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司库奇尤单抗在银屑病关节炎中的留存率及治疗持续性的预测因素:一项意大利多中心研究的结果

Ixekizumab Retention Rate and Predictors of Treatment Persistence in Psoriatic Arthritis: Results of an Italian Multicenter Study.

作者信息

Mazzanti Camilla, Paroli Marino, Santoboni Gianluca, Addimanda Olga, Raffeiner Bernd, Bezzi Alessandra, Visalli Elisa, Celletti Eleonora, Farina Antonella, Bernardi Simone, Larosa Maddalena, Andracco Romina, Del Medico Patrizia, Colella Molica Aldo Biagio, Giuggioli Dilia, Lumetti Federica, Sandri Gilda, Priora Marta, Serale Francesca, Nucera Valeria, Ometto Francesca, Bravi Elena, Lo Gullo Alberto, Scolieri Palma, Parisi Simone, Ravagnani Viviana, Vitetta Rosetta, Marchetta Antonio, Becciolini Andrea, Angrisani Claudio, De Simone Massimiliano, Caccavalle Rosalba, Reta Massimo, Magnani Mirco, Mascella Fabio, Foti Roberta, Amato Giorgio, De Lucia Francesco, Dal Bosco Ylenia, Foti Rosario, Di Penta Myriam, Sabatini Emanuela, Del Biondo Pietro, Girelli Francesco, Camellino Dario, Bianchi Gerolamo, Mansueto Natalia, Smerilli Gianluca, Franchina Veronica, Salvarani Carlo, Ianniello Aurora, Giampietro Cecilia, Di Donato Eleonora, Santilli Daniele, Lucchini Gianluca, Arrigoni Eugenio, Platè Ilaria, Bruzzese Vincenzo, Fusaro Enrico, Ditto Maria Chiara, Murgia Davide, Rovera Guido, Volpe Alessandro, Ferrero Giulio, Adorni Giuditta, Molica Francesco Colella, Ariani Alarico

机构信息

Center for the diagnosis and therapy of autoimmune rheumatological diseases, Belcolle Hospital, Viterbo, Italy.

Polo Pontino Sapienza University of Rome, Rome, Italy.

出版信息

J Psoriasis Psoriatic Arthritis. 2025 May 13:24755303251342503. doi: 10.1177/24755303251342503.

Abstract

UNLABELLED

IXE (Ixekizumab) is a monoclonal antibody targeting interleukin-17A (IL17A) which has demonstrated significant efficacy and safety in the management of psoriatic arthritis (PsA) in randomized controlled trials (RCTs). However, available data on long-term persistence of therapy are scarce.

METHODS

This multi-center study aimed to evaluate the drug retention rate (DRR) of IXE in a real-world setting and to identify key factors influencing treatment persistence. 195 patients with PsA treated with IXE between 2018 and 2024 were included. The primary outcome was DRR, calculated at 360, 720, and 1080 days after treatment initiation. Clinical and demographic factors were analyzed as potential predictors of IXE treatment permanency.

RESULTS

IXE retention rates were 66% at 360 days, 49% at 720 days, and 39% at 1080 days. Low baseline disease activity was a strong predictor of higher retention (HR 0.24, 95% CI: 0.09-0.62, = 0.003), while younger age was significantly associated with improved persistence (HR 0.98, 95% CI: 0.96-1.00, = 0.045). Conversely, patients with both axial and peripheral joint involvement were more likely to discontinue therapy (HR 1.78, 95% CI: 1.04-3.06, = 0.036), as were those receiving IXE as a second- or third-line therapy (HR 1.17, 95% CI: 1.02-1.33, = 0.021).

CONCLUSIONS

This multicenter real-world study confirms the long-term retention rate of IXE in PsA. The findings highlight key factors influencing treatment persistence and provide valuable insights to optimize patient management. Further real-world research is needed to better understand the therapeutic performance of IXE in different patient populations.

摘要

未标注

IXE(司库奇尤单抗)是一种靶向白细胞介素-17A(IL17A)的单克隆抗体,在随机对照试验(RCT)中已证明其在治疗银屑病关节炎(PsA)方面具有显著疗效和安全性。然而,关于长期持续治疗的数据却很匮乏。

方法

这项多中心研究旨在评估IXE在实际临床环境中的药物留存率(DRR),并确定影响治疗持续性的关键因素。纳入了195例在2018年至2024年间接受IXE治疗的PsA患者。主要结局指标是DRR,在治疗开始后的360天、720天和1080天计算得出。对临床和人口统计学因素进行分析,作为IXE治疗持续性的潜在预测因素。

结果

IXE在360天时的留存率为66%,720天时为49%,1080天时为39%。低基线疾病活动度是更高留存率的有力预测因素(风险比[HR] 0.24,95%置信区间[CI]:0.09 - 0.62,P = 0.003),而年龄较小与更好的持续性显著相关(HR 0.98,95% CI:0.96 - 1.00,P = 0.045)。相反,既有轴向关节又有外周关节受累的患者更有可能停药(HR 1.78,95% CI:1.04 - 3.06,P = 0.036),接受IXE作为二线或三线治疗的患者也是如此(HR 1.17,95% CI:1.02 - 1.33,P = 0.021)。

结论

这项多中心实际临床研究证实了IXE在PsA中的长期留存率。研究结果突出了影响治疗持续性的关键因素,并为优化患者管理提供了有价值的见解。需要进一步的实际临床研究,以更好地了解IXE在不同患者群体中的治疗效果。

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本文引用的文献

1
Axial Disease in Psoriatic Arthritis: A Challenging Domain in Clinical Practice.
Diagnostics (Basel). 2024 Jul 30;14(15):1637. doi: 10.3390/diagnostics14151637.
2
Retention Rate of Ixekizumab in Psoriatic Arthritis: A Real-World Study.
J Pers Med. 2024 Jul 3;14(7):716. doi: 10.3390/jpm14070716.
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BASDAI versus ASDAS in evaluating axial involvement in patients with psoriatic arthritis: a pooled analysis of two phase 3 studies.
Rheumatol Adv Pract. 2024 Apr 23;8(2):rkae058. doi: 10.1093/rap/rkae058. eCollection 2024.
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Comorbidities in Psoriatic Arthritis: A Narrative Review.
Clin Ther. 2023 Feb;45(2):177-189. doi: 10.1016/j.clinthera.2023.01.006. Epub 2023 Feb 2.

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