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真实世界中中重度化脓性汗腺炎:阿达木单抗可降低疾病负担。

Real-World Moderate-to-Severe Hidradenitis Suppurativa: Decrease in Disease Burden With Adalimumab.

机构信息

NewLab Clinical Research Inc, St. John's, NL, Canada.

Faculty of Medicine, Memorial University of Newfoundland, NL, Canada.

出版信息

J Cutan Med Surg. 2022 Jul-Aug;26(4):361-370. doi: 10.1177/12034754221088584. Epub 2022 Mar 24.

DOI:10.1177/12034754221088584
PMID:35322692
Abstract

BACKGROUND

Real-world knowledge of the burden of hidradenitis suppurativa (HS) on patients remains limited.

OBJECTIVES

To measure the impact of adalimumab on moderate-to-severe HS patients' health-related quality of life (HRQoL) and work productivity.

METHODS

In 23 Canadian centres, 138 adults with moderate-to-severe HS requiring a change in ongoing therapy were treated with adalimumab for up to 52 weeks as per the physician's practice. Patient-reported outcome measures (PROMs) were obtained at baseline, weeks 24 and 52 to measure overall HRQoL, HS severity, levels of anxiety and depression, impact and symptoms of HS, work productivity and activity impairment. A post-hoc analysis further explored the PROMs by abscess and inflammatory nodule (AN) count at baseline (≤5, low; 6-10, medium; ≥11, high).

RESULTS

From baseline to weeks 24 and 52, all PRO overall scores improved significantly ( ≤ .0023). The number of patients reporting "good disease control" and "complete disease control" increased from 9.7% to 66.4% over 52 weeks. The score in Health Utility Index Mark 3 (HUI3) pain attribute meaningfully decreased over 52 weeks (mean difference ≥.05). The HS symptoms skin "tenderness" and "itchiness" improved the most. Work productivity loss and activity impairment improved by approximately 20% over 52 weeks. Disease burden improved more in 24 week responders with low and medium AN counts at baseline than in those with high AN count or in 24 week nonresponders.

CONCLUSION

At week 24 and maintained at week 52 in a real-world setting, adalimumab meaningfully improved HRQoL, work productivity, and activity impairment in moderate-to-severe HS patients.

摘要

背景

真实世界中对化脓性汗腺炎(HS)患者负担的了解仍然有限。

目的

评估阿达木单抗对中重度 HS 患者健康相关生活质量(HRQoL)和工作生产力的影响。

方法

在 23 个加拿大中心,138 名中重度 HS 患者需要改变正在进行的治疗,根据医生的实践,用阿达木单抗治疗,最长达 52 周。在基线、第 24 周和第 52 周时,使用患者报告的结局测量(PROMs)来测量整体 HRQoL、HS 严重程度、焦虑和抑郁水平、HS 的影响和症状、工作生产力和活动障碍。进一步的事后分析根据基线时的脓肿和炎性结节(AN)计数(≤5,低;6-10,中;≥11,高),探索了 PROMs。

结果

从基线到第 24 周和第 52 周,所有 PRO 整体评分均显著改善(≤.0023)。在 52 周内,报告“良好疾病控制”和“完全疾病控制”的患者比例从 9.7%增加到 66.4%。在 Health Utility Index Mark 3(HUI3)疼痛属性中,得分在 52 周内有明显下降(平均差值≥.05)。HS 症状的皮肤“压痛”和“瘙痒”改善最大。工作生产力损失和活动障碍在 52 周内改善了约 20%。在基线时 AN 计数较低和中等的 24 周应答者中,疾病负担的改善大于 AN 计数较高的患者或 24 周无应答者。

结论

在真实环境中,阿达木单抗在第 24 周和第 52 周时显著改善了中重度 HS 患者的 HRQoL、工作生产力和活动障碍。

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引用本文的文献

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Clin Cosmet Investig Dermatol. 2023 Jan 19;16:135-148. doi: 10.2147/CCID.S391356. eCollection 2023.