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Otten M, Greis C, Reinders P, Fleyder A, Reich K, Augustin M. Patient and physician outcomes of a store-and-forward teledermatology application in Germany. J Eur Acad Dermatol Venereol 2024; 38:e148-e151. [PMID: 37669866 DOI: 10.1111/jdv.19501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023]
Affiliation(s)
- M Otten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Greis
- Department of Dermatology, University Hospital Zurich, Zürich, Switzerland
| | - P Reinders
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Fleyder
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Reich K, Silverberg JI, Papp KA, Deleuran M, Katoh N, Strober B, Beck LA, de Bruin-Weller M, Werfel T, Zhang F, Biswas P, DiBonaventura MD, Chan G, Farooqui SA, Kerkmann U, Clibborn C. Abrocitinib effect on patient-reported outcomes in patients with moderate-to-severe atopic dermatitis: Results from phase 3 studies, including the long-term extension JADE EXTEND study. J Eur Acad Dermatol Venereol 2023; 37:2047-2055. [PMID: 37319109 DOI: 10.1111/jdv.19254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/26/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Abrocitinib improved signs and symptoms of moderate-to-severe atopic dermatitis (AD) at Weeks 12 and 16 in phase 3 studies, with a manageable safety profile. Patient-reported outcomes with long-term abrocitinib treatment were not reported. OBJECTIVE To evaluate patient-reported outcomes with long-term abrocitinib treatment in patients with moderate-to-severe AD. METHODS JADE EXTEND (NCT03422822) is an ongoing, phase 3, long-term extension study that enrolled patients from previous abrocitinib AD trials. This analysis includes patients from the phase 3 trials JADE MONO-1 (NCT03349060), JADE MONO-2 (NCT03575871) and JADE COMPARE (NCT03720470) who completed the full treatment period of placebo or abrocitinib (200 or 100 mg once daily) and subsequently entered JADE EXTEND and were randomised to receive once-daily abrocitinib 200 or 100 mg. Patient-reported endpoints to Week 48 included the proportion of patients who achieved Dermatology Life Quality Index (DLQI) scores of 0/1 (no effect of AD on quality of life [QoL]) and a ≥4-point improvement in Patient-Oriented Eczema Measure (POEM) score (clinically meaningful improvement). Data cut-off: April 22, 2020. RESULTS Baseline DLQI mean scores were 15.4 and 15.3 in the abrocitinib 200- and 100-mg groups, respectively, which corresponded to a 'very large effect' on QoL; at Week 48, mean DLQI scores were lower with abrocitinib 200 mg (4.6; 'small effect' on QoL) and abrocitinib 100 mg (5.9; 'moderate effect' on QoL). Baseline POEM mean scores were 20.4 and 20.5 in the abrocitinib 200- and 100-mg groups, respectively; at Week 48, mean POEM scores were 8.2 and 11.0. Week 48 patient-reported responses with abrocitinib 200 mg and abrocitinib 100 mg were 44% and 34% for DLQI 0/1, and 90% and 77% for a ≥4-point reduction in POEM score. CONCLUSION In patients with moderate-to-severe AD, long-term abrocitinib treatment resulted in clinically meaningful improvement in patient-reported symptoms of AD, including QoL.
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Affiliation(s)
- K Reich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Moonlake Immunotherapeutics AG, Zug, Switzerland
| | - J I Silverberg
- The George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - K A Papp
- Alliance Clinical Trials and Probity Medical Research, Waterloo, Ontario, Canada
- The University of Toronto, Toronto, Ontario, Canada
| | - M Deleuran
- Aarhus University Hospital, Aarhus, Denmark
| | - N Katoh
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - B Strober
- Yale University, New Haven, Connecticut, USA
- Central Connecticut Dermatology Research, Cromwell, Connecticut, USA
| | - L A Beck
- University of Rochester Medical Center, Rochester, New York, USA
| | | | - T Werfel
- Hannover Medical School, Hannover, Germany
| | - F Zhang
- Pfizer Inc., Groton, Connecticut, USA
| | - P Biswas
- Pfizer Inc., New York City, New York, USA
| | | | - G Chan
- Pfizer Inc., Groton, Connecticut, USA
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Schäkel K, Reich K, Asadullah K, Pinter A, Jullien D, Weisenseel P, Paul C, Gomez M, Wegner S, Personke Y, Kreimendahl F, Chen Y, Angsana J, Leung MWL, Eyerich K. Early disease intervention with guselkumab in psoriasis leads to a higher rate of stable complete skin clearance ('clinical super response'): Week 28 results from the ongoing phase IIIb randomized, double-blind, parallel-group, GUIDE study. J Eur Acad Dermatol Venereol 2023; 37:2016-2027. [PMID: 37262309 DOI: 10.1111/jdv.19236] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Guselkumab is an interleukin (IL)-23 inhibitor with demonstrated efficacy in patients with psoriasis. OBJECTIVES Evaluate the impact of early disease intervention on clinical responses following 28 weeks of guselkumab treatment in patients with moderate-to-severe plaque psoriasis. Correlate clinical response and disease duration data with serum biomarker data. METHODS GUIDE is a phase IIIb randomized, double-blind, parallel-group, multicentre study of adults with moderate-to-severe plaque psoriasis. In study part 1, patients with a short disease duration (SDD [≤2 years]) or a long disease duration (LDD [>2 years]) received guselkumab 100 mg at Week (W) 0, 4, 12, and 20. Those achieving complete skin clearance at W20 and W28 were defined as a super responder (SRe). A multivariable logistic regression analysed the association between baseline factors and the likelihood of becoming an SRe. The relationship between clinical response, disease duration and serum biomarker data was assessed at W0 and 4. RESULTS In total, 880 patients were enrolled (SDD/LDD = 40.6%/59.4% of patients). More SDD than LDD patients achieved absolute Psoriasis Area and Severity Index (PASI) = 0 at W28 (51.8% vs. 39.4%) and were SRes (43.7% vs. 28.1% [overall 34.4%]). SDD patients also achieved PASI = 0 quicker than LDD patients (median 141 vs. 200 days). Disease duration and prior biologic use had the greatest impact on becoming an SRe, with no strong association among these independent variables. At baseline, there were no significant differences in the serum biomarker levels of IL-17A, IL-17F, IL-22 and β-defensin 2 between SDD and LDD patients, or between SRe and non-SRe patients. Guselkumab rapidly decreased these markers of systemic inflammation across all patient groups analysed at W4. Guselkumab was well tolerated. CONCLUSIONS Guselkumab efficacy was consistent across subpopulations, on the skin and systemically. The proportion of SRes was higher in SDD than LDD patients, indicating early treatment intervention may improve clinical outcomes.
