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性别、年龄、疾病严重程度、体重指数和糖尿病可能不会影响治疗 16 周后骨关节炎患者对皮下注射替纳珠单抗的反应。安慰剂对照试验的亚组分析。

Gender, age, disease severity, body mass index and diabetes may not affect response to subcutaneous tanezumab in patients with osteoarthritis after 16 weeks of treatment. A subgroup analysis of placebo-controlled trials.

机构信息

Sorbonne University, INSERM, AP-HP Saint Antoine Hospital, Paris, France.

Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

Int J Clin Pract. 2021 Dec;75(12):e14975. doi: 10.1111/ijcp.14975. Epub 2021 Oct 21.

Abstract

AIM

To assess the impact of pre-specified patient characteristics on efficacy and safety of subcutaneous tanezumab in patients with osteoarthritis (OA).

METHODS

Data were pooled from two (efficacy; N = 1545) or three (safety; N = 1754) phase 3 placebo-controlled trials. Change from baseline to week 16 in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain, WOMAC Physical Function and patient global assessment of OA (PGA-OA) scores was compared between tanezumab (2.5 and 5 mg) and placebo groups via analysis of covariance. Treatment-emergent adverse events (TEAEs) were summarised descriptively. Analyses were done in patient subgroups (men or women; age <65, ≥65, or ≥75 years; body mass index [BMI] <25, 25 to <30, 30 to <35 or ≥35 kg/m ; diabetes or no diabetes; baseline WOMAC Pain score <7 or ≥7; and Kellgren-Lawrence [KL] grades 2, 3 or 4 in the index joint) and the overall population.

RESULTS

In all subgroups, improvements in WOMAC Pain were numerically greater and often statistically significant (P < .05) for both tanezumab groups compared with placebo. Results were similar for WOMAC Physical Function and PGA-OA. TEAE profiles were generally consistent across subgroups and similar to the overall population (ie slightly higher rates of TEAEs, serious TEAEs and severe TEAEs with tanezumab relative to placebo) with a few exceptions. Exceptions included women reporting slightly more TEAEs with tanezumab than men, and patients with diabetes reporting slightly more severe TEAEs with tanezumab than patients without diabetes. Additionally, TEAEs were more frequent with tanezumab than placebo in the age ≥65 and ≥75 years, but not the age <65 years, subgroups.

CONCLUSIONS

Efficacy and safety/tolerability of tanezumab may not be meaningfully impacted by gender, age, BMI, diabetes status, baseline pain severity or KL grade in the index joint. Conclusions are limited by low patient number in some subgroups. Clinicaltrials.gov: NCT02697773, NCT02709486, NCT01089725.

摘要

目的

评估特定患者特征对皮下注射替纳珠单抗治疗骨关节炎(OA)患者疗效和安全性的影响。

方法

数据来自两项(疗效;n=1545)或三项(安全性;n=1754)安慰剂对照 3 期研究的汇总分析。通过协方差分析比较替纳珠单抗(2.5 和 5mg)和安慰剂组在基线至第 16 周时的西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)疼痛、WOMAC 躯体功能和患者 OA 整体评估(PGA-OA)评分的变化。采用描述性方法汇总治疗出现的不良事件(TEAE)。在患者亚组(男性或女性;年龄<65、≥65 或≥75 岁;体重指数[BMI] <25、25 至<30、30 至<35 或≥35kg/m;糖尿病或无糖尿病;基线 WOMAC 疼痛评分<7 或≥7;和索引关节的 Kellgren-Lawrence[KL]分级 2、3 或 4)和总体人群中进行分析。

结果

在所有亚组中,与安慰剂相比,替纳珠单抗组的 WOMAC 疼痛改善程度更大且通常具有统计学意义(P<.05)。替纳珠单抗组的 WOMAC 躯体功能和 PGA-OA 结果相似。TEAE 谱在各亚组中基本一致,与总体人群相似(即替纳珠单抗组的 TEAE、严重 TEAE 和重度 TEAE 发生率略高于安慰剂组),但也有一些例外。例外情况包括与男性相比,女性报告替纳珠单抗治疗组的 TEAE 略多,以及与无糖尿病患者相比,糖尿病患者报告替纳珠单抗治疗组的重度 TEAE 略多。此外,替纳珠单抗组的 TEAE 发生率高于安慰剂组,年龄≥65 岁和≥75 岁组,但年龄<65 岁组则无此现象。

结论

替纳珠单抗的疗效和安全性/耐受性可能不受性别、年龄、BMI、糖尿病状况、基线疼痛严重程度或索引关节的 KL 分级的影响。结论受到一些亚组患者数量较少的限制。Clinicaltrials.gov:NCT02697773、NCT02709486、NCT01089725。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbd9/9285028/13ba0b2b0162/IJCP-75-0-g001.jpg

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