Honma Masaru, Kanai Yasumasa, Murotani Kenta, Ito Kei, Ohata Chika, Yamazaki Fumikazu, Saeki Hidehisa, Seishima Mariko, Mizutani Yoko, Kitabayashi Hiroki, Imafuku Shinichi
Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan.
Medical Affairs, Kyowa Kirin Co., Ltd., Tokyo, Japan.
J Dermatol. 2023 Apr;50(4):453-461. doi: 10.1111/1346-8138.16682. Epub 2022 Dec 20.
Itching and skin pain are bothersome symptoms of psoriasis, but evidence is limited regarding the treatment effectiveness on these symptoms in daily clinical settings. We assessed the changes in the levels of itching and skin pain after brodalumab treatment in Japanese patients with psoriasis using patient-reported outcomes (PROs). Patients with psoriasis who have inadequate response to existing treatments were enrolled in the single-arm, open-label, multicenter, prospective ProLOGUE study and received brodalumab 210 mg subcutaneously in daily clinical practice. Psoriasis Area and Severity Index (PASI) and PRO assessments were performed at baseline and weeks 12 and 48. Seventy-three patients (men, 82.2%; median age, 54.0 years) were enrolled. The Itch Numeric Rating Scale (NRS; p < 0.0001 at weeks 12 and 48) and Skin Pain NRS (week 12, p = 0.0004; week 48, p < 0.0001) scores significantly decreased from baseline. The Itch NRS score was significantly higher in patients with a Dermatology Life Quality Index (DLQI) score of ≥2 (vs. 0/1; p < 0.0001 at weeks 12 and 48) and in patients with a Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9) global satisfaction domain score of ≤70% (vs. >70%; week 12, p = 0.0120; week 48, p = 0.0348). The Itch NRS score cutoff value for achieving a PASI score of ≤2, DLQI score of 0/1, and TSQM-9 global satisfaction domain score of >70% was 1 at week 12 and 0 at week 48. Brodalumab treatment was associated with improvement in itching and skin pain in Japanese patients with psoriasis. An Itch NRS score of 0 can be a long-term treatment goal for psoriasis (Japan Registry of Clinical Trials identifier: jRCTs031180037).
瘙痒和皮肤疼痛是银屑病令人烦恼的症状,但在日常临床环境中,关于这些症状的治疗效果的证据有限。我们使用患者报告结局(PROs)评估了日本银屑病患者接受布罗达单抗治疗后瘙痒和皮肤疼痛水平的变化。对现有治疗反应不佳的银屑病患者被纳入单臂、开放标签、多中心、前瞻性的ProLOGUE研究,并在日常临床实践中接受皮下注射210mg布罗达单抗治疗。在基线以及第12周和第48周进行银屑病面积和严重程度指数(PASI)及PRO评估。共纳入73例患者(男性占82.2%;中位年龄54.0岁)。瘙痒数字评定量表(NRS;第12周和第48周时p<0.0001)和皮肤疼痛NRS(第12周时p=0.0004;第48周时p<0.0001)评分与基线相比显著降低。皮肤病生活质量指数(DLQI)评分≥2的患者(与DLQI评分为0/1的患者相比;第12周和第48周时p<0.0001)以及药物治疗满意度问卷-9(TSQM-9)总体满意度领域评分≤70%的患者(与评分>70%的患者相比;第12周时p=0.0120;第48周时p=0.0348)的瘙痒NRS评分显著更高。在第12周时,达到PASI评分≤2、DLQI评分0/1以及TSQM-9总体满意度领域评分>70%的瘙痒NRS评分临界值为1,在第48周时为0。布罗达单抗治疗可改善日本银屑病患者的瘙痒和皮肤疼痛。瘙痒NRS评分为0可作为银屑病的长期治疗目标(日本临床试验注册标识符:jRCTs031180037)。