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Affiliation(s)
- K Schäkel
- Department of Dermatology, and Interdisciplinary Center for Inflammatory Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Asadullah
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Prof. Dr. med. Asadullah, Dermatological Practice, Potsdam, Germany
| | - A Pinter
- University Hospital Frankfurt am Main, Frankfurt, Germany
| | - D Jullien
- Department of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - C Paul
- Toulouse University, Toulouse, France
| | - M Gomez
- Janssen-Cilag GmbH, Neuss, Germany
| | - S Wegner
- Janssen-Cilag GmbH, Neuss, Germany
| | | | | | - Y Chen
- Janssen R&D, LLC, San Diego, USA
| | | | | | - K Eyerich
- Department of Dermatology and Venereology, Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
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Valencia López M, Meineke A, Stephan B, Rustenbach S, Kis A, Thaci D, Mrowietz U, Reich K, Staubach-Renz P, von Kiedrowski R, Bogena H, Augustin M. SARS-CoV-2 vaccination status and adverse events among patients with psoriasis - data from the German Registries PsoBest and CoronaBest. J Eur Acad Dermatol Venereol 2023. [PMID: 36914370 DOI: 10.1111/jdv.19039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/16/2023]
Affiliation(s)
- M Valencia López
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Meineke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - B Stephan
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - S Rustenbach
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - A Kis
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - D Thaci
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - U Mrowietz
- Psoriasis Center Kiel, Department of Dermatology, Venereology and Allergology University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - P Staubach-Renz
- Department of Dermatology and Allergy, University Medical Center Mainz, Mainz, Germany
| | | | - H Bogena
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Reich K, de Bruin-Weller MS, Deleuran M, Calimlim BM, Chen N, Hu X, Tenorio AR, Silverberg JI. Higher levels of response on clinical atopic dermatitis severity measures are associated with meaningful improvements in patient-reported symptom and quality of life measures: Integrated analysis of three Upadacitinib phase 3 trials. J Eur Acad Dermatol Venereol 2023. [PMID: 36840396 DOI: 10.1111/jdv.18995] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND It is not fully understood how different degrees of improvements in atopic dermatitis (AD) clinical outcome measures translate to improvements in patient-reported outcome (PRO) measures, such as those assessing itch, symptoms, sleep, anxiety, depression, quality of life (QoL), and work productivity. OBJECTIVES This post hoc analysis of three clinical studies assessed how more robust improvements in clinical responses are associated with improvements in PROs and QoL. METHODS Data from three randomized, double-blind, placebo-controlled, phase 3 trials in adults and adolescents with moderate to severe atopic dermatitis (Measure Up 1, Measure Up 2, and AD Up) were included. Patients were randomly assigned (1:1:1) to upadacitinib (15 or 30 mg) or placebo once daily (alone or in combination with topical corticosteroids). The mean percentage improvement from baseline to week 16 and percentage of patients achieving responses at week 16 were summarized by the Eczema Area and Severity Index (EASI) and validated Investigator Global Assessment of Atopic Dermatitis (vIGA-AD) response level categories. RESULTS A total of 2392 patients from the three trials were included in the analysis. Increasingly greater mean percentage improvement and proportion of patients achieving response was observed at higher clinical response levels (i.e., stepwise pattern). Mean percentage improvement and proportion of patients achieving response exceeded 69% and 70% at EASI ≥ 90 and vIGA-AD 0/1, respectively, for most PROs including Worst Pruritus Numeric Rating Scale, Patient Oriented Eczema Measure, and Dermatology Life Quality Index. CONCLUSIONS Greater degrees of clinical responses are related to more robust improvements across multiple dimensions impacted by AD, including itch, skin pain, sleep, anxiety, depression, and QoL.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M S de Bruin-Weller
- Department of Dermatology and Allergology, National Expertise Center of Atopic Dermatitis, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | | | - N Chen
- AbbVie Inc., North Chicago, Illinois, USA
| | - X Hu
- AbbVie Inc., North Chicago, Illinois, USA
| | | | - J I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Paus R, Keren A, Reich K, Bertolini M, Riethmüller C, Ullmann Y, Gilhar A. 323 A Novel, Stress-Responsive and Clinically Predictive Humanized Mouse Model of Atopic Dermatitis: Autologous Th2-Polarized Lymphocytes Suffice to Induce Characteristic Lesions in Healthy Non-Atopic Human Skin Xenotransplants In Vivo. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Reich K, Mrowietz U, Sorbe C, von Kiedrowski R, Diemert S, Schaeffer L, Kirsten N, Ben-Anaya N, Augustin M. Response to fumaric acid esters for plaque type psoriasis in real-world practice is largely independent of patient characteristics at baseline - a multivariable regression analysis from the German psoriasis registry PsoBest. J DERMATOL TREAT 2022; 33:3170-3177. [PMID: 35981144 DOI: 10.1080/09546634.2022.2115285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVES Fumaric acid esters (FAEs) are a well-established treatment option for long-term therapy of moderate to severe plaque psoriasis. This study examines effectiveness of FAEs for the treatment of plaque psoriasis in real-world practice at 12 months and if patient characteristics affect the odds of clinical response. METHODS A descriptive, multivariable logistic regression analysis was conducted in a cohort drawn from the German registry PsoBest. Baseline patient characteristics were assessed as potential treatment effect modifiers. RESULTS 444 patients (mean age 47.0 years, 39.0% female) were eligible for response analysis using nonresponder imputation at month 12. Of these, 39.6% achieved clinical response, i.e., Psoriasis Area and Severity Index (PASI) ≤3 or skin clearance. In logistic regression analysis (R2 = 0.114), only baseline PASI was a significant factor: patients with PASI <10 had a 4 times higher odds (p ≤ 0.001, OR 4.088), patients with PASI of 10-20 a twofold higher odds of response (p ≤ 0.044, OR 1.961) compared to those with PASI >20. Neither sex, age, body weight, disease duration, comorbidity nor pre-treatment had an impact on the odds of response (p > 0.05). CONCLUSIONS FAEs showed a favorable response at 12 months, largely independent of patient characteristics.
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Affiliation(s)
- K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - U Mrowietz
- Psoriasis-Center Kiel, Department of Dermatology, Venerology and Allergology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - C Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - S Diemert
- Almirall Hermal GmbH, Reinbek, Germany
| | - L Schaeffer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Ben-Anaya
