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日本类风湿关节炎患者托法替布的六个月安全性和有效性:上市后监测的中期分析。

Six-month safety and effectiveness of tofacitinib in patients with rheumatoid arthritis in Japan: Interim analysis of post-marketing surveillance.

机构信息

Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan.

Inflammation and Immunology Medical Affairs, Pfizer Japan Inc., Tokyo, Japan.

出版信息

Mod Rheumatol. 2024 Feb 26;34(2):272-286. doi: 10.1093/mr/road063.

Abstract

OBJECTIVES

We evaluated the real-world safety/effectiveness of tofacitinib, an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA), in patients with RA in Japan registered in a post-marketing surveillance study.

METHODS

This interim analysis included data from July 2013 to December 2018. Adverse events (AEs), serious AEs (SAEs), Simplified Disease Activity Index (SDAI)/Clinical Disease Activity Index (CDAI)/Disease Activity Score in 28 joints, erythrocyte sedimentation rate [DAS28-4(ESR)] scores, and rates of SDAI/CDAI/DAS28-4(ESR)-defined remission and low disease activity were analysed using 6 months of data. Risk factors for serious infections were assessed by multivariable analyses.

RESULTS

Safety and disease activity were evaluated in 6866 and 6649 patients, respectively. Overall, 32.73%/7.37% of patients reported AEs/SAEs. Clinically important AEs with tofacitinib included serious infections/infestations [3.13% of patients; incidence rate (IR; patients with events) 6.91/100 patient-years (PY)], herpes zoster (3.63%; IR 8.02/100 PY), and malignancies (0.68%; IR 1.45/100 PY). SDAI/CDAI/DAS28-4(ESR) scores and remission/low disease activity rates improved over 6 months. Male sex, older age, Steinbrocker's stage IV, history of infection, and diabetes mellitus at baseline were independent risk factors for serious infection.

CONCLUSIONS

In patients with RA receiving tofacitinib in Japan, safety was consistent with the reported profile, and disease activity improved over 6 months.

STUDY IDENTIFIER

NCT01932372.

摘要

目的

我们评估了托法替布(一种用于治疗类风湿关节炎(RA)的口服 Janus 激酶抑制剂)在日本接受上市后监测研究注册的 RA 患者中的真实世界安全性/疗效。

方法

本中期分析包括 2013 年 7 月至 2018 年 12 月的数据。使用 6 个月的数据分析不良事件(AE)、严重不良事件(SAE)、简化疾病活动指数(SDAI)/临床疾病活动指数(CDAI)/28 个关节疾病活动度评分(DAS28-4(ESR))、SDAI/CDAI/DAS28-4(ESR)定义的缓解率和低疾病活动率,同时评估严重感染的危险因素。

结果

分别对 6866 例和 6649 例患者进行了安全性和疾病活动评估。总体而言,32.73%/7.37%的患者报告了 AE/SAE。托法替布相关的重要临床 AE 包括严重感染/感染(3.13%的患者;发生率(IR;有事件的患者)为 6.91/100 患者年(PY))、带状疱疹(3.63%;IR 8.02/100 PY)和恶性肿瘤(0.68%;IR 1.45/100 PY)。SDAI/CDAI/DAS28-4(ESR)评分和缓解/低疾病活动率在 6 个月内得到改善。男性、年龄较大、Steinbrocker 分期 IV、感染史和基线时的糖尿病是严重感染的独立危险因素。

结论

在日本接受托法替布治疗的 RA 患者中,安全性与报告的情况一致,疾病活动在 6 个月内得到改善。

研究识别码

NCT01932372。

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