BJD:司库奇尤单抗每周两次与每周四次给药对斑块型银屑病患者的疗效分析

2021-09-04 医路坦克 MedSci原创

银屑病是一种慢性炎症,在其长期治疗中实现和维持最佳反应的治疗策略至关重要。

    银屑病是一种慢性炎症,在其长期治疗中实现和维持最佳反应的治疗策略至关重要。银屑病面积和严重程度指数 (PASI) 评分在临床上用于评估疾病严重程度和对治疗的反应。到治疗第 16 周 PASI 评分降低 75% (PASI75) 通常被一致认为是银屑病治疗的既定治疗目标。 司库奇尤单抗是一种全人源单克隆抗体,可选择性地中和 IL-17A,并在斑块状银屑病中显示出持久的疗效和安全性。

    该文旨在 16 周后达到 PASI75 但未达到 PASI90 的患者中,比较司库奇尤单抗 300 mg 每两周 (q2w) 每 4 周 300 mg (q4w) 的疗效和安全性。772 名中度至重度斑块状银屑病患者接受司库奇尤单抗 300mg 皮下注射。在第 1、2、3 和 4 周,然后 q4w 直到第 16 周。在第 16 周,PASI≥75 至 PASI<90 的患者按 1:1 随机分配继续 q4w (n=162) 或换 q2w (n= 163)至第 32 周。最终是第 32 周 PASI90 反应的 q2w 给药优于 q4w。

    结果:在达到 PASI75 但未达到 PASI90 的患者中,第 32 周的 PASI90 的患者数量上300mg q2w 组更多,但未达到统计学差异 (64.4 % 与 57.4%,OR0.64 95% CI[0.39, 1.07],p=0.087)。但在第 32 周,q2w 与 q4w 患者的绝对 PASI 显着降低(2.14 对 2.81,p=0.024)。 与 q4w 给药相比,q2w组中更多的患者在一周内表现出最小的疾病活动性(IGA0/1,71.2% 与 61.7%,p<0.05)和改善的 QoL(DLQI0/1,58.9% 与 50.5%,p<0.05)。

   结论:大多数患者使用司库奇尤单抗 q4w 达到 PASI90 反应。在一些PASI75 但未达到 PASI90 的患者中,q2w 给药具有潜在益处。即使在 16 周后继续 q4w 治疗也可以改善反应。

 原文出处:Reich K,  Körber A,  Mrowietz U, Secukinumab 2-weekly vs. 4-weekly dosing in patients with plaque-type psoriasis: results from the randomized GAIN study.Br J Dermatol 2021 05;184(5) 

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    2021-09-04 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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