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Reich K, Gordon KB, Strober B, Langley RG, Miller M, Yang YW, Shen YK, You Y, Zhu Y, Foley P, Blauvelt A. Super-Response to Guselkumab Treatment in Patients With Moderate-to-Severe Psoriasis: Age, Body Weight, Baseline Psoriasis Area and Severity Index, and Baseline Investigator's Global Assessment Scores Predict Complete Skin Clearance. J Eur Acad Dermatol Venereol 2022; 36:2393-2400. [PMID: 35920762 DOI: 10.1111/jdv.18474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Psoriasis is a chronic immune-mediated inflammatory skin disease that often leads to a diminished quality of life. Goals of treating patients with psoriasis have shifted with more focus on achieving near or complete clearance of the skin. Guselkumab, a fully human monoclonal antibody targeting interleukin-23, is effective in treating moderate-to-severe psoriasis. OBJECTIVE To describe the baseline characteristics of patients with moderate-to-severe psoriasis achieving super-response (Psoriasis Area and Severity Index [PASI] 100 response at Weeks 20 and 28) after commencing guselkumab treatment. METHODS Pooled data from VOYAGE-1 and VOYAGE-2 studies identified super-response; baseline demographic, disease, and pharmacokinetic characteristics were compared with non-super-response. A stepwise logistic regression analysis identified which factors were potentially predictive of super-response status, with significance level of 0.1. RESULTS A subset of patients randomized to guselkumab comprised this post hoc analysis (n=664); 271 patients achieved super-response vs 393 with non-super-response. Patient age at study entry and baseline body weight (≤90 kg vs >90 kg), PASI, and Investigator's Global Assessment (IGA) score were significant predictors of super-response status, with odds ratios (95% confidence intervals) of 0.98 (0.967-0.993; p=0.003), 1.42 (1.026-1.977; p=0.034), 0.97 (0.955-0.993; p=0.007), and 0.66 (0.433-0.997; p=0.048), respectively. More patients with super-response achieved an early response: Week 2 PASI 75 (5.5% vs 1.8%) and Week 8 PASI 100 (22.5% vs 3.3%) vs non-super-response. Median serum guselkumab concentrations through Week 28 were slightly greater in patients with super-response vs non-super-response. CONCLUSION Guselkumab was more likely to achieve early clinical responses (complete skin clearance) in younger patients, less obese patients, and patients with less severe psoriasis.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K B Gordon
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - B Strober
- Yale University, New Haven, CT, USA.,Central Connecticut Dermatology Research, Cromwell, CT, USA
| | - R G Langley
- Dalhousie University, Halifax, Nova Scotia, Canada
| | - M Miller
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Y-W Yang
- Immunology Global Medical Affairs, Janssen Pharmaceutical Companies of Johnson & Johnson, LLC , Horsham, PA, USA
| | - Y-K Shen
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Y You
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Y Zhu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - P Foley
- The University of Melbourne, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Probity Medical Research Inc., Skin Health Institute, Carlton, VIC, Australia
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
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Lindner L, Augustin M, Kühl L, Weiß A, Rustenbach SJ, Behrens F, Feuchtenberger M, Schwarze I, Mrowietz U, Thaçi D, Reich K, Strangfeld A, Regierer A. AB0952 Characterization of patients with psoriatic arthritis in dermatologic and rheumatologic care: an analysis of two disease registries. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPsoriatic arthritis (PsA) is a chronic inflammatory disease affecting the musculoskeletal system, skin and nails. Therapeutic management in Germany is usually provided by a dermatologist or rheumatologist.ObjectivesThe aim is to characterize the socioeconomic and clinical patient profiles in dermatologic and rheumatologic settings.MethodsBaseline data of patients with PsA from [1] the dermatological German Psoriasis Registry PsoBest (PB) and [2] the rheumatological German disease register RABBIT-SpA (RS) [2] were analyzed. For this purpose, comparable anamnestic and clinical variables collected in the period 10/2017 to 12/2020 were identified and descriptively analyzed. The analysis was carried out in each of the data-holding registers.Results1066 RS patients and 704 PB patients were included in the analysis (Table 1). The proportion of women was higher in the rheumatology setting (RS) (60% vs. 49%). Disease duration of psoriasis was longer in the dermatology setting (PB). Cutaneous severity was higher in PB, including affected body surface area and nail psoriasis. However, more patients in RS had tender joints and swollen joints. The physician-reported global disease activity was higher in RS. The mean DLQI (Dermatology Life Quality Index) was higher in PB and the mean HAQ (Health Assessment Questionnaire) was higher in RS. Patient reported global disease activity and pain were lower in PB.Table 1.Baseline data of patients with PsA from the registers PsoBest and RABBIT-SpA included 10/2017 to 12/2020.RABBIT-SpA(Rheumatology setting)PsoBest(Dermatology setting)N1066704Age, mean (SD)51.9 (12.2)51.7 (13.2)Female, n (%)637 (60)346 (49)Disease duration skin, mean (SD)14.3 (13.9)21.6 (16.0)Body surface area, mean (SD)8.5 (15.0)20.8 (19.8)Nail psoriasis, n (%)434 (41)407 (58)Tender joints, n (%)905 (85)498 (71)Swollen joints, n (%)708 (67)387 (55)Physician reported disease activity, mean (SD)5.2 (1.9)4.6 (2.7)DLQI, mean (SD)5.6 (6.2)12.2 (7.6)HAQ, mean (SD)0.9 (0.7)0.7 (0.6)Patient reported disease activity, mean (SD)5.7 (2.4)4.9 (2.9)Patient reported pain, mean (SD)5.5 (2.4)5.2 (2.8)bDMARD, n (%)751 (71)514 (73)TNF, n (%)346 (46)117 (23)IL17, n (%)351 (47)246 (48)IL23, n (%)54 (7)151 (29)tsDMARD, n (%)109 (10)47 (7)csDMARD, n (%)195 (18)142 (20)Most of the patients received biologics at inclusion (RS: 71% and PB: 73%). In the dermatology setting IL23 inhibitors were used more frequently, whereas TNF inhibitors were used more frequently in the rheumatology setting.ConclusionThe clinical specialization of the treating physician was associated with a different treatment and clinical status of patients with PsA. Our analysis showed that patients in the rheumatology setting more frequently had joint affections and lower functional status, whereas skin severity was worse in the dermatology setting, indicating selection effects of health care access. We hypothesize out that these differences may be biased due to different diagnostic and therapeutic routines in the specialized health care settings. Psoriatic arthritis should be treated in a multidisciplinary approach to take into account all facets of this complex disease.References[1]PMID: 24393314[2]PMID: 30874933Disclosure of InterestsLisa Lindner Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Matthias Augustin Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Laura Kühl Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Weiß Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Stephan Jeff Rustenbach Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Frank Behrens: None declared, Martin Feuchtenberger: None declared, Ilka Schwarze: None declared, Ulrich Mrowietz: None declared, Diamant Thaçi: None declared, Kristian Reich Grant/research support from: The PsoBest registry is/was supported by AbbVie, Almirall Hermal, Amgen, Biogen, BMS, Celgene, Hexal, Janssen-Cilag, LEO Pharma, Eli Lilly, Medac, Novartis, Pfizer, UCB and Viatris. These companies do not have influence on the design of the registry, data collection, analyses, the publication decisions or development., Anja Strangfeld Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris., Anne Regierer Grant/research support from: RABBIT-SpA is supported by a joint, unconditional grant from AbbVie, Amgen, Biogen, Hexal, Janssen-Cilag, Lilly, MSD, Novartis, Pfizer, UCB and Viatris.
