J Rheumatol:巴瑞克替尼治疗活动性类风湿性关节炎超过2年的安全性特征

2018-09-19 xiangting MedSci原创

在对暴露时间长达5.5年的中重度活动性RA患者的综合分析中,证实疗效的同时,巴瑞克替尼具有可接受的安全性。

巴瑞克替尼是一种口服、每日一次的选择性Janus激酶(JAK1/JAK2)抑制剂,适用于中至重度活动性类风湿性关节炎(RA)成年患者。研究人员使用综合数据库[8项III/II/Ib期试验、1项长期延长(LTE)]评估了288周内(截至2016年9月1日)巴瑞克替尼的安全性特征。

"全部-巴瑞克替尼-RA"组包括接受任何巴瑞克替尼剂量的患者。基于6项使用4mg巴瑞克替尼和安慰剂直至24周的研究进行安慰剂比较("安慰剂-4mg"数据集)。基于4项研究评估剂量反应,其中使用2mg和4mg巴瑞克替尼包括LTE数据("2mg-4mg-延长")。使用非对照全部-巴瑞克替尼-RA描述不常见事件。

共有3492名患者接受巴瑞克替尼治疗,暴露的总患者年(PY)为6637(中位数为2年,最长为5.5年)。4mg vs 安慰剂 或4mg vs 2mg的死亡率、导致停药的不良事件、恶性肿瘤,主要不良血管事件(MACE)或严重感染没有差异。与安慰剂相比,4mg组包括带状疱疹在内的感染更为常见。4mg组报道有深静脉血栓形成/肺栓塞,而安慰剂组没有报道[全部-巴瑞克替尼-RA发病率(IR)0.5/100PY];不同剂量组间或与已发表的RA比率相比,IR没有差异(2 mg vs 4 mg分别为0.5 vs 0.6/100 PY)。全部-巴瑞克替尼-RA组有6例淋巴瘤(IR 0.09/100 PY),3例肠穿孔(0.05/100 PY),10例肺结核(均在流行区;0.15/100 PY)和22例全因死亡(0.33/100 PY)。恶性肿瘤(0.8/100 PY)和MACE(0.5/100 PY)的IR较低,并且随着暴露时间延长,IR不会增加。

在对暴露时间长达5.5年的中重度活动性RA患者的综合分析中,证实疗效的同时,巴瑞克替尼具有可接受的安全性。试验注册号:clinicaltrials.gov NCT01185353, NCT00902486, NCT01469013, NCT01710358, NCT01721044, NCT01721057, NCT01711359和NCT01885078。

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    2018-09-19 清风拂面

    谢谢分享学习

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