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在真实环境中,古塞库单抗治疗银屑病的疗效和安全性:西班牙银屑病组的一项回顾性、观察性、多中心研究。

Effectiveness and safety of guselkumab for the treatment of psoriasis in real-world settings at 24 weeks: A retrospective, observational, multicentre study by the Spanish Psoriasis Group.

机构信息

Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain.

Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

出版信息

Dermatol Ther. 2022 Feb;35(2):e15231. doi: 10.1111/dth.15231. Epub 2022 Jan 17.

DOI:10.1111/dth.15231
PMID:34820971
Abstract

Data on the effectiveness and safety of a drug in real-world clinical practice complement the evidence from clinical trials, which are carried out in a different setting. Little has been published on the effectiveness and safety of guselkumab in the treatment of psoriasis in clinical practice. The ojective of this study was to assess the effectiveness and safety of guselkumab at 24 weeks in patients with moderate to severe plaque psoriasis in routine clinical practice. A retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis treated with guselkumab for at least 24 weeks was carried out in Spain. We studied 343 patients, 249 of whom were followed for 24 weeks. By week 24, the mean (SD) psoriasis area severity index (PASI) had decreased from 11.1 (7.3) to 1.7 (2.8) (-9.3; [-10.2;-8.4]), 85.9% of the patients had achieved PASI score of 4 or less and 77.9% a PASI score of 2 or less. In terms of relative PASI response, 59.4% of the patients achieved a PASI-90 response and 49.0% a PASI-100 response. On multivariate analysis, two factors reduced the probability of a PASI of 2 or less at 24 weeks: a BMI ≥30 (OR, 0.44; 95% CI, 0.22-0.88) and a greater previous exposure to biologic therapy (OR, 0.69; 95% CI, [0.56-0.84]). Adverse events were rare (9.9%) and led to withdrawal from treatment in only nine patients (2.6%) by the end of the follow-up period. The results of this study confirm the high efficacy and safety of guselkumab indicated by the clinical trial data. In clinical practice, the absolute PASI score appears to be a better marker of response to treatment than the relative value.

摘要

在真实临床实践中,药物的有效性和安全性数据补充了临床试验的证据,后者是在不同的环境中进行的。在临床实践中,关于古塞库单抗治疗银屑病的疗效和安全性的研究甚少。本研究的目的是评估古塞库单抗在常规临床实践中治疗中度至重度斑块型银屑病患者 24 周时的疗效和安全性。在西班牙进行了一项回顾性、多中心研究,纳入了至少接受 24 周古塞库单抗治疗的中度至重度斑块型银屑病成年患者。我们研究了 343 例患者,其中 249 例患者随访 24 周。到第 24 周时,平均(SD)银屑病面积严重指数(PASI)从 11.1(7.3)下降至 1.7(2.8)(-9.3;[-10.2;-8.4]),85.9%的患者达到 PASI 评分 4 或更低,77.9%达到 PASI 评分 2 或更低。在相对 PASI 反应方面,59.4%的患者达到 PASI-90 反应,49.0%达到 PASI-100 反应。多变量分析显示,有两个因素降低了 24 周时 PASI 评分达到 2 或更低的概率:BMI≥30(OR,0.44;95%CI,0.22-0.88)和先前接受生物治疗的次数更多(OR,0.69;95%CI,[0.56-0.84])。不良事件罕见(9.9%),只有 9 例(2.6%)患者因不良事件在随访结束时停药。本研究结果证实了古塞库单抗临床试验数据表明的高疗效和安全性。在临床实践中,绝对 PASI 评分似乎是治疗反应的更好标志物,而相对值则不然。

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