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Mease PJ, Foley P, Reich K, Chakravarty SD, Shawi M, Yang YW, Miller M, Kollmeier A, Xu XL, Yu J, Wang Y, Sheng S, You Y, Mcinnes I. AB0892 Targeted Safety Analyses of Guselkumab: Long-Term Results from Randomized Clinical Trials in Patients with Active Psoriatic Arthritis and Moderate to Severe Psoriasis. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundGuselkumab (GUS) demonstrated efficacy and a favorable safety profile in active PsA in the Phase (Ph) 21 and Ph3 DISCOVER-1&2 trials2,3 and in moderate-to-severe plaque psoriasis (PsO) in the Ph3 VOYAGE-1&2 trials.4,5ObjectivesTo assess long-term safety of GUS across PsA/PsO trials.MethodsUsing pooled safety data through 2 years (yrs) from PsA trials (N=1229; GUS 100 mg every 4/8 weeks [Q4W/Q8W])1-3 and through 5 yrs from PsO trials (N=1721; GUS 100 mg Q8W),4,5 incidences of serious adverse events (SAEs); gastrointestinal (GI)-related SAEs and other targeted AEs; including candidiasis, uveitis, and opportunistic infections (OIs) were evaluated. Incidence rates (IRs) were calculated as the number of events per 100 pt-yrs (PY) of follow-up with 95% CI. Patients (pts) with an IBD history were not excluded in PsA/PsO trials. Max exposure duration was W100 for PsA trials and W252 for PsO trials.ResultsThe PsA and PsO populations had comparable mean age and BMI. IRs of SAEs and GI-related SAEs were generally similar between GUS- and PBO-treated pts during PBO-controlled periods, and between PsA pts receiving GUS Q4W/Q8W for up to 2 yrs and PsO pts receiving GUS Q8W for up to 5 yrs (Table 1). IRs of other targeted AEs of interest were low. OIs did not occur in PsO pts and were infrequent in PsA pts (Table 1). Candidal infections were infrequent and non-serious. Iridocyclitis was reported in 1 PBO- and 1 GUS Q8W-treated PsA pt. No exacerbations or new onset of IBD or active tuberculosis was reported in GUS-treated PsA/PsO pts.Table 1.Targeted AEs of InterestPooled PsA*Pooled PsOThrough 2 YrsThrough 5 YrsGUS 100 mg Q4W (N=373)GUS 100 mg Q8W (N=475)PBO→GUS 100 mg Q4W (N=352)aPBO→GUS 100 mg Q8W (N=29)aGUS Combined (N=1229)GUS 100 mg Q8W (N=1221)bADA→GUS 100 mg Q8W (N=500)cGUS Combined (N=1721)Total PY645748461171871525419127166Mean PY1.71.61.30.61.54.33.84.2Events/100 PY (95% CI)Overall SAEs4.65(3.14, 6.64)6.42(4.73, 8.51)5.86(3.86, 8.52)0.00(0.00, 17.24)5.61(4.59, 6.79)5.18(4.58, 5.83)4.55(3.64, 5.61)5.01(4.50, 5.56)GI-related SAEs0.46(0.10, 1.36)0.27(0.03, 0.97)0.00 (0.00, 0.65)0.00(0.00, 17.24)0.27(0.09, 0.62)0.44(0.28, 0.66)0.42(0.18, 0.82)0.43(0.29, 0.61)OIsd0.00(0.00, 0.46)0.27(0.03, 0.97)0.22(0.01, 1.21)0.00(0.00, 17.24)0.16(0.03, 0.47)0.00(0.00, 0.06)0.00(0.00, 0.16)0.00(0.00, 0.04)Candida infections0.31(0.04, 1.12)0.00(0.00, 0.40)0.00(0.00, 0.65)0.00(0.00, 17.24)0.11(0.01, 0.39)0.49(0.32, 0.73)0.52(0.25, 0.96)0.50(0.35, 0.70)Non-pathogen specific fungal infections, suspicious for candida0.00(0.00, 0.46)0.27(0.03, 0.97)0.00(0.00, 0.65)0.00(0.00, 17.24)0.11(0.01, 0.39)0.11(0.04, 0.25)0.16(0.03, 0.46)0.13(0.06, 0.24)Uveitis/ Iridocyclitis0.00(0.00, 0.46)0.13(0.00, 0.75)0.00(0.00, 0.65)0.00(0.00, 17.24)0.05(0.00, 0.30)0.00(0.00, 0.06)0.00(0.00, 0.16)0.00(0.00, 0.04)*In PsA Ph2, data after early escape at W16 were excluded. AEs are coded using MedDRA Version 23.1aFor PBO→GUS, data on/after 1st GUS administration were includedbPBO crossover pts were included in GUS column after crossover to GUScEvents prior to GUS (ADA events) were excluded. Only includes pts randomized to ADA at W0 and crossed over to GUS at/after W52 for VOYAGE-1 & W28 for VOYAGE-2dHerpes zoster disseminated, fungal oesophagitis, and meningitis listeria (1 each)ADA=AdalimumabConclusionIRs of SAEs; GI-related SAEs; and AEs of interest including candidiasis, uveitis, and OIs were low, or no cases were reported. No new safety concerns were identified with GUS treatment through 2 yrs and 5 yrs of follow-up in the pooled PsA and PsO trials, respectively, supporting a durable and favorable GUS safety profile consistent between pts with active PsA and moderate-to-severe PsO.References[1]Deodhar A, et al. Lancet. 2018;391:2213-2224.[2]Deodhar A, et al. Lancet. 2020;395:1115-1125.[3]Mease PJ, et al. Lancet. 2020;395:1126-1136.[4]Blauvelt A, et al. J Am Acad Dermatol. 2017;76:405-417.[5]Reich K, et al. J Am Acad Dermatol. 2017;76:418-431.Disclosure of InterestsPhilip J Mease Speakers bureau: AbbVie, Aclaris, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Celgene, Crescendo Bioscience, Genentech, Inmagene, Janssen, Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB, Consultant of: AbbVie, Aclaris, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Celgene, Crescendo Bioscience, Genentech, Inmagene, Janssen, Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB, Grant/research support from: AbbVie, Aclaris, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Celgene, Crescendo Bioscience, Genentech, Inmagene, Janssen, Lilly, Merck, Novartis, Pfizer, SUN Pharma, and UCB, Peter Foley Speakers bureau: AbbVie, Celgene, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Valeant, Galderma, GlaxoSmithKline, Leo Pharma, and Roche, Paid instructor for: (Advisory boards) AbbVie, Amgen, Aslan, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Sun Pharma, UCB Pharma, Valeant, Galderma, GlaxoSmithKline, Leo Pharma, and Sanofi, Consultant of: Janssen, Eli Lilly, Novartis, Pfizer, UCB Pharma, Bristol-Myers Squibb, Galderma, Leo Pharma, and Roche; investigator for AbbVie, Amgen, AstraZeneca, Arcutis, Aslan, Boehringer Ingelheim, Celgene, Hexima, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Sun Pharma, UCB Pharma, Valeant, Bristol-Myers Squibb, Celtaxsys, CSL, Cutanea, Dermira, Galderma, Genentech, GlaxoSmithKline, Leo Pharma, Regeneron Pharmaceuticals Inc, Reistone, Roche, and Sanofi, Grant/research support from: AbbVie, Amgen, Celgene, Janssen, Leo Pharma, Eli Lilly, Merck, Novartis, Pfizer, Sanofi, and Sun Pharma; travel grants from AbbVie, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Galderma, Leo Pharma, Roche, Sun Pharma, and Sanofi; served as speaker for or received honoraria from AbbVie, Celgene, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Valeant, Galderma, GlaxoSmithKline, Leo Pharma, and Roche, Kristian Reich Speakers bureau: Abbvie, Affibody, Amgen, Biogen, Boehringer Ingelheim Pharma, Bristol Myers Squibb, Celgene, Centocor, Covagen, Eli Lilly, Forward Pharma, Galderma, GlaxoSmithKline, Janssen-Cilag, Leo, Medac, Merck Sharp & Dohme Corp., Novartis, Ocean Pharma, Pfizer, Regeneron, Sanofi, Takeda, UCB Pharma, and Xenoport, Paid instructor for: Abbvie, Affibody, Amgen, Biogen, Boehringer Ingelheim Pharma, Bristol Myers Squibb, Celgene, Centocor, Covagen, Eli Lilly, Forward Pharma, Galderma, GlaxoSmithKline, Janssen-Cilag, Leo, Medac, Merck Sharp & Dohme Corp., Novartis, Ocean Pharma, Pfizer, Regeneron, Sanofi, Takeda, UCB Pharma, and Xenoport, Consultant of: Participated in clinical trials sponsored by Abbvie, Affibody, Amgen, Biogen, Boehringer Ingelheim Pharma, Bristol Myers Squibb, Celgene, Centocor, Covagen, Eli Lilly, Forward Pharma, Galderma, GlaxoSmithKline, Janssen-Cilag, Leo, Medac, Merck Sharp & Dohme Corp., Novartis, Ocean Pharma, Pfizer, Regeneron, Sanofi, Takeda, UCB Pharma, and Xenoport, Soumya D Chakravarty Employee of: Janssen Scientific Affairs, LLC and may own stock or stock options in Johnson & Johnson, May Shawi Employee of: Janssen Global Services, LLC and may own stock or stock options in Johnson & Johnson, Ya-Wen Yang Employee of: Janssen Global Services, LLC and may own stock or stock options in Johnson & Johnson, Megan Miller Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Alexa Kollmeier Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Xie L Xu Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Jenny Yu Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Yanli Wang Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Shihong Sheng Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Yin You Employee of: Janssen Research & Development, LLC and may own stock or stock options in Johnson & Johnson, Iain McInnes Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer-Ingelheim, Celgene, Eli Lilly, Gilead, Janssen, Novartis and UCB., Grant/research support from: Astra Zeneca, Bristol-Myers Squibb, Celgene, Janssen, Lilly, Novartis, and UCB
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Reich K, Iversen L, Puig L, Lambert J, Mrowietz U, Kaplan Saday K, Warren RB. Long‐term efficacy and safety of brodalumab in moderate‐to‐severe plaque psoriasis: a post hoc pooled analysis of AMAGINE‐2 and ‐3. J Eur Acad Dermatol Venereol 2022; 36:1275-1283. [DOI: 10.1111/jdv.18068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - L. Iversen
- Department of Dermatology Aarhus University Hospital Aarhus Denmark
| | - L. Puig
