Thaçi Diamant, Strober Bruce, Gordon Kenneth B, Foley Peter, Gooderham Melinda, Morita Akimichi, Papp Kim A, Puig Lluís, Menter M Alan, Colombo Matthew J, Elbez Yedid, Kisa Renata M, Ye June, Napoli Andrew A, Wei Lan, Banerjee Subhashis, Merola Joseph F, Gottlieb Alice B
Institute and Comprehensive Center for Inflammation Medicine, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
Yale University, Central Connecticut Dermatology Research, New Haven, CT, USA.
Dermatol Ther (Heidelb). 2022 Feb;12(2):495-510. doi: 10.1007/s13555-021-00649-y. Epub 2022 Jan 13.
INTRODUCTION: Deucravacitinib is an oral, selective tyrosine kinase 2 inhibitor that demonstrated therapeutic benefit in a Phase 2 clinical trial of adults with moderate to severe plaque psoriasis. This analysis was designed to evaluate the effect of deucravacitinib on additional clinical and quality-of-life (QoL) outcomes and assess the relationship between these outcomes in adults with psoriasis. METHODS: Post-hoc analysis of a 12-week Phase 2 trial was conducted for the three most efficacious dosage groups (3 mg twice daily, 6 mg twice daily, 12 mg once daily) and placebo. Investigator assessments for efficacy included Psoriasis Area and Severity Index (PASI), body surface area (BSA) involvement, and static Physician's Global Assessment; QoL was assessed using the Dermatology Life Quality Index (DLQI). Treatment responses and their associations were evaluated over time. RESULTS: Deucravacitinib elicited improvement versus placebo as early as Week 4 for most efficacy measures (including changes in absolute PASI and BSA), with efficacy trends observed from Week 2 to Week 12. Improvements in QoL, assessed by achievement of a DLQI overall score of 0/1 (no effect at all on patient's life), followed a pattern similar to deucravacitinib-related clinical outcomes over 12 weeks. Overall, patients with greater improvements in psoriasis-related clinical signs and symptoms also reported greater improvement in QoL. However, complete skin clearance was not required for achieving DLQI 0/1. CONCLUSION: Deucravacitinib treatment produced early response and similar trends in improvements across multiple efficacy assessments and QoL in moderate to severe plaque psoriasis. Deucravacitinib has the potential to become a promising new oral therapy for this condition. TRIAL REGISTRATION: ClinicalTrials.gov identifier; NCT02931838.
引言:德卡伐替尼是一种口服的选择性酪氨酸激酶2抑制剂,在一项针对中度至重度斑块状银屑病成人患者的2期临床试验中显示出治疗益处。本分析旨在评估德卡伐替尼对其他临床和生活质量(QoL)结局的影响,并评估银屑病成人患者这些结局之间的关系。 方法:对三项最有效的剂量组(每日两次3毫克、每日两次6毫克、每日一次12毫克)和安慰剂进行了为期12周的2期试验的事后分析。研究者对疗效的评估包括银屑病面积和严重程度指数(PASI)、体表面积(BSA)受累情况以及静态医师整体评估;使用皮肤病生活质量指数(DLQI)评估生活质量。随时间评估治疗反应及其关联。 结果:早在第4周,对于大多数疗效指标(包括绝对PASI和BSA的变化),德卡伐替尼与安慰剂相比就有改善,从第2周到第12周观察到疗效趋势。通过DLQI总体评分达到0/1(对患者生活完全没有影响)评估的生活质量改善,在12周内遵循与德卡伐替尼相关的临床结局相似的模式。总体而言,银屑病相关临床体征和症状改善更大的患者,其生活质量改善也更大。然而,实现DLQI 0/1并不需要完全清除皮肤。 结论:在中度至重度斑块状银屑病中,德卡伐替尼治疗产生了早期反应,并且在多项疗效评估和生活质量改善方面具有相似的趋势。德卡伐替尼有潜力成为治疗这种疾病的一种有前景的新型口服疗法。 试验注册:ClinicalTrials.gov标识符;NCT02931838。
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