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托珠单抗治疗日本系统性硬化症相关间质性肺病患者的疗效和安全性:一项全球性、随机、对照 3 期临床试验的亚组分析。

Efficacy and safety of tocilizumab in Japanese patients with systemic sclerosis and associated interstitial lung disease: A subgroup analysis of a global, randomised, controlled Phase 3 trial.

机构信息

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

Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.

出版信息

Mod Rheumatol. 2024 Mar 28;34(3):530-540. doi: 10.1093/mr/road068.

Abstract

OBJECTIVES

The aim of this article is to investigate the efficacy and safety of tocilizumab in Japanese patients with systemic sclerosis.

METHODS

Post hoc subgroup analysis of a global, randomised, controlled trial in patients treated with weekly tocilizumab 162 mg or placebo subcutaneously in a 48-week double-blind period (tocilizumab and placebo groups) followed by tocilizumab for 48 weeks in an open-label extension (continuous-tocilizumab and placebo-tocilizumab groups).

RESULTS

Among 20 patients, 12 were randomised to tocilizumab (all had interstitial lung disease) and eight were randomised to placebo (six had interstitial lung disease). The modified Rodnan skin score improved in both treatment groups. The mean change in percent-predicted forced vital capacity was 3.3% [95% confidence interval (CI), -2.5 to 9.0] for tocilizumab and -3.8% (95% CI, -9.9 to 2.2) for placebo in the double-blind period and 2.0% (95% CI, -0.7 to 4.6) for continuous-tocilizumab and -1.4% (95% CI, -6.7 to 4.0) for placebo-tocilizumab in the open-label extension. Rates of serious adverse events per 100 patient-years were 19.3 for tocilizumab and 26.8 for placebo in the double-blind period and 0.0 for continuous-tocilizumab and 13.6 for placebo-tocilizumab in the open-label period.

CONCLUSIONS

The efficacy and safety of tocilizumab in patients with systemic sclerosis were consistent between the Japanese subpopulation and the global trial population.

摘要

目的

本文旨在研究托珠单抗治疗系统性硬化症日本患者的疗效和安全性。

方法

在一项全球随机对照试验中进行事后亚组分析,该试验对接受每周皮下注射 162mg 托珠单抗或安慰剂的患者进行治疗,在 48 周双盲期(托珠单抗组和安慰剂组)后进行 48 周开放标签扩展(连续托珠单抗组和安慰剂-托珠单抗组)。

结果

在 20 名患者中,12 名被随机分配至托珠单抗组(均患有间质性肺病),8 名被随机分配至安慰剂组(6 名患有间质性肺病)。两组治疗均改善了改良 Rodnan 皮肤评分。双盲期托珠单抗组用力肺活量预计百分比的平均变化为 3.3%(95%置信区间,-2.5 至 9.0),安慰剂组为-3.8%(95%置信区间,-9.9 至 2.2);开放标签扩展期连续托珠单抗组为 2.0%(95%置信区间,-0.7 至 4.6),安慰剂-托珠单抗组为-1.4%(95%置信区间,-6.7 至 4.0)。双盲期托珠单抗组每 100 患者年的严重不良事件发生率为 19.3,安慰剂组为 26.8;开放标签期连续托珠单抗组为 0.0,安慰剂-托珠单抗组为 13.6。

结论

托珠单抗治疗系统性硬化症日本患者的疗效和安全性与全球试验人群一致。

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