The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
AbbVie, Inc., North Chicago, IL, USA.
J Eur Acad Dermatol Venereol. 2022 Nov;36(11):2120-2129. doi: 10.1111/jdv.18475.
Psoriatic arthritis (PsA) is a chronic inflammatory disease that reduces the quality of life. This study assessed the effects of risankizumab (RZB) on the achievement of minimal clinically important differences (MCID) in patient-reported outcomes (PROs).
KEEPsAKE-1 and -2 are randomized, placebo-controlled Phase 3 clinical studies assessing RZB (150 mg) vs. placebo (PBO) in adult patients with PsA with inadequate response or intolerance to disease-modifying antirheumatic drugs and/or biologics. Patients were randomized 1:1 to receive RZB or PBO for 24 weeks; starting at Week 24, all patients received RZB 150 mg through Week 52. PROs assessed were Patient's Global Assessment of Disease Activity (PtGA), Patient's Assessment of Pain, Health Assessment Questionnaire-Disability Index (HAQ-DI), Short-Form 36 Physical and Mental Component Summary scores (PCS and MCS, respectively), 5-Level EQ-5D (EQ-5D-5L), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), and Work Productivity and Activity Impairment (WPAI). The proportion of patients achieving MCID at Weeks 24 and 52 are reported. Odds ratios of achieving MCID with RZB treatment at Week 24, relative to PBO, were estimated by logistic regression controlling for baseline and stratification factors.
In KEEPsAKE-1, RZB- vs. PBO-treated patients were more likely to report MCID in all PROs at Week 24; similar results were obtained in KEEPsAKE-2, except for SF-36 MCS and WPAI presenteeism domain. In KEEPsAKE-1 and KEEPsAKE-2, 65% and 62% of RZB-treated patients, respectively, reported MCID in PtGA at Week 24, which increased to 74% and 68%, respectively, at Week 52. Approximately 48% of all PBO-treated patients reported MCID in PtGA at Week 24 and, after initiating RZB, >65% reported MCID at Week 52. Results were similar in the remaining PROs.
These data demonstrate that patients with PsA receiving RZB treatment are more likely to report clinically important improvements in PROs compared with patients receiving PBO.
银屑病关节炎(PsA)是一种慢性炎症性疾病,降低了生活质量。本研究评估了 risankizumab(RZB)对患者报告结局(PROs)达到最小临床重要差异(MCID)的影响。
KEEPsAKE-1 和 -2 是两项随机、安慰剂对照的 3 期临床研究,评估了 RZB(150mg)与安慰剂(PBO)在对疾病修饰抗风湿药物和/或生物制剂反应不足或不耐受的成年 PsA 患者中的疗效。患者以 1:1 的比例随机接受 RZB 或 PBO 治疗 24 周;从第 24 周开始,所有患者接受 RZB 150mg 治疗至第 52 周。评估的 PROs 包括患者的整体疾病活动评估(PtGA)、患者的疼痛评估、健康评估问卷残疾指数(HAQ-DI)、短表单 36 精神和身体成分综合评分(PCS 和 MCS)、5 级 EQ-5D(EQ-5D-5L)、慢性病治疗疲劳评估量表-疲劳(FACIT-Fatigue)和工作生产力和活动障碍(WPAI)。报告了第 24 周和第 52 周达到 MCID 的患者比例。通过 logistic 回归控制基线和分层因素,估计第 24 周时 RZB 治疗与 PBO 相比达到 MCID 的可能性比。
在 KEEPsAKE-1 中,与接受 PBO 治疗的患者相比,接受 RZB 治疗的患者在所有 PROs 中更有可能在第 24 周报告 MCID;在 KEEPsAKE-2 中也获得了类似的结果,除了短表单 36 精神成分综合评分和 WPAI 出勤障碍领域。在 KEEPsAKE-1 和 KEEPsAKE-2 中,分别有 65%和 62%的 RZB 治疗患者在第 24 周报告了 PtGA 的 MCID,在第 52 周分别增加到 74%和 68%。大约 48%的所有接受 PBO 治疗的患者在第 24 周报告了 PtGA 的 MCID,在开始接受 RZB 治疗后,超过 65%的患者在第 52 周报告了 MCID。其余 PROs 的结果相似。
这些数据表明,接受 RZB 治疗的 PsA 患者在 PROs 方面更有可能报告具有临床意义的改善,而接受 PBO 治疗的患者则不然。