- Department of Dermatology Hospital de la Santa Creu i Sant Pau Autonomous University of Barcelona Barcelona Spain
| | - J. Lambert
- Department of Dermatology Ghent University Ghent Belgium
| | - U. Mrowietz
- Department of Dermatology University Medical Center Schleswig‐Holstein Kiel Germany
| | | | - R. B. Warren
- Dermatology Centre Salford Royal NHS Foundation Trust Manchester NIHR Biomedical Research Centre University of Manchester United Kingdom
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Gordon KB, Lebwohl M, Papp KA, Bachelez H, Wu JJ, Langley RG, Blauvelt A, Kaplan B, Shah M, Zhao Y, Sinvhal R, Reich K. Long-term safety of risankizumab from 17 clinical trials in patients with moderate-to-severe plaque psoriasis. Br J Dermatol 2021; 186:466-475. [PMID: 34652810 PMCID: PMC9298814 DOI: 10.1111/bjd.20818] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 01/14/2023]
Abstract
Background Risankizumab has demonstrated efficacy and safety in patients with moderate‐to‐severe plaque psoriasis in randomized clinical trials. Objectives To evaluate safety data from risankizumab psoriasis phase I–III clinical trials. Methods Short‐term safety (through week 16) was analysed using integrated data from five phase II and III clinical trials. Long‐term safety was evaluated using integrated data from 17 phase I–III completed and ongoing trials. Results Short‐term safety analyses included 1306 patients receiving risankizumab 150 mg and 300 patients receiving placebo [402·2 and 92·0 patient‐years (PY) of exposure, respectively]. Long‐term analyses included 3072 risankizumab‐treated patients (exposure: 7927 PY). The median (excluding four outliers) treatment duration was 2·9 years (range 2 days to 5·9 years). Exposure‐adjusted adverse event rates did not increase with long‐term treatment (318 vs. 171 events per 100 PY for short‐ and long‐term analyses). With long‐term risankizumab treatment, rates of serious adverse events were 7·8 per 100 PY, serious infections 1·2 per 100 PY, nonmelanoma skin cancer (NMSC) 0·7 per 100 PY, malignant tumours excluding NMSC 0·5 per 100 PY, and adjudicated major adverse cardiovascular events 0·3 per 100 PY, with no important identified risks. Limitations include that the study inclusion and exclusion criteria varied and that three studies enrolled ≤ 50 patients. Conclusions Risankizumab demonstrated a favourable safety profile over short‐ and long‐term treatment in patients with moderate‐to‐severe psoriasis. Whatis already known about this topic? In clinical trials of patients with moderate‐to‐severe plaque psoriasis, risankizumab, a selective interleukin‐23 inhibitor, was well tolerated and efficacious.
Whatdoes this study add? In this comprehensive evaluation of risankizumab safety in patients with moderate‐to‐severe psoriasis, adverse event rates were comparable between risankizumab (n = 1306, 402 patient‐years) and placebo (n = 300, 92 patient‐years) in the short‐term (16‐week) analysis set, and were consistent with those in the long‐term analysis (n = 3072, 7927 patient‐years of risankizumab exposure). These findings are consistent with the known safety profile of risankizumab and support its long‐term use in moderate‐to‐severe psoriasis.
Linked Comment: S. Mirali et al. Br J Dermatol 2022; 186:394–395. Plain language summary available online
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Affiliation(s)
- K B Gordon
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K A Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | - H Bachelez
- Hôpital Saint-Louis, AP-HP, Université de Paris, Paris, France
| | - J J Wu
- Dermatology Research and Education Foundation, Irvine, CA, USA
| | - R G Langley
- Division of Dermatology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - B Kaplan
- AbbVie Inc., North Chicago, IL, USA
| | - M Shah
- AbbVie Inc., North Chicago, IL, USA
| | - Y Zhao
- AbbVie Inc., North Chicago, IL, USA
| | | | - K Reich
- Center for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Reich K, Simpson E, Wollenberg A, Bissonnette R, Abe M, Cardillo T, Janes J, Sun L, Chen S, Silverberg J. 041 Efficacy with continuous dosing, down-titration, or treatment withdrawal after successful treatment with baricitinib in patients with moderate-to-severe atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Augustin M, Valencia López M, Reich K. Network meta-analyses in psoriasis: overview and critical discussion. J Eur Acad Dermatol Venereol 2021; 35:2367-2376. [PMID: 34506643 DOI: 10.1111/jdv.17650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/30/2021] [Indexed: 01/23/2023]
Abstract
Network meta-analyses (NMAs) increasingly assist in treatment decisions in disease areas such as psoriasis, where data from multiple clinical trials (CTs) on a growing number of different drugs become available. This study aimed to characterize NMAs published in psoriasis. A systematic literature search in PubMed was conducted using a structured search protocol based on the PRISMA criteria. Twenty-seven NMAs were identified, including an average of 43 CTs per NMA. Only eight of 27 NMAs (29.6%) were documented in the PROSPERO registry and only 17 (63%) reported following the PRISMA criteria. The mean number of patients per NMA was 19 624 (range: 6113-51 749). Across all NMAs, the drugs most frequently included were ustekinumab (n = 27 NMAs), followed by adalimumab (n = 25), infliximab and etanercept (n = 24 each). In all n = 27 NMAs, placebo comparisons and in n = 25, comparisons with active controls were used for bridging. Effect estimates were performed in all cases, SUCRA in 14. Most frequently used outcomes were Psoriasis Area and Severity Index (PASI) 75 (n = 25) and PASI 90 (n = 24), and Dermatology Life Quality Index (n = 10). NMAs mostly measured induction efficacy (weeks 10-16, n = 25) but rarely long-term outcomes (weeks 48-56, n = 4). Sensitivity analyses were performed in n = 17 (63%) of the studies. Main results varied considerably between studies and depended on the year of publication and thus the number of available drugs and studies. However, the concordance between NMA efficacy rankings based on PASI 75 was high. Although a large number of NMAs have been published on psoriasis showing highly comparable results on efficacy, no sufficient information on the quality criteria was reported, and PROSPERO registry criteria were not followed. This argues in favour of greater standardization of NMA methodology and reporting.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Valencia López
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Reich K, Mrowietz U, Menter A, Griffiths CEM, Bagel J, Strober B, Nunez Gomez N, Shi R, Guerette B, Lebwohl M. Effect of baseline disease severity on achievement of treatment target with apremilast: results from a pooled analysis. J Eur Acad Dermatol Venereol 2021; 35:2409-2414. [PMID: 34255891 DOI: 10.1111/jdv.17520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Treating to absolute treatment targets rather than relative measures such as Psoriasis Area and Severity Index (PASI)-75 is emerging as an important clinical concept included in psoriasis guidelines and clinical practice. Achieving treatment targets is associated with achievement of long-term outcomes. OBJECTIVE To evaluate the relationship between psoriasis severity, disease characteristics and achievement of PASI ≤2 with apremilast in a pooled analysis of the phase 3 ESTEEM 1 and 2 (NCT01194219 and NCT01232283), phase 3b LIBERATE (NCT01690299) and phase 4 UNVEIL (NCT02425826) clinical trials. METHODS Pooled data from patients with moderate-to-severe plaque psoriasis randomized to apremilast 30 mg BID were analysed by baseline PASI quartiles (Q1: 2.4-13.1; Q2: 13.2-15.9; Q3: 16.0-20.0; Q4: 20.1-57.8). Assessments included PASI, Dermatology Life Quality Index (DLQI), Scalp Physician's Global Assessment (ScPGA; ScPGA ≥1) and target (worst) Nail Psoriasis Severity Index (NAPSI; NAPSI ≥1). RESULTS Of 1062 patients, 963 had ScPGA ≥1 and 643 had NAPSI ≥1; 771 patients with baseline and Week 32 PASI assessments were included in analyses of Week 32 PASI target achievement. Rates of PASI ≤2 at Week 32 were greater in lower PASI quartiles (Q1: 43.5%; Q2: 31.2%; Q3: 26.8%; Q4: 18.4%). Most patients achieving PASI ≤2 target (83.6%) achieved DLQI ≤5 at Week 32; 59.3% of patients who did not achieve PASI ≤2 target achieved DLQI ≤5. At Week 32, mean improvements in ScPGA and NAPSI were similar with more moderate vs. more severe disease (ScPGA, range: 1.1-1.4; NAPSI, range: 1.6-2.5). In a subgroup analysis, achievement of PASI ≤2 target was higher in the lowest PASI quartile and with disease duration <5 years. CONCLUSIONS Greater achievement of PASI ≤2 was observed in patients with more moderate vs. more severe skin disease. Apremilast may be particularly beneficial in more moderate disease early in the treatment paradigm.
