Department of Dermatology, Yale University, New Haven, Connecticut; Central Connecticut Dermatology Research, Cromwell, Connecticut.
Department of Dermatology, Henry Ford Health System, Detroit, Michigan.
J Am Acad Dermatol. 2022 Oct;87(4):800-806. doi: 10.1016/j.jaad.2022.06.1171. Epub 2022 Jun 27.
Tapinarof cream 1% once daily, an aryl hydrocarbon receptor-modulating agent, was significantly more efficacious than vehicle and well tolerated in two 12-week phase 3 trials in adults with mild to severe plaque psoriasis.
To assess long-term safety, efficacy, remittive effect, durability of response, and tolerability of tapinarof.
Patients completing the 12-week trials were eligible for 40-weeks' open-label treatment and 4-weeks' follow-up. Treatment was based on the Physician Global Assessment (PGA) score. Patients entering with PGA≥1 received tapinarof until PGA = 0. Patients with PGA = 0 discontinued tapinarof and were monitored for remittive effect. Patients with PGA≥2 were re-treated until PGA = 0.
Overall, 91.6% (n = 763) of eligible patients enrolled; 40.9% of patients achieved complete disease clearance (PGA = 0), and 58.2% entering with PGA≥2 achieved PGA = 0 or 1. Mean duration of off therapy remittive effect for patients achieving PGA = 0 was 130.1 days. No new safety signals were observed. Most frequent adverse events were folliculitis (22.7%), contact dermatitis (5.5%), and upper respiratory tract infection (4.7%).
Open-label; no control; may not be generalizable to all forms of psoriasis; remittive effect/response rate potentially underestimated.
Efficacy improved beyond the 12-week trials, with a 40.9% complete disease clearance rate, ∼4-month off therapy remittive effect, durability on therapy, and consistent safety.
每日一次使用 1%他卡西醇乳膏,一种芳基烃受体调节剂,在两项为期 12 周的 3 期临床试验中,与安慰剂相比,在治疗轻至重度斑块型银屑病成人患者方面具有显著疗效且耐受性良好。
评估他卡西醇的长期安全性、疗效、缓解效果、应答持久性和耐受性。
完成 12 周试验的患者有资格接受 40 周开放标签治疗和 4 周随访。治疗基于医生总体评估(PGA)评分。PGA≥1 的入组患者接受他卡西醇治疗,直至 PGA=0。PGA=0 的患者停止使用他卡西醇,并监测缓解效果。PGA≥2 的患者再次接受治疗,直至 PGA=0。
总体而言,符合条件的 91.6%(n=763)的患者入组;40.9%的患者达到完全疾病清除(PGA=0),58.2%的 PGA≥2 入组患者达到 PGA=0 或 1。达到 PGA=0 的患者停药缓解效果的平均持续时间为 130.1 天。未观察到新的安全性信号。最常见的不良事件是毛囊炎(22.7%)、接触性皮炎(5.5%)和上呼吸道感染(4.7%)。
开放性;无对照;可能不适用于所有形式的银屑病;缓解效果/应答率可能被低估。
疗效在 12 周试验的基础上进一步改善,完全疾病清除率为 40.9%,停药缓解效果持续约 4 个月,治疗的持久性和一致性良好,安全性良好。