups, and scores were comparable between groups at Week 17 (SDZ-ADL, 0.5 [0.6]; ref-ADL, 0.5 [0.6]) and after switching at Week 51 ('continued SDZ-ADL,' 0.4 [0.5]; 'continued ref-ADL,' 0.4 [0.6]; 'switched to SDZ-ADL,' 0.5 [0.8]; 'switched to ref-ADL,' 0.7 [0.6]). In ADMYRA, proportion of patients achieving HAQ-DI in the normal range (≤ 0.5) was comparable between treatment groups at Week 24 (SDZ-ADL, 37.8%; ref-ADL, 36.3%) and after switching at Week 48 ('SDZ-ADL,' 41.6%; 'ref-ADL/switched to SDZ-ADL,' 40.0%). In ADMYRA, mean FACIT-Fatigue scores increased from baseline in both treatment groups. At Week 24, mean (SD) percent change from baseline in the FACIT-Fatigue scores was 75.4 (135.5) in SDZ-ADL and 73.0 (96.3) in ref-ADL groups; the scores were sustained after switching at Week 48.

CONCLUSION

Treatment with SDZ-ADL and ref-ADL resulted in comparable improvements in PROs as well as QoL scores across the three diseases, PsO, PsA, and RA. Switching between SDZ-ADL and ref-ADL had no negative impact on PROs across the reported period. CLINICAL TRIALS.

GOV IDENTIFIER

NCT02744755, NCT02016105.

摘要

背景

SDZ-ADL(GP2017;山德士公司,奥地利)是一种经 EMA-/FDA 批准的阿达木单抗生物类似药。在两项 III 期研究中评估了 SDZ-ADL 对生活质量(QoL)和患者报告结果(PROs)的影响,一项在中度至重度慢性斑块型银屑病(PsO;ADACCESS)患者中进行,另一项在类风湿关节炎(RA;ADMYRA)患者中进行。此外,ADACCESS 还包括患有银屑病关节炎(PsA)的患者。

方法

ADACCESS 纳入了 465 名 PsO 患者,ADMYRA 纳入了 353 名 RA 患者。两项研究均证实 SDZ-ADL 与参考阿达木单抗(ref-ADL)具有等效的疗效、相似的安全性和免疫原性。三分之一的患者在第 17 周(ADACCESS)开始时进行了多次(四次)治疗转换;所有患者均在第 24 周(ADMYRA)从 ref-ADL 转换为 SDZ-ADL。评估的 PROs 包括在 ADACCESS 中使用皮肤病生活质量指数(DLQI)和 EuroQol 五维健康状况问卷(EQ-5D-5L),在 ADMYRA 中使用功能评估慢性疾病治疗疲劳量表(FACIT-Fatigue)评分,以及在两项研究中使用健康评估问卷残疾指数(HAQ-DI)。

结果

在两项研究中,两组患者的所有 PRO 评估的基线评分均无差异。在 ADACCESS 中,两组患者的 DLQI 评分均从基线下降,第 17 周时两组的 DLQI 评分从基线的平均(标准偏差 [SD])百分比降幅相似(SDZ-ADL,-64.5 [80.3];ref-ADL,-70.6 [41.7]),并且在第 51 周(“持续 SDZ-ADL”,-79.7 [36.2];“持续 ref-ADL”,-80.8 [44.6];“转换为 SDZ-ADL”,-70.7 [32.2];“转换为 ref-ADL”,-69.3 [49.6])时仍保持持续。在 ADACCESS 中,所有治疗组的所有五个维度的 EQ-5D-5L 评分均从基线开始增加,并且在第 51 周时各治疗组之间的比例相当。在 ADACCESS 中,基线时患有 PsA 的患者的 HAQ-DI 评分从基线开始下降,在第 17 周时两组的评分相当(SDZ-ADL,0.5 [0.6];ref-ADL,0.5 [0.6]),并且在第 51 周时转换后评分相当(“持续 SDZ-ADL”,0.4 [0.5];“持续 ref-ADL”,0.4 [0.6];“转换为 SDZ-ADL”,0.5 [0.8];“转换为 ref-ADL”,0.7 [0.6])。在 ADMYRA 中,第 24 周时达到 HAQ-DI 正常范围(≤ 0.5)的患者比例在治疗组之间相当(SDZ-ADL,37.8%;ref-ADL,36.3%),并且在第 48 周时转换后相当(“SDZ-ADL”,41.6%;“ref-ADL/转换为 SDZ-ADL”,40.0%)。在 ADMYRA 中,两组患者的 FACIT-Fatigue 评分均从基线开始增加。第 24 周时,SDZ-ADL 组和 ref-ADL 组的 FACIT-Fatigue 评分从基线的平均(SD)百分比变化分别为 75.4(135.5)和 73.0(96.3);在第 48 周转换后,评分仍保持不变。

结论

SDZ-ADL 和 ref-ADL 的治疗均导致 PROs 以及 PsO、PsA 和 RA 三种疾病的生活质量评分得到可比的改善。在报告期间,SDZ-ADL 和 ref-ADL 之间的转换对 PROs 没有负面影响。临床试验。

注册号

NCT02744755,NCT02016105。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/03235542d5e8/40259_2021_470_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/7b528a9293e6/40259_2021_470_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/9b254c8e4a58/40259_2021_470_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/03235542d5e8/40259_2021_470_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/7b528a9293e6/40259_2021_470_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/9b254c8e4a58/40259_2021_470_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb3a/7952364/03235542d5e8/40259_2021_470_Fig3_HTML.jpg

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