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Affiliation(s)
- K Reich
- Center for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - U Mrowietz
- University Medical Center Schleswig-Holstein Campus, Kiel, Germany
| | - A Menter
- Baylor University Medical Center, Dallas, TX, USA
| | - C E M Griffiths
- The Dermatology Centre, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - J Bagel
- Psoriasis Treatment Center of Central New Jersey, East Windsor, NJ, USA
| | - B Strober
- Yale University, New Haven, CT, USA.,Central Connecticut Dermatology Research, Cromwell, CT, USA
| | | | - R Shi
- Amgen Inc., Thousand Oaks, CA, USA
| | | | - M Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Reich K, Gordon KB, Strober BE, Armstrong AW, Miller M, Shen YK, You Y, Han C, Yang YW, Foley P, Griffiths CEM. Five-year maintenance of clinical response and health-related quality of life improvements in patients with moderate-to-severe psoriasis treated with guselkumab: results from VOYAGE 1 and VOYAGE 2. Br J Dermatol 2021; 185:1146-1159. [PMID: 34105767 DOI: 10.1111/bjd.20568] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Psoriasis is a chronic disease requiring long-term therapy. OBJECTIVES Physician- and patient-reported outcomes were evaluated through week 252 in VOYAGE 1 and VOYAGE 2. METHODS In total, 1829 patients were randomized at baseline to receive guselkumab 100 mg every 8 weeks, placebo or adalimumab. Patients receiving placebo crossed over to guselkumab at week 16. Patients receiving adalimumab crossed over to guselkumab at week 52 in VOYAGE 1, and randomized withdrawal and retreatment occurred at weeks 28-76 in VOYAGE 2; all patients then received open-label guselkumab through week 252. Efficacy and health-related quality of life (HRQoL) endpoints were analysed through week 252. Safety was monitored through week 264. RESULTS The proportions of patients in the guselkumab group who achieved clinical responses at week 252 in VOYAGE 1 and VOYAGE 2, respectively, were 84·1% and 82·0% [≥ 90% improvement in Psoriasis Area and Severity Index (PASI)]; 82·4% and 85·0% [Investigator's Global Assessment (IGA) 0 or 1]; 52·7% and 53·0% (100% improvement in PASI) and 54·7% and 55·5% (IGA 0). HRQoL endpoints were achieved as follows: 72·7% and 71·1% of patients (Dermatology Life Quality Index 0 or 1: no effect on patient's life); 42·4% and 42·0% [Psoriasis Symptoms and Signs Diary (PSSD) symptom score = 0] and 33·0% and 31·0% (PSSD sign score = 0). As measured in VOYAGE 2 only, approximately 45% of patients achieved ≥ 5-point reduction in Short Form-36 physical and mental component scores, and 80% reported no anxiety or depression (Hospital Anxiety and Depression Scale scores < 8). Similar findings were reported for adalimumab crossovers. These effects were maintained from week 52 in VOYAGE 1 and week 100 in VOYAGE 2. No new safety signals were identified. CONCLUSIONS Guselkumab maintains high levels of clinical response and improvement in patient-reported outcomes through 5 years in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K B Gordon
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - B E Strober
- Yale University, New Haven, CT, USA.,Central Connecticut Dermatology Research, Cromwell, CT, USA
| | - A W Armstrong
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Miller
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Y K Shen
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Y You
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - C Han
- Janssen Global Services, LLC, Horsham and Malvern, PA, USA
| | - Y W Yang
- Janssen Global Services, LLC, Horsham and Malvern, PA, USA
| | - P Foley
- The University of Melbourne, St Vincent's Hospital Melbourne and Probity Medical Research, Skin Health Institute, Carlton, VIC, Australia
| | - C E M Griffiths
- Dermatology Centre, Salford Royal Hospital, University of Manchester, Manchester, UK
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Reich K, Hansen JB, Puig L, Konstantinou MP, Warren RB. Complete clearance and Psoriasis Area and Severity Index response for brodalumab and ustekinumab by previous treatment history in AMAGINE-2 and AMAGINE-3. J Eur Acad Dermatol Venereol 2021; 35:2034-2044. [PMID: 34076919 DOI: 10.1111/jdv.17433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/26/2021] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND The pathway for treatment of psoriasis is partly dependent upon disease severity, and patients may experience inadequate response at any point along the treatment pathway. Patients who repeatedly fail therapy represent a population in whom effective and well-tolerated treatment options are limited. OBJECTIVES To investigate and describe patients achieving Psoriasis Area and Severity Index (PASI) 100 and cumulative treatment benefit over time in patients with moderate-to-severe psoriasis receiving brodalumab or ustekinumab by prior treatment. METHODS We conducted a post hoc analysis of data from two phase 3, randomized, controlled, 52-week AMAGINE trials of brodalumab to describe patients who achieved complete clearance as measured by PASI 100 by prior treatment subgroup (naïve to systemic and biologic treatment, systemic-treated but biologic-naïve, biologic-treated without failure, and biologic-treated with failure). A competing risk model was used to assess cumulative incidence over a 52-week period with outcomes of PASI 100 or inadequate response. Cumulative clinical benefit of treatment was determined with an area under the curve analysis. RESULTS The 52-week cumulative incidence of patients achieving PASI 100 was consistently higher for brodalumab vs. ustekinumab across treatment pathway subgroups (76% vs. 58% in systemic/biologic-naïve patients, 78% vs. 55% in systemic-treated/biologic-naïve patients, 75% vs. 41% in biologic-treated patients without failure, and 70% vs. 30% in biologic-treated patients with failure). Rates of inadequate response were lower with brodalumab compared with ustekinumab across all subgroups. Cumulative treatment benefit was also higher for all subgroups treated with brodalumab compared with those treated with ustekinumab. CONCLUSION Treatment with brodalumab was associated with higher levels of complete clearance and greater cumulative benefit over time compared with ustekinumab, in patients with moderate-to-severe psoriasis, regardless of prior treatment experience.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | | | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, University of Manchester, Manchester, UK
