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戈利木单抗治疗活动性非放射学中轴型脊柱关节炎的长期耐受性和疗效:开放标签扩展研究结果

Long-term tolerability and efficacy of golimumab in active non-radiographic axial spondyloarthritis: results from open-label extension.

作者信息

van der Heijde Désirée, Dougados Maxime, Maksymowych Walter P, Bergman Gina, Curtis Sean P, Tzontcheva Anjela, Huyck Susan, Philip George, Sieper Joachim

机构信息

Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

Rheumatology Department - Hôpital Cochin, Université de Paris, Assistance Publique - Hôpitaux de Paris, INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité. Paris, France.

出版信息

Rheumatology (Oxford). 2022 Feb 2;61(2):617-627. doi: 10.1093/rheumatology/keab346.

Abstract

OBJECTIVES

We report the open-label extension (OLE) of the GO-AHEAD study evaluating the long-term efficacy and safety of golimumab (GLM) in patients with non-radiographic axial spondyloarthritis (nr-axSpA).

METHODS

Patients [both GLM- and placebo (PBO)-treated in the double-blind phase] received GLM 50 mg every 4 weeks during the OLE (36-week treatment; additional 8-week safety follow-up; GLM/GLM and PBO/GLM groups). All patients who entered and received ≥1 dose of study treatment in the OLE were included in the efficacy and safety analyses. The primary efficacy evaluations were the proportions of patients achieving 20% and 40% improvement in the ASAS criteria (ASAS20 and ASAS40, respectively). Responders' analyses were calculated using a non-responder imputation approach.

RESULTS

Of 198 patients randomised, 189/198 (95.5%) entered the OLE; 174/198 patients (87.9%) completed all visits. Although the proportion of responders increased from week 16 to week 52 in the OLE in both GLM/GLM and PBO/GLM groups, the GLM/GLM group had a higher proportion of responders than the PBO/GLM group throughout the OLE from week 16 to week 52 (ASAS20: 71.1% to 83.9% vs 40.0% to 75.0%, respectively; ASAS40: 56.7% to 76.3% vs 23.0% to 59.4%, respectively; ASAS partial remission: 33.0% to 53.8% and 18.0% to 45.8%). In the OLE, the overall incidence of AEs was lower in the GLM/GLM vs PBO/GLM groups (41.9% and 54.2%).

CONCLUSIONS

Sustained improvement in clinical efficacy was observed at 52 weeks in patients with nr-axSpA following GLM treatment. GLM was well tolerated and provided substantial long-term benefits to patients with nr-axSpA.

TRIAL REGISTRATION

NCT01453725; United States National Library of Medicine clinical trials database; www.clinicaltrials.gov.

摘要

目的

我们报告了GO-AHEAD研究的开放标签扩展(OLE),评估了戈利木单抗(GLM)在非放射学中轴型脊柱关节炎(nr-axSpA)患者中的长期疗效和安全性。

方法

患者(在双盲阶段接受GLM和安慰剂(PBO)治疗)在OLE期间每4周接受50mg GLM(36周治疗;额外8周安全性随访;GLM/GLM组和PBO/GLM组)。所有进入OLE并接受≥1剂研究治疗的患者均纳入疗效和安全性分析。主要疗效评估指标为达到ASAS标准改善20%和40%的患者比例(分别为ASAS20和ASAS40)。使用无反应者插补法计算反应者分析。

结果

在198例随机分组的患者中,189/198例(95.5%)进入OLE;174/198例患者(87.9%)完成了所有访视。虽然在OLE中,GLM/GLM组和PBO/GLM组的反应者比例从第16周增加到第52周,但在整个OLE期间,从第16周到第52周,GLM/GLM组的反应者比例高于PBO/GLM组(ASAS20:分别为71.1%至83.9%和40.0%至75.0%;ASAS40:分别为56.7%至76.3%和23.0%至59.4%;ASAS部分缓解:33.0%至53.8%和18.0%至45.8%)。在OLE中,GLM/GLM组的不良事件总发生率低于PBO/GLM组(41.9%和54.2%)。

结论

nr-axSpA患者接受GLM治疗52周后,临床疗效持续改善。GLM耐受性良好,为nr-axSpA患者提供了显著的长期益处。

试验注册

NCT01453725;美国国立医学图书馆临床试验数据库;www.clinicaltrials.gov。

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