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在长达 3.5 年的时间里,继续使用奥法妥木单抗治疗复发型多发性硬化症患者的安全性经验。

Safety experience with continued exposure to ofatumumab in patients with relapsing forms of multiple sclerosis for up to 3.5 years.

机构信息

UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.

Washington University School of Medicine, St Louis, MO, USA.

出版信息

Mult Scler. 2022 Sep;28(10):1576-1590. doi: 10.1177/13524585221079731. Epub 2022 Mar 1.

Abstract

BACKGROUND

Ofatumumab is approved for the treatment of relapsing multiple sclerosis (RMS). Ongoing safety reporting is crucial to understand its long-term benefit-risk profile.

OBJECTIVE

Report the safety and tolerability of ofatumumab in RMS after extended treatment up to 3.5 years.

METHODS

Patients completing ASCLEPIOS I/II (phase 3), APLIOS, or APOLITOS (phase 2) trials could enter ALITHIOS, a phase 3b, open-label, long-term safety study. We analyzed cumulative data of continuous ofatumumab treatment and of patients newly switched from teriflunomide.

RESULTS

The safety population had 1969 patients: 1292 continuously treated with ofatumumab (median time-at-risk 35.5 months, 3253 patient-years) and 677 newly switched (median time-at-risk 18.3 months, 986 patient-years). A total of 1650 patients (83.8%) had ⩾1 adverse events and 191 (9.7%) had ⩾1 serious adverse events. No opportunistic infections or progressive multifocal leukoencephalopathy events were identified; the risk of malignancies was low. Mean serum immunoglobulin (Ig) G levels remained stable. Mean IgM levels decreased but remained above the lower limit of normal in most. Serious infection incidence was low; decreased Ig levels were not associated with serious infections.

CONCLUSION

In patients with up to 3.5 years' exposure, ofatumumab was well tolerated, with no new safety risks identified. These findings, with its established effectiveness, support a favorable benefit-risk profile of ofatumumab in RMS.

摘要

背景

奥法妥木单抗获批用于治疗复发型多发性硬化症(RMS)。持续的安全性报告对于了解其长期获益-风险特征至关重要。

目的

报告 RMS 患者接受奥法妥木单抗扩展治疗长达 3.5 年的安全性和耐受性。

方法

完成 ASCLEPIOS I/II(III 期)、APL IOS 或 APOLITOS(II 期)试验的患者可进入 ALITHIOS,这是一项 IIIb 期、开放标签、长期安全性研究。我们分析了连续接受奥法妥木单抗治疗和新转换为特立氟胺的患者的累积数据。

结果

安全性人群有 1969 例患者:1292 例持续接受奥法妥木单抗治疗(风险时间中位数为 35.5 个月,3253 患者-年),677 例新转换(风险时间中位数为 18.3 个月,986 患者-年)。共有 1650 例患者(83.8%)发生了 ⩾1 次不良反应,191 例(9.7%)发生了 ⩾1 次严重不良反应。未发现机会性感染或进行性多灶性白质脑病事件;恶性肿瘤风险较低。血清免疫球蛋白(Ig)G 水平平均保持稳定。IgM 水平平均下降,但大多数仍高于正常值下限。严重感染发生率较低;Ig 水平下降与严重感染无关。

结论

在长达 3.5 年的暴露中,奥法妥木单抗具有良好的耐受性,未发现新的安全性风险。这些发现及其已确立的有效性支持奥法妥木单抗在 RMS 中的获益-风险状况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8d4/9330270/069f228e8b22/10.1177_13524585221079731-fig1.jpg

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