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基于健康结果的银屑病生物制剂治疗风险共担协议:培塞利珠单抗

[Translated article] Risk-sharing agreement based on health outcomes for the treatment of moderate-severe psoriasis with certolizumab pegol.

机构信息

Servicio de Farmacia del Hospital General Universitario de Elche, Alicante, Spain.

Servicio de Dermatología del Hospital General Universitario de Elche, Alicante, Spain.

出版信息

Farm Hosp. 2024 Mar-Apr;48(2):T51-T56. doi: 10.1016/j.farma.2023.11.004. Epub 2023 Dec 25.

Abstract

OBJECTIVE

To provide evidence of the effectiveness of certolizumab pegol (CZP) in real clinical practice in adult patients with moderate-to-severe plaque psoriasis (PsO) in the context of a risk-sharing agreement (RSA).

METHODS

Retrospective observational study based on variables collected in the RSA for treatment with CZP of adult patients with moderate-severe plaque PsO. Ten Spanish hospitals where the RSA was implemented participated. The percentage of patients who achieved the target clinical response of the RSA at the follow-up visit (week 16) was evaluated: absolute Psoriasis Area and Severity Index (PASI) value ≤3 for biologic naïve population, and ≤5 in case of previous failure to a single biologic drug. In addition, the improvement in the scores of other scales included in the study was analysed: Body Surface Area (BSA), Dermatology Life Quality Index (DLQI), Physician's Global Assessment (PGA), and Nail Psoriasis Severity Index (NAPSI). A descriptive analysis was performed for the total population and by patient subgroups (naive vs. non-naive to biologic, male vs. female, and with vs. without discontinuation).

RESULTS

Sixty-six patients were included, 12 men and 54 women. 90.9% achieved the target clinical response, with a mean reduction of 8 (-78.4%) absolute PASI points. Improvement was observed in BSA, PGA, NAPSI, and DLQI, with a reduction of 11.3 (-80.6%), 1.9 (-65.5%), 3.3 (-30.7%), and 9.0 (-66.4%) absolute value points, respectively. Despite not achieving the therapeutic target set in the RSA in 6 patients (9%) (the cost of the drug was assumed by the laboratory), only 2 (3%) discontinued treatment.

CONCLUSION

Our study shows that CZP is effective in real clinical practice in patients with moderate-severe plaque PsO, with an improvement in absolute PASI and DLQI, as well as other scales, both for the total population and in the subgroups analysed. Nearly 91% of patients reached the therapeutic target fixed in the RSA. Implementing this type of agreement can provide a direct or indirect benefit for all the agents involved in the process, providing valuable information for decision-making.

摘要

目的

在风险分担协议(RSA)的背景下,为成人中重度斑块型银屑病(PsO)患者使用培塞利珠单抗(CZP)治疗提供真实临床实践中的有效性证据。

方法

基于 RSA 中收集的变量,对接受中重度斑块型 PsO 成人患者使用 CZP 治疗的患者进行回顾性观察研究。共有 10 家参与 RSA 的西班牙医院参与了该研究。评估在随访(第 16 周)时达到 RSA 目标临床应答的患者比例:生物制剂初治人群的绝对银屑病面积和严重程度指数(PASI)值≤3,先前单一生物制剂药物治疗失败的患者为≤5。此外,还分析了纳入研究的其他量表评分的改善情况:体表面积(BSA)、皮肤病生活质量指数(DLQI)、医生整体评估(PGA)和指甲银屑病严重程度指数(NAPSI)。对总人群和患者亚组(初治 vs. 生物制剂既往治疗失败、男性 vs. 女性、继续治疗 vs. 停药)进行描述性分析。

结果

共纳入 66 例患者,其中男性 12 例,女性 54 例。90.9%的患者达到了目标临床应答,绝对 PASI 值平均降低 8 分(-78.4%)。BSA、PGA、NAPSI 和 DLQI 均有改善,绝对值分别降低 11.3(-80.6%)、1.9(-65.5%)、3.3(-30.7%)和 9.0(-66.4%)分。尽管有 6 例(9%)患者(实验室承担药物费用)未达到 RSA 中设定的治疗目标,但仅有 2 例(3%)停药。

结论

我们的研究表明,在真实临床实践中,CZP 对中重度斑块型 PsO 患者有效,可改善绝对 PASI 和 DLQI 以及其他量表评分,无论是在总人群还是在分析的亚组中。近 91%的患者达到了 RSA 中设定的治疗目标。实施这种类型的协议可以为参与该过程的所有药物提供直接或间接的益处,为决策提供有价值的信息。

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