Merck & Co., Inc, Rahway, NJ, USA.
MSD Italy, Rome, Italy.
Clin Rheumatol. 2023 Dec;42(12):3397-3405. doi: 10.1007/s10067-023-06760-z. Epub 2023 Sep 26.
Golimumab, a monoclonal antibody against tumor necrosis factor-α (TNF-α), is used widely for treatment of rheumatic diseases. Long-term persistence is an important factor influencing therapeutic benefit and is a surrogate measure of efficacy. We compared five-year golimumab treatment persistence across studies, indications, and lines of therapy using pooled data from pivotal golimumab Phase III clinical trials.
This post-hoc analysis evaluated use of golimumab administered subcutaneously (50 or 100 mg every four weeks) for up to five years in 2228 adult participants with rheumatoid arthritis (RA; GO-BEFORE, GO-AFTER, and GO-FORWARD studies), psoriatic arthritis (PsA; GO-REVEAL study), or ankylosing spondylitis (AS; GO-RAISE study). Retention rate differences were evaluated by study, indication, and line of therapy using log-rank tests, and probability of treatment persistence was estimated by Kaplan-Meier analysis.
Golimumab retention rates at Year 5 were consistently high when used as 1-line therapy (69.8%) and did not differ significantly across the three indications tested (p = 0.5106) or across 1-line studies (p = 0.2327). Retention at Year 5 was better in participants using golimumab as 1-line than in those using it as 2-line (41.6%) therapy. Participants on 2-line golimumab therapy had a longer disease duration (median 9.2 years versus 3.7 years) than those on 1-line golimumab therapy.
These data support the value of long-term golimumab therapy in patients with chronic, immune-mediated rheumatic diseases when used as 1-line (RA, PsA, AS) or 2-line (RA) therapy. Key Points • Golimumab is a human monoclonal antibody directed against tumor necrosis factor-α (TNF-α) and is approved widely for the treatment of rheumatic autoimmune diseases. • We compared the probability of treatment persistence, or the time of continuous drug use, for golimumab across five Phase III studies spanning multiple rheumatic indications over five years. • Treatment persistence was favorable and did not differ significantly for participants with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, but persistence was greater when golimumab was used as 1st-line than as 2nd-line biologic therapy.
戈利木单抗是一种针对肿瘤坏死因子-α(TNF-α)的单克隆抗体,广泛用于治疗风湿性疾病。长期持续是影响治疗效果的一个重要因素,也是疗效的替代衡量指标。我们使用戈利木单抗关键 III 期临床试验的汇总数据,比较了不同研究、适应证和治疗线中五年戈利木单抗治疗的持续时间。
这项事后分析评估了皮下注射戈利木单抗(50 或 100mg,每四周一次)长达五年的治疗效果,2228 名成年类风湿关节炎(RA;GO-BEFORE、GO-AFTER 和 GO-FORWARD 研究)、银屑病关节炎(PsA;GO-REVEAL 研究)或强直性脊柱炎(AS;GO-RAISE 研究)患者参与了这项研究。使用对数秩检验按研究、适应证和治疗线评估保留率差异,并通过 Kaplan-Meier 分析估计治疗持续时间。
当作为一线治疗时,戈利木单抗的五年保留率始终很高(69.8%),并且在三种测试的适应证之间(p=0.5106)或在一线研究之间(p=0.2327)没有显著差异。与二线(41.6%)相比,一线使用戈利木单抗的患者保留率更好。二线戈利木单抗治疗的患者疾病持续时间更长(中位数 9.2 年,而非一线戈利木单抗治疗的 3.7 年)。
这些数据支持在慢性免疫介导性风湿性疾病中作为一线(RA、PsA、AS)或二线(RA)治疗时,长期戈利木单抗治疗的价值。关键点: • 戈利木单抗是一种针对肿瘤坏死因子-α(TNF-α)的人源单克隆抗体,广泛批准用于治疗风湿性自身免疫性疾病。 • 我们比较了五项跨越五年时间、涵盖多种风湿适应证的 III 期研究中戈利木单抗的治疗持续时间,或连续药物使用时间。 • 治疗持续时间对类风湿关节炎、银屑病关节炎和强直性脊柱炎患者是有利的,且没有显著差异,但与二线生物治疗相比,一线戈利木单抗治疗的保留率更高。