Saint Louis University School of Medicine, St. Louis, MO, USA.
Eli Lilly and Company, Indianapolis, IN, USA.
Adv Ther. 2022 May;39(5):2256-2269. doi: 10.1007/s12325-022-02065-w. Epub 2022 Mar 22.
INTRODUCTION: Number needed to treat (NNT) estimates are a practical metric to help identify the most effective therapies. Our objective is to compare 11 biologic drugs for moderate-to-severe psoriasis in terms of NNT. METHODS: The NNT data were obtained from a Bayesian network meta-analysis of 42 double-blind, randomized, phase 3 clinical trials for 11 biologics (adalimumab, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, and ustekinumab). We determined NNT to achieve Psoriasis Area and Severity Index (PASI) 75/90/100 responses at weeks 4, 8, 12, 16, and 48/52 and Dermatology Life Quality Index (DLQI) response 0, 1 at week 12. RESULTS: Highest efficacy (lowest NNT) was with brodalumab and ixekizumab for PASI 90 at weeks 4, 8, and 12; ixekizumab for PASI 90/100 at week 16; and brodalumab for PASI 100 at week 12. After 48/52 weeks, risankizumab had the highest efficacy for PASI 90/100 overlapping with guselkumab, brodalumab, and ixekizumab for PASI 90 and with brodalumab and ixekizumab for PASI 100. Ixekizumab had the highest efficacy for DLQI (0,1) at week 12. CONCLUSIONS: Brodalumab and ixekizumab had the lowest NNTs for achieving PASI responses at early time points and were not significantly different than risankizumab and guselkumab after 48/52 weeks.
简介:需要治疗的人数 (NNT) 估计是一种实用的指标,可以帮助确定最有效的治疗方法。我们的目的是比较 11 种用于中度至重度银屑病的生物药物的 NNT。
方法:NNT 数据来自对 11 种生物制剂(阿达木单抗、布罗达umab、依那西普、古塞库单抗、英夫利昔单抗、依奇珠单抗、瑞莎珠单抗、司库奇尤单抗、特诺利珠单抗、乌司奴单抗和替西珠单抗)的 42 项双盲、随机、3 期临床试验的贝叶斯网络荟萃分析。我们确定了在第 4、8、12、16 周和第 48/52 周达到银屑病面积和严重程度指数 (PASI) 75/90/100 反应以及在第 12 周达到皮肤病生活质量指数 (DLQI) 0、1 反应的 NNT。
结果:阿达木单抗和依奇珠单抗在第 4、8 和 12 周时对 PASI 90 的疗效最高(NNT 最低);依奇珠单抗在第 16 周时对 PASI 90/100 的疗效最高;布罗达单抗在第 12 周时对 PASI 100 的疗效最高。第 48/52 周后,瑞莎珠单抗对 PASI 90/100 的疗效最高,与古塞库单抗、布罗达单抗和依奇珠单抗的 PASI 90 重叠,与布罗达单抗和依奇珠单抗的 PASI 100 重叠。依奇珠单抗在第 12 周时对 DLQI(0,1)的疗效最高。
结论:布罗达单抗和依奇珠单抗在早期时间点达到 PASI 反应的 NNT 最低,与第 48/52 周后的瑞莎珠单抗和古塞库单抗无显著差异。
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