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寡关节型银屑病关节炎患者中白细胞介素-17的抑制作用

Inhibition of Interleukin-17 in Patients with Oligoarticular Psoriatic Arthritis.

作者信息

Ogdie Alexis, Gladman Dafna D, Coates Laura C, Pournara Effie, Parikh Bhumik, Mease Philip J

机构信息

Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 5 White Building, Philadelphia, PA, 19104, USA.

Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital and University of Toronto, Toronto, ON, Canada.

出版信息

Rheumatol Ther. 2023 Aug;10(4):849-860. doi: 10.1007/s40744-023-00548-y. Epub 2023 May 6.

Abstract

INTRODUCTION

This study evaluated the efficacy of the interleukin-17A inhibitor secukinumab in patients with oligoarticular psoriatic arthritis (PsA).

METHODS

A total of 84 patients with oligoarticular PsA, defined as 1-4 tender joints and 1-4 swollen joints, were pooled from the FUTURE 2-5 and MAXIMISE trials (NCT01752634, NCT01989468, NCT02294227, NCT02404350, and NCT02721966). Patients were grouped by treatment received at week 12 (secukinumab 300 mg, secukinumab 150 mg, or placebo) and week 52 (any secukinumab 300 mg or any secukinumab 150 mg). Efficacy was assessed by the proportion of patients achieving selected clinical outcomes. The predictors of Disease Activity index for Psoriatic Arthritis (DAPSA) responses at weeks 12 and 52 were identified by logistic regression analysis.

RESULTS

Secukinumab treatment resulted in greater achievement of DAPSA-based low disease activity (LDA), DAPSA-based remission (REM), DAPSA50, and DAPSA75 than placebo at week 12, with improvements sustained or further increased through week 52. LDA or REM was achieved at week 52 by more than 90% of patients who received either secukinumab dose, although secukinumab 300 mg resulted in the highest achievement of the stringent DAPSA75 and DAPSA REM outcomes. At week 12, younger age was associated with DAPSA LDA or REM and DAPSA50, while lower baseline swollen joint count was associated with DAPSA REM. No predictors were identified at week 52. The safety profile was consistent with the full study populations.

CONCLUSION

Secukinumab demonstrated efficacy vs placebo across several outcome measures in patients with oligoarticular PsA at week 12, with sustained or improved responses through week 52.

摘要

简介

本研究评估了白细胞介素-17A抑制剂司库奇尤单抗在少关节型银屑病关节炎(PsA)患者中的疗效。

方法

从FUTURE 2-5和MAXIMISE试验(NCT01752634、NCT01989468、NCT02294227、NCT02404350和NCT02721966)中汇总了总共84例少关节型PsA患者,定义为1-4个压痛关节和1-4个肿胀关节。患者按第12周接受的治疗(司库奇尤单抗300mg、司库奇尤单抗150mg或安慰剂)和第52周接受的治疗(任何司库奇尤单抗300mg或任何司库奇尤单抗150mg)进行分组。通过达到选定临床结局的患者比例评估疗效。通过逻辑回归分析确定第12周和第52周银屑病关节炎疾病活动指数(DAPSA)反应的预测因素。

结果

在第12周时,与安慰剂相比,司库奇尤单抗治疗使基于DAPSA的低疾病活动度(LDA)、基于DAPSA的缓解(REM)、DAPSA50和DAPSA75的达成率更高,且这些改善在第52周时持续或进一步增加。接受任一司库奇尤单抗剂量的患者中,超过90%在第52周时实现了LDA或REM,尽管司库奇尤单抗300mg在严格的DAPSA75和DAPSA REM结局方面达成率最高。在第12周时,年龄较小与DAPSA LDA或REM以及DAPSA50相关,而基线肿胀关节数较低与DAPSA REM相关。在第52周时未发现预测因素。安全性概况与整个研究人群一致。

结论

在少关节型PsA患者中,司库奇尤单抗在第12周时在多项结局指标上显示出优于安慰剂的疗效,且在第52周时反应持续或改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcde/10326182/60ec3d1e29d1/40744_2023_548_Fig1_HTML.jpg

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