Nakamura Shiro, Asano Teita, Tsuchiya Hiroaki, Sugimoto Kanami, Imai Yuya, Yokoyama Seiji, Suzuki Yasuo
Department of Internal Medicine II, Osaka Medical College Hospital, Takatsuki, Japan.
Janssen Pharmaceutical K.K., Tokyo, Japan.
Intest Res. 2022 Jul;20(3):329-341. doi: 10.5217/ir.2021.00032. Epub 2021 Aug 4.
BACKGROUND/AIMS: Golimumab (GLM) is an anti-tumor necrosis factor-α drug approved for treating moderate-to-severe active ulcerative colitis (UC). A 52-week post-marketing surveillance (PMS) was initiated to evaluate its safety and effectiveness in patients with UC in Japan. We present an interim report of the ongoing PMS.
Patients received 200 mg of subcutaneous GLM at week 0, 100 mg at week 2, and 100 mg 4 weekly thereafter. The safety analysis set included 392 patients with UC, and the effectiveness analysis set 387 patients. Safety and effectiveness were assessed at week 6.
Adverse drug reactions (ADRs) were reported in 8.2% (32/392) and serious ADRs in 4.6% (18/392). The most frequent ADRs were infection and infestation (3.3%), with herpes zoster being the most common. ADRs were significantly higher in patients with concomitant corticosteroid use (odds ratio [OR], 3.45; 95% confidence interval [CI], 1.40-9.68). No significant difference in ADR incidence was observed between patients aged ≥65 and <65 years (OR, 1.23; 95% CI, 0.35-3.47). Six-week effectiveness of GLM was confirmed by a decrease in the partial Mayo score (-2.3; 95% CI, -2.6 to -2.1) and C-reactive protein levels (-0.64; 95% CI, -0.92 to -0.36), including in the biologics-experienced population.
The safety and effectiveness of GLM at week 6 in a real-world setting were demonstrated in patients with UC in Japan. ADR patterns were consistent with previous reports with no new safety signals. Concomitant corticosteroid use may be associated with increased ADR incidence. The final results of the ongoing PMS are necessary for further evaluation.
背景/目的:戈利木单抗(GLM)是一种获批用于治疗中重度活动性溃疡性结肠炎(UC)的抗肿瘤坏死因子-α药物。在日本启动了一项为期52周的上市后监测(PMS),以评估其在UC患者中的安全性和有效性。我们给出了正在进行的PMS的中期报告。
患者在第0周接受200mg皮下注射GLM,第2周接受100mg,此后每4周接受100mg。安全性分析集包括392例UC患者,有效性分析集包括387例患者。在第6周评估安全性和有效性。
8.2%(32/392)的患者报告了药物不良反应(ADR),4.6%(18/392)的患者报告了严重ADR。最常见的ADR是感染和寄生虫感染(3.3%),带状疱疹最为常见。同时使用皮质类固醇的患者ADR明显更高(比值比[OR],3.45;95%置信区间[CI],1.40 - 9.68)。年龄≥65岁和<65岁的患者之间ADR发生率无显著差异(OR,1.23;95% CI,0.35 - 3.47)。GLM的六周有效性通过部分梅奥评分降低(-2.3;95% CI,-2.6至-2.1)和C反应蛋白水平降低(-0.64;95% CI,-0.92至-0.36)得到证实,包括在有生物制剂使用经验的人群中。
在日本的UC患者中证明了GLM在第6周的真实世界环境中的安全性和有效性。ADR模式与先前报告一致,没有新的安全信号。同时使用皮质类固醇可能与ADR发生率增加有关。正在进行的PMS的最终结果对于进一步评估是必要的。