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Wilsmann-Theis D, Kromer C, Gerdes S, Linker C, Magnolo N, Sabat R, Reich K, Mössner R. A multicentre open-label study of apremilast in palmoplantar pustulosis (APLANTUS). J Eur Acad Dermatol Venereol 2021; 35:2045-2050. [PMID: 34077577 DOI: 10.1111/jdv.17441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a chronic skin disease with painful erythematous scaly or crusty lesions and pustules on the palms and soles. Apremilast is a phosphodiesterase 4 inhibitor that has proven effective in the therapy of psoriasis, psoriatic arthritis and in oral ulcers associated with Behcet's disease. OBJECTIVE To explore the efficacy of apremilast in PPP. METHODS APLANTUS was a phase 2 single-arm multicentre study of apremilast in 21 subjects with moderate-to-severe PPP. Primary endpoint was the per cent change of the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI) at week 20 compared to baseline. RESULTS 20 weeks of oral treatment with apremilast in patients with moderate-to-severe PPP resulted in a significant decrease of the PPPASI with a median reduction of 57.1% (p < 0.001), and 61.9% of patients achieved at least a 50% improvement of the PPPASI relative to baseline. The total number of pustules per patient decreased significantly relative to baseline with 76.2% of patients achieving at least a 50% reduction in total pustules count at week 20. Improvement of PPP was also apparent in a significant decrease of the dermatologic life quality index (DLQI). The median DLQI score dropped from 8.5 at baseline to 2.0 at week 20 (p = 0.030). Apremilast was generally well tolerated, and no serious adverse events occurred. CONCLUSIONS Patients with PPP treated with apremilast showed benefit both in objective and subjective disease parameters. Apremilast should be investigated further in this difficult-to-treat skin condition. EudraCT number: 2016-005122-11.
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Affiliation(s)
- D Wilsmann-Theis
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - C Kromer
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - S Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - C Linker
- TFS Clinic, TFS Trial Form Support GmbH, Hamburg, Germany
| | - N Magnolo
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - R Sabat
- Psoriasis Research and Treatment Centre, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Mössner
- Department of Dermatology, University Medical Center Göttingen, Göttingen, Germany
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Mease PJ, Foley P, Reich K, Bagel J, Lebwohl M, Yang YW, Shawi M, Miller M, Kollmeier A, Hsia EC, Xu XL, Izutsu M, Ramachandran P, Sheng S, You Y, Helliwell P, Boehncke WH. POS1031 LOW INCIDENCE OF GASTROINTESTINAL-RELATED AND OVERALL SERIOUS ADVERSE EVENTS AMONG GUSELKUMAB-TREATED PATIENTS: POOLED ANALYSES OF VOYAGE 1 & 2 AND DISCOVER 1 & 2 THROUGH 1-YEAR. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Guselkumab (GUS), a human monoclonal antibody that specifically binds to the p19-subunit of interleukin (IL)-23, demonstrated efficacy in the Phase 3 VOYAGE 1&2 trials of patients (pts) with moderate to severe plaque psoriasis (PsO)1,2 and in the DISCOVER 1&2 trials of pts with active psoriatic arthritis (PsA).3,4 IL-17 inhibitors used to treat PsO and PsA have been associated with exacerbation or new onset of inflammatory bowel disease (IBD) (e.g., Crohn’s disease or ulcerative colitis).5Objectives:Evaluate the incidence of gastrointestinal (GI)-related and overall serious adverse events (SAEs) from pooled safety data through 1-year of GUS 100 mg treatment from the VOYAGE 1&2 and DISCOVER 1&2 trials.Methods:Using pooled safety data from the VOYAGE 1&2 PsO trials and DISCOVER 1&2 PsA trials, SAEs related to GI disorders were identified using the Medical Dictionary for Regulatory Activities (MedDRA) system-organ class “GI disorders”. Pts with a previous history of IBD were not excluded in these trials; medical history of IBD was collected at baseline in DISCOVER 1&2. Rates of overall SAEs and GI-related SAEs were calculated as the number of SAEs per 100 pt-years (PY) of follow-up (95% confidence intervals). Data are presented for the placebo (PBO)-controlled period (Weeks 0-16 for VOYAGE 1&2; Weeks 0-24 for DISCOVER 1&2) and through 1-year (defined as through Week 48 for VOYAGE 1&2; through Week 60 for DISCOVER 1, and through Week 52 for DISCOVER 2). Events of uveitis and opportunistic infections were also analyzed.Results:Through the PBO-controlled period, the overall rates of GI-related SAEs per 100 PY for pooled VOYAGE 1&2 were: PBO 0.78 (0.02, 4.34), GUS q8w 0; and for pooled DISCOVER 1&2: PBO 0.58 (0.01, 3.23), GUS q8w 0.58 (0.01, 3.21), GUS q4w 0. The GI-related SAEs included: gastrointestinal hemorrhage (PBO; n=1) for pooled VOYAGE 1&2; and inflammatory bowel disease (PBO; n=1) and mechanical ileus (GUS q8w; n=1) for pooled DISCOVER 1&2. Through 1-year, the overall rates of GI-related SAEs for pooled VOYAGE 1&2 were: Combined GUS group (GUS q8w and PBO→GUS groups) 0.51 (0.17, 1.20); and for pooled DISCOVER 1&2: GUS q8w 0.52 (0.06, 1.88), GUS q4w 0, Combined GUS group (GUS q8w, GUS q4w, and PBO→GUS groups) 0.21 (0.02, 0.74). The GI-related SAEs in the Combined GUS group for pooled VOYAGE 1&2 included: gastritis, hemorrhoids, inguinal hernia, pancreatitis, and umbilical hernia (0.10/100PY [0.00, 0.57]; n=1 for each); and in the Combined GUS group for pooled DISCOVER 1&2: mechanical ileus and pancreatitis chronic (0.10/100PY [0.00, 0.57]; n=1 for each). Overall, no cases of exacerbation or new onset of IBD were reported in GUS-treated pts, including 2 pts with a prior history of IBD in DISCOVER 1&2 (total PY of follow-up for the Combined GUS groups in VOYAGE and DISCOVER were 974 and 973, respectively). Through the PBO-controlled period, rates of overall SAEs for GUS-treated pts were comparable to PBO-pts and SAE rates remained low through 1-year of follow-up in the VOYAGE 1&2 and DISCOVER 1&2 trials. There were no reported cases of uveitis, opportunistic infections, or tuberculosis in GUS-treated pts through 1-year.Conclusion:Through 1-year of follow-up with GUS treatment in pooled VOYAGE 1&2 and DISCOVER 1&2, GI-related SAE rates were low. There were no reported cases of uveitis, opportunistic infections, or new onset/exacerbation of IBD in GUS-treated pts. No new safety concerns were identified through 1-year.References:[1]Blauvelt A., et al. J Am Acad Dermatol. 2017;76:405-17.[2]Reich K., et al. J Am Acad Dermatol. 2017;76:418-31.[3]Deodhar A., et al. Lancet. 2020;395:1115-25.[4]Mease P.J., et al. Lancet. 2020; 395:1126-36.[5]Hohenberger M., et al. J Dermatolog Treat. 