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多关节病程幼年特发性关节炎患者(年龄 2 至 17 岁)接受皮下注射阿巴西普治疗的患者报告结局:一项国际 III 期研究的两年结果。

Patient-Reported Outcomes Among Patients Ages Two to Seventeen Years With Polyarticular-Course Juvenile Idiopathic Arthritis Treated With Subcutaneous Abatacept: Two-Year Results From an International Phase III Study.

机构信息

IRCCS Istituto G. Gaslini Clinica Pediatrica e Reumatologia, UOSID Centro Trial, PRINTO, Genova, Italy.

Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.

出版信息

Arthritis Care Res (Hoboken). 2023 Aug;75(8):1804-1814. doi: 10.1002/acr.24989. Epub 2023 Jan 29.

Abstract

OBJECTIVE

To describe longitudinal changes in patient-reported outcomes (PROs) in children with polyarticular-course juvenile idiopathic arthritis (pJIA) treated with subcutaneous abatacept.

METHODS

Secondary analysis of a single-arm, open-label 24-month study of patients ages 6-17 years and 2-5 years. PROs included Childhood Health Assessment Questionnaire-Disability Index (CHAQ-DI), parent global assessment of child well-being (PaGA), pain assessment, and Activity Limitation Questionnaire (ALQ). Clinical outcomes included 50% or greater improvement in JIA American College of Rheumatology (ACR) criteria, clinically inactive disease, and Juvenile Arthritis Disease Activity Score.

RESULTS

For the 6- to 17-year-old (n = 173) and 2- to 5-year-old (n = 46) cohorts, respectively, median (Q1, Q3) changes from baseline in CHAQ-DI at months 4 and 24 were -0.3 (-0.8, 0.0) and -0.5 (-1.0, -0.1), and -0.4 (-0.8, 0.0) and -0.5 (-1.0--0.1). Median pain scores were below cutoff threshold for clinically relevant pain (<35 mm) by month 1 (6 to 17 years, 32.3 mm; 2 to 5 years, 25.7 mm), reaching a nadir at month 24 (6 to 17 years, 6.0 mm; 2 to 5 years, 2.0 mm). For the 6- to 17-year-old and 2- to 5-year-old cohorts, respectively, median PaGA scores were 47.8 (n = 172) and 42.1 (n = 46) at baseline and 6.3 (n = 107) and 2.0 (n = 37) at month 24. In both cohorts, ALQ components improved from baseline to month 4 and were largely maintained to month 24. Clinical outcomes improved through to month 24.

CONCLUSION

Early and sustained PRO improvements were reported in this phase III, open-label trial of subcutaneous abatacept in patients with pJIA.

摘要

目的

描述接受皮下注射阿巴西普治疗的多关节型幼年特发性关节炎(pJIA)患儿的患者报告结局(PROs)的纵向变化。

方法

对一项 6-17 岁和 2-5 岁患者的单臂、开放标签、24 个月的研究进行二次分析。PROs 包括儿童健康评估问卷-残疾指数(CHAQ-DI)、父母对孩子整体健康状况的评估(PaGA)、疼痛评估和活动受限问卷(ALQ)。临床结局包括美国风湿病学会(ACR)20%或更大程度改善的 JIA 标准、临床无疾病活动和青少年关节炎疾病活动评分。

结果

对于 6-17 岁(n=173)和 2-5 岁(n=46)两组患者,分别从基线到第 4 个月和第 24 个月 CHAQ-DI 的中位数(Q1,Q3)变化为-0.3(-0.8,0.0)和-0.5(-1.0,-0.1),和-0.4(-0.8,0.0)和-0.5(-1.0,-0.1)。中位疼痛评分在第 1 个月(6-17 岁,32.3mm;2-5 岁,25.7mm)就低于有临床意义的疼痛临界值(<35mm),在第 24 个月达到最低点(6-17 岁,6.0mm;2-5 岁,2.0mm)。对于 6-17 岁和 2-5 岁两组,基线时 PaGA 中位数分别为 47.8(n=172)和 42.1(n=46),第 24 个月时为 6.3(n=107)和 2.0(n=37)。在两个队列中,ALQ 成分从基线到第 4 个月均有所改善,到第 24 个月基本维持。临床结局在第 24 个月仍有改善。

结论

在这项 III 期、开放标签的皮下注射阿巴西普治疗 pJIA 患者的试验中,报告了早期和持续的 PRO 改善。

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