ARD:IL-12/23通路抑制剂优特克单抗或TNFi 治疗银屑病关节炎患者的持久性和有效性相当

2022-06-30 彼岸河边草 MedSci原创

在现实世界的PsABio研究中,经过1年的治疗,倾向评分调整后的比较显示出优特克单抗和肿瘤坏死因子抑制剂(TNFi)对银屑病关节炎治疗具有相当的整体持久性、有效性和安全性。

目的该研究评估了银屑病关节炎(PsA)开始使用IL-12/23抑制剂优特克单抗或肿瘤坏死因子抑制剂(TNFi)1年的真实世界治疗持久性和有效性。

方法PsABio (NCT02627768)是一项前瞻性、观察性研究,对PsA患者进行了一线至三线优特克单抗或 TNFi的随访。6 个月评估一次药物持久性、有效性(达到银屑病关节炎临床疾病活动指数(cDAPSA)低疾病活动度(LDA)/缓解和最小疾病活动度/极低疾病活动度 (MDA/VLDA))和安全性除了描述性统计数据外,还进行了跨队列的倾向评分(PS)调整比较通过匹配、分层、逆概率加权和协变量校正的方法来提高组间均衡性,削弱混杂因素影响的统计学方法)。

结果1年时,优特克单抗(n=317/438, 72.4%)和TNFin=321/455, 70.5%)组的总体持久性相似。停止/转换优特克单抗与TNFi的倾向评分调整 HR (95% CI)0.82 (0.60; 1.13)cDAPSA LDA(包括缓解)/缓解在55.9%/22.1% 的优特克单抗治疗和67.1%/31.7%TNFi治疗患者中实现;cDAPSA LDA的倾向评分调整OR (95%CI)0.80 (0.57; 1.10),缓解为 0.73 (0.49; 1.07)34.2%/11.9%的优特克单抗治疗患者和43.1%/12.6%TNFi治疗患者实现了MDA/VLDAMDAVLDA的倾向评分调整OR (95%CI)分别为0.89 (0.63; 1.26)0.90(0.54; 1.49)两组的安全性相似

结论在现实世界的PsABio研究中,经过1年的治疗,虽然未经调整的优特克单抗的持久性在数值上略高于 TNFi,而未经调整的疗效在数值上 TNFi 略高于优特克单抗,但倾向评分调整后的比较显示出优特克单抗和 TNFi 具有相当的整体持久性、有效性和安全性,适用于 PsA 中的两种作用模式。

出处:Gossec L, Siebert S, Bergmans P, et al. Persistence and effectiveness of the IL-12/23 pathway inhibitor ustekinumab or tumour necrosis factor inhibitor treatment in patients with psoriatic arthritis: 1-year results from the real-world PsABio Study. Annals of the Rheumatic Diseases 2022;81:823-830.

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    2023-01-20 jklm09
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    2022-06-30 lmm397
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    2022-06-30 snowpeakxu
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    2022-06-30 jjjiang0202
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    2022-06-30 xiongliangxl

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