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现实世界中银屑病生物制剂的处方模式与安全性概况:一项为期四年的卡拉布里亚药物警戒分析。

Prescribing Pattern and Safety Profile of Biological Agents for Psoriasis in Real-World Practice: A Four-Year Calabrian Pharmacovigilance Analysis.

作者信息

De Sarro Caterina, Bosco Francesca, Gagliardi Agnese, Guarnieri Lorenza, Ruga Stefano, Fabiano Antonio, Costantino Laura, Leo Antonio, Palleria Caterina, Verduci Chiara, Rania Vincenzo, Ashour Michael, Gallelli Luca, Citraro Rita, Sarro Giovambattista De

机构信息

Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

System and Applied Pharmacology@University Magna Grecia, (FAS@UMG) Research Center, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

出版信息

Pharmaceutics. 2024 Oct 14;16(10):1329. doi: 10.3390/pharmaceutics16101329.

Abstract

BACKGROUND

The treatment of psoriasis has made considerable progress with biologicals, including tumor necrosis factor inhibitors, and recently, monoclonal antibodies inhibiting directly interleukin (IL) 17, IL-23, or both IL-12/23. Newer biologicals are directed to the interleukin pathway and appear to improve complete or near-complete clearance. The newer biologicals have also been shown to have an excellent safety profile. However, despite experience with patients having confirmed the results obtained in clinical trials, there are still few data on using the newer biologicals.

METHODS

The present active study aimed to prospectively evaluate safety profiles and persistence of some biologicals in a multicenter pharmacovigilance study, that enrolled 733 patients treated with a biologic drug in five Calabrian hospital units. Informative and treatment persistence evaluations with predictors for suspension and occurrence of adverse events (AEs) were executed. In particular, reasons for treatment discontinuation in our program take account of primary/secondary failure or development of an AE.

RESULTS

AEs occurred in 187/733 patients and serious AEs (SAEs) were identified in 5/733 patients. An number of 182/733 patients showed a primary/secondary inefficacy. The AEs and SAEs were described with adalimumab, infliximab, and etanercept but not with abatacept, brodalumab, tildrakizumab, golinumab, ixekizumab, guselkumab, risankizumab, secukinumab, and ustekinumab.

CONCLUSIONS

Our analysis, although limited by a small sample size and a short-term follow-up period, offers suitable data on commonly used biological agents and their safety, interruption rate, and the attendance of SAEs. Real-world studies should be carried out to evaluate other safety interests.

摘要

背景

银屑病的治疗随着生物制剂取得了显著进展,包括肿瘤坏死因子抑制剂,以及最近直接抑制白细胞介素(IL)-17、IL-23或IL-12/23两者的单克隆抗体。新型生物制剂针对白细胞介素途径,似乎能改善完全或接近完全清除率。新型生物制剂也已显示出优异的安全性。然而,尽管患者的经验证实了临床试验获得的结果,但关于使用新型生物制剂的数据仍然很少。

方法

本项现行研究旨在通过一项多中心药物警戒研究前瞻性评估某些生物制剂的安全性和持续性,该研究纳入了卡拉布里亚五个医院科室中733例接受生物药物治疗的患者。进行了信息性评估和治疗持续性评估,并分析了停药和不良事件(AE)发生的预测因素。特别是,我们方案中治疗中断的原因考虑了原发性/继发性失败或AE的发生。

结果

187/733例患者发生了AE,5/733例患者出现了严重AE(SAE)。182/733例患者显示原发性/继发性无效。使用阿达木单抗、英夫利昔单抗和依那西普时描述了AE和SAE,但使用阿巴西普、布罗达单抗、替拉珠单抗、戈利木单抗、司库奇尤单抗、古塞库单抗、瑞莎珠单抗、苏金单抗和乌司奴单抗时未描述。

结论

我们的分析虽然受到样本量小和随访期短的限制,但提供了关于常用生物制剂及其安全性、中断率和SAE发生率的合适数据。应开展真实世界研究以评估其他安全问题。

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