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阿普司特治疗52周对高影响区域斑块状银屑病及生活质量受损患者的疗效和安全性

Efficacy and Safety of Apremilast Over 52 Weeks in Patients with Plaque Psoriasis in High-Impact Areas and Impaired Quality of Life.

作者信息

Augustin Matthias, Barker Jonathan, Conrad Curdin, Jullien Denis, Carrascosa Jose-Manuel, Reddy Jyotsna, Amouzadeh Hamid, Colgan Stephen, Zou Henry, Mrowietz Ulrich

机构信息

Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.

St John's Institute of Dermatology of King's College, London, UK.

出版信息

Dermatol Ther (Heidelb). 2025 May 3. doi: 10.1007/s13555-025-01389-z.

Abstract

INTRODUCTION

In EMBRACE, significant benefits were seen with apremilast versus placebo on quality of life (QoL) and clinical outcomes after 16 weeks in patients with chronic plaque psoriasis in ≥ 1 high-impact area, limited skin involvement, and impaired QoL, in a European population previously unstudied with apremilast. Our objective was to evaluate the 52-week efficacy and safety of apremilast.

METHODS

EMBRACE was a phase 4, multicenter, randomized, placebo-controlled, double-blind study. Eligible patients had chronic plaque psoriasis for ≥ 6 months prior to baseline; involvement in ≥ 1 high-impact area; a Psoriasis Area and Severity Index score ≥ 3 to ≤ 10; and a Dermatology Life Quality Index score > 10. Patients were randomized (2:1) to receive apremilast 30 mg twice daily or placebo from weeks 0 to 16; after that, all patients continued with apremilast (apremilast/apremilast) or switched from placebo to apremilast (placebo/apremilast) until week 52.

RESULTS

Of 277 patients randomized (apremilast: 185, placebo: 92), 158 (apremilast/apremilast: 105; placebo/apremilast: 53) completed 52 weeks. Improvements in QoL, itch, skin discomfort/pain, patient-reported treatment benefits, and skin outcomes at week 16 were maintained over 52 weeks in patients continuing apremilast treatment. Similar improvements were seen at week 52 in patients who switched from placebo to apremilast at week 16. No new safety signals were observed.

CONCLUSIONS

Improvements in QoL and disease severity at week 16 were maintained through week 52 with continued apremilast treatment in EMBRACE, with no new safety signals. TRIAL REGISTRATION CLINICALTRIALS.

GOV IDENTIFIER

NCT03774875.

摘要

简介

在“欣然接受”(EMBRACE)研究中,对于慢性斑块状银屑病患者,在≥1个高影响区域、皮肤受累有限且生活质量受损的欧洲人群中,与安慰剂相比,阿普米拉斯在16周后对生活质量(QoL)和临床结局具有显著益处,此前该人群未接受过阿普米拉斯治疗。我们的目的是评估阿普米拉斯52周的疗效和安全性。

方法

“欣然接受”研究是一项4期、多中心、随机、安慰剂对照、双盲研究。符合条件的患者在基线前患有慢性斑块状银屑病≥6个月;累及≥1个高影响区域;银屑病面积和严重程度指数评分≥3至≤10;皮肤病生活质量指数评分>10。患者被随机分组(2:1),在第0至16周接受每日两次30毫克阿普米拉斯或安慰剂治疗;之后,所有患者继续接受阿普米拉斯治疗(阿普米拉斯/阿普米拉斯)或从安慰剂转换为阿普米拉斯治疗(安慰剂/阿普米拉斯)直至第52周。

结果

在随机分组的277例患者中(阿普米拉斯组:185例,安慰剂组:92例),158例(阿普米拉斯/阿普米拉斯组:105例;安慰剂/阿普米拉斯组:53例)完成了52周治疗。继续接受阿普米拉斯治疗的患者在第16周时生活质量、瘙痒、皮肤不适/疼痛、患者报告的治疗益处和皮肤结局方面的改善在52周内得以维持。在第16周从安慰剂转换为阿普米拉斯治疗的患者在第52周时也有类似改善。未观察到新的安全信号。

结论

在“欣然接受”研究中,继续使用阿普米拉斯治疗至第52周时,第16周时生活质量和疾病严重程度的改善得以维持,且未出现新的安全信号。试验注册临床试验。

政府标识符

NCT03774875。

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