van der Horst-Bruinsma Irene, Miceli-Richard Corinne, Braun Juergen, Marzo-Ortega Helena, Pavelka Karel, Kivitz Alan J, Deodhar Atul, Bao Weibin, Porter Brian, Pournara Effie
Department of Rheumatology, ZH0D53, Amsterdam UMC/VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Université de Paris, Hôpital Cochin-Assistance Publique-Hôpitaux de Paris, Paris, France.
Rheumatol Ther. 2021 Dec;8(4):1775-1787. doi: 10.1007/s40744-021-00380-2. Epub 2021 Oct 7.
Despite of higher disease burden, lower efficacy to biologics has been reported in female compared to male patients with ankylosing spondylitis (AS). The aim of this study was to evaluate the efficacy and safety of secukinumab by sex in patients with active AS from five phase 3 studies (MEASURE 1-5) through 52 weeks.
Baseline demographics, disease characteristics and efficacy outcomes at Weeks 16 and 52 were summarized for males versus females. Baseline predictor analysis used multivariable logistic regression for binary outcome measures or generalized linear model for continuous outcome measures to assess the impact of sex as one of the independent variables on selected efficacy outcomes at Week 52.
Overall, 1031 males and 396 females were included in this analysis. Smoking status, hs-CRP, prior exposure to TNF inhibitors, BASMI occiput-to-wall and tragus-to-wall distance (cm) were higher in males, whereas MASES was higher in females. Efficacy outcomes i.e., ASAS40 responses and BASDAI change from baseline at Weeks 16 and 52 were generally comparable between males and females. Response rates were found to be significantly higher in male patients when compared with female patients only for ASDAS-CRP inactive disease (ID) at Week 52.
Comparable efficacy and safety outcomes were observed between male and female patients with active AS treated with secukinumab over 52 weeks. Further, sex was not an independent predictor of treatment response to secukinumab as assessed by ASAS40 responder rates and BASDAI change from baseline; association of ASDAS-CRP ID responder rates with sex warrants further exploration.
ClinicalTrials.gov; NCT01358175, NCT01649375, NCT02008916, NCT02159053, and NCT02896127.
尽管疾病负担较高,但据报道,与男性强直性脊柱炎(AS)患者相比,女性患者对生物制剂的疗效较低。本研究的目的是通过五项3期研究(MEASURE 1-5)评估司库奇尤单抗在52周内对活动性AS患者按性别分类的疗效和安全性。
总结了男性和女性患者的基线人口统计学、疾病特征以及第16周和第52周的疗效结果。基线预测因素分析使用多变量逻辑回归分析二元结局指标,或使用广义线性模型分析连续结局指标,以评估性别作为自变量之一对第52周选定疗效指标的影响。
总体而言,本分析纳入了1031名男性和396名女性。男性的吸烟状况、hs-CRP、既往使用TNF抑制剂的情况、BASMI枕墙距和耳屏墙距(厘米)较高,而女性的MASES较高。疗效指标,即第16周和第52周时从基线开始的ASAS40反应和BASDAI变化,在男性和女性之间总体上具有可比性。仅在第52周时,男性患者的反应率在ASDAS-CRP非活动疾病(ID)方面显著高于女性患者。
在接受司库奇尤单抗治疗52周的活动性AS男性和女性患者中,观察到了相当的疗效和安全性结果。此外,根据ASAS40反应率和BASDAI从基线的变化评估,性别不是司库奇尤单抗治疗反应的独立预测因素;ASDAS-CRP ID反应率与性别的关联值得进一步探索。
ClinicalTrials.gov;NCT01358175、NCT(01649375、NCT02008916、NCT02159053和NCT02896127。