2018;29:13-8.Disclosure of Interests:Philip J Mease Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, SUN, and UCB, Peter Foley Speakers bureau: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, Valeant, Galderma, GSK, Leo Pharma, and Roche, Consultant of: Janssen, Lilly, Novartis, Pfizer, Galderma, AbbVie, Amgen, AstraZeneca, Arcutis, Aslan, Boehringer Ingelheim, Celgene, Hexima, Merck, Sun Pharma, UCB Pharma, Valeant, BMS, Celtaxsys, CSL, Cutanea, Dermira, Genentech, GSK, Leo Pharma, Regeneron Pharmaceuticals Inc, Reistone, Roche, and Sanofi, Grant/research support from: AbbVie, Amgen, Celgene, Janssen, Leo Pharma, Lilly, Merck, Novartis, Pfizer, Sanofi, and Sun Pharma; travel grants from AbbVie, Janssen, Lilly, Merck, Novartis, Pfizer, Galderma, Leo Pharma, Roche, Sun Pharma, and Sanofi, Kristian Reich Consultant of: AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB Pharma, Grant/research support from: AbbVie, Amgen, and UCB Pharma, Jerry Bagel Speakers bureau: AbbVie, Celgene Corporation, Eli Lilly, Janssen Biotech, and Novartis, Consultant of: AbbVie, Amgen, Celgene Corporation, Eli Lilly and Company, Janssen Biotech, Leo Pharma, Novartis, Sun Pharmaceutical Industries Ltd, and Valeant Pharmaceuticals, Grant/research support from: AbbVie, Amgen, Arcutis Biotherapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Celgene Corporation, Corrona, LLC, Dermavant Sciences, LTD, Dermira/UCB, Eli Lilly and Company, Glenmark Pharmaceuticals Ltd, Janssen Biotech, Kadmon Corporation, Leo Pharma, Lycera Corp, Menlo Therapeutics, Novartis, Pfizer, Regeneron Pharmaceuticals, Sun Pharma, Taro Pharmaceutical Industries Ltd, and Valeant Pharmaceuticals, Mark Lebwohl Consultant of: Aditum Bio, Allergan, Almirall, Arcutis, Inc., Avotres Therapeutics, BirchBioMed Inc., BMD skincare, Boehringer-Ingelheim, Bristol-Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Evommune, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Kyowa Kirin, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr. Reddy’s Laboratories, Serono, Theravance, and Verrica, Grant/research support from: Abbvie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Evommune, Incyte, Janssen, Leo Pharmaceutucals, Ortho Dermatologics, Pfizer, and UCB, Ya-Wen Yang Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, May Shawi Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Megan Miller Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Alexa Kollmeier Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Elizabeth C Hsia Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Xie L Xu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Miwa Izutsu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Paraneedharan Ramachandran Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Shihong Sheng Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Yin You Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Philip Helliwell Consultant of: Galapagos, Janssen, Novartis, Grant/research support from: Abbvie, Janssen, Pfizer, Wolf-Henning Boehncke Speakers bureau: AbbVie, Almirall, Celgene, Janssen, Leo, Lilly, Novartis, and UCB Pharma, Consultant of: AbbVie, Almirall, Celgene, Janssen, Leo, Lilly, Novartis, and UCB Pharma, Grant/research support from: Pfizer
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20
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Thaci D, Piaserico S, Warren RB, Gupta AK, Cantrell W, Draelos Z, Foley P, Igarashi A, Langley RG, Asahina A, Young M, Falqués M, Pau-Charles I, Mendelsohn AM, Rozzo SJ, Reich K. Five-year efficacy and safety of tildrakizumab in patients with moderate-to-severe psoriasis who respond at week 28: pooled analyses of two randomized phase III clinical trials (reSURFACE 1 and reSURFACE 2). Br J Dermatol 2021; 185:323-334. [PMID: 33544883 DOI: 10.1111/bjd.19866] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND The phase III reSURFACE 1 and reSURFACE 2 (NCT01722331/NCT01729754) trials of the anti-interleukin-23p19 monoclonal antibody tildrakizumab (TIL) for psoriasis treatment are complete. OBJECTIVES We present 5-year pooled data from reSURFACE 1 and reSURFACE 2. METHODS reSURFACE 1 and reSURFACE 2 were double-blind, randomized, controlled studies with optional long-term extensions. Adults with moderate-to-severe chronic plaque psoriasis were randomized 2 : 2 : 1 to TIL 100 mg (TIL 100) or 200 mg (TIL 200) or placebo at weeks 0 and 4, and every 12 weeks thereafter [reSURFACE 2 included an etanercept (ETN) arm]. Efficacy outcomes included proportions of patients achieving absolute and relative improvement from baseline Psoriasis Area and Severity Index (PASI) score through week 244 in TIL responders (≥ 75% improvement from baseline PASI; PASI 75 response) continuously receiving the same dose and ETN partial responders and nonresponders (PASI < 75 response) switched to TIL 200 at week 28. Safety was assessed from adverse events (AEs) in all patients as treated. RESULTS Efficacy analyses included 329 and 227 week 28 responders to TIL 100 and TIL 200, respectively, and 121 ETN partial responders/nonresponders switched to TIL 200 at week 28. Of TIL 100 or TIL 200 responders and ETN partial responders/nonresponders entering the extensions, 235/302, 176/213 and 85/107, respectively, were evaluated at week 244, and 88·7%, 92·5% and 81·3%, respectively, achieved PASI 75 response. Exposure-adjusted rates of serious AEs were 6·3 and 6·0 patients with events per 100 patient-years of TIL 100 and TIL 200, respectively. CONCLUSIONS TIL treatment provided sustained disease control over 5 years in week 28 TIL responders and ETN partial responders/nonresponders, with a reassuring safety profile.
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Affiliation(s)
- D Thaci
- Institute and Comprehensive Centre for Inflammation Medicine, University of Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany
| | - S Piaserico
- Dermatology Unit, Department of Medicine, University of Padua, Via Vincenzo Gallucci 4, Padua, 35128, Italy
| | - R B Warren
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, M6 8HD, UK
| | - A K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, 190 Elizabeth Street, R. Fraser Elliott Building, 3-805, Toronto, ON, M5G 2C4, Canada.,Mediprobe Research Inc, 645 Windermere Road, London, ON, N5X 2P1, Canada
| | - W Cantrell
- Village Dermatology, 2900 Cahaba Road, Birmingham, AL, 35223, USA
| | - Z Draelos
- Dermatology Consulting Services, 2444 North Main Street, High Point, NC, 27262, USA
| | - P Foley
- Skin Health Institute Inc., Level 1, 80 Drummond Street, Carlton, Victoria, 3053, Australia
| | - A Igarashi
- NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - R G Langley
- Division of Dermatology, Department of Medicine, Dalhousie University, 6054 Coburg Road, Halifax, NS, B3H 1Z2, Canada
| | - A Asahina
- Department of Dermatology, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - M Young
- Mindful Dermatology, Modern Research Associates, 9101 N Central Expy Ste 160, Dallas, TX, 75231, USA
| | - M Falqués
- Almirall R&D, Carrer de Laureà Miró, 408, 410, Sant Feliu de Llobregat, Barcelona, 08980, Spain
| | - I Pau-Charles
- Almirall R&D, Carrer de Laureà Miró, 408, 410, Sant Feliu de Llobregat, Barcelona, 08980, Spain
| | - A M Mendelsohn
- Sun Pharmaceutical Industries, Inc., 2 