Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Kyowa Kirin International, Marlow, UK.
Arch Dermatol Res. 2024 Nov 6;316(10):747. doi: 10.1007/s00403-024-03426-x.
In a randomized phase 2b trial (NCT03703102) for adult patients with moderate-to-severe atopic dermatitis (AD), treatment with the T cell rebalancing anti-OX40 receptor antibody rocatinlimab (AMG 451/KHK4083) led to significant improvements in clinical measurements versus placebo including whole-body Eczema Area and Severity Index (EASI) score. AD manifestations can impact variable anatomic regions, and involvement of the head and neck, a sensitive, hard-to-treat area, can negatively impact quality of life. In this post hoc analysis, we investigated response to rocatinlimab treatment across anatomic regions, including the head and neck. Least squares mean change from baseline to Week 56 in EASI score was analyzed by anatomic region (head and neck, trunk, upper extremities, or lower extremities) for patients with baseline moderate-to-severe AD in the respective anatomic region, using mixed models for repeated measures. Rocatinlimab groups were compared with placebo at Week 16. The proportion of patients achieving at least 75% reduction from baseline in EASI (EASI-75) was calculated. Probability of relapsing in EASI-75 during the off-treatment follow-up period (Weeks 36-56) was estimated using a Kaplan - Meier approach. At Week 16, decrease from baseline in mean EASI score was greater with all rocatinlimab regimens versus placebo across all anatomic regions for patients with baseline moderate-to-severe AD in the respective region (all P < 0.001). EASI scores continued to improve on treatment after Week 16 and were maintained during the off-treatment period across all regions. Among patients with baseline moderate-to-severe AD in the head and neck (n = 219; rocatinlimab, n = 174; placebo, n = 45), mean difference (rocatinlimab vs placebo) at Week 16 in LS mean percent change in head and neck EASI score ranged from - 30.4% to - 42.6% across treatment regimens. In patients who received rocatinlimab from the start of the trial, 47% - 71% achieved EASI-75 in the head and neck at Week 36. Among EASI-75 responders at Week 36, the probability of relapsing in EASI-75 in any region was low (< 25% in the head and neck) 20 weeks after treatment discontinuation until Week 56.Rocatinlimab treatment led to durable improvements in AD across multiple anatomic regions, including the sensitive head and neck region.
在一项针对中度至重度特应性皮炎(AD)成人患者的随机 2b 期试验(NCT03703102)中,与安慰剂相比,使用 T 细胞再平衡抗 OX40 受体抗体 rocatinlimab(AMG 451/KHK4083)治疗可显著改善临床测量指标,包括全身湿疹面积和严重程度指数(EASI)评分。AD 表现可能影响不同的解剖区域,头颈部受累是一个敏感且难以治疗的区域,会对生活质量产生负面影响。在这项事后分析中,我们研究了 rocatinlimab 治疗在不同解剖区域的反应,包括头颈部。对于基线时在相应解剖区域患有中度至重度 AD 的患者,使用重复测量混合模型,按解剖区域(头颈部、躯干、上肢或下肢)分析基线至第 56 周时 EASI 评分的最小二乘均数变化。在第 16 周时,比较了 rocatinlimab 组与安慰剂组。计算 EASI 至少降低 75%(EASI-75)的患者比例。使用 Kaplan-Meier 方法估计在治疗随访期(第 36-56 周)内 EASI-75 复发的概率。在第 16 周时,与安慰剂相比,所有 rocatinlimab 方案在各个区域的基线中度至重度 AD 患者中,从基线开始 EASI 评分的平均下降均大于所有 rocatinlimab 方案(所有 P<0.001)。在治疗后第 16 周后,EASI 评分继续改善,并在所有区域的治疗后期间保持稳定。在基线时患有中度至重度头颈部 AD 的患者中(n=219;rocatinlimab,n=174;安慰剂,n=45),在不同治疗方案中,第 16 周时头颈部 EASI 评分的 LS 均值百分比变化的均值差(rocatinlimab 与安慰剂)在 30.4%至 42.6%之间。在从试验开始就接受 rocatinlimab 治疗的患者中,在第 36 周时,47%至 71%的患者在头颈部达到 EASI-75。在第 36 周时达到 EASI-75 的应答者中,在治疗结束后 20 周内,任何区域 EASI-75 复发的概率均较低(头颈部<25%),直至第 56 周。 Rocatinlimab 治疗可在多个解剖区域,包括敏感的头颈部区域,持久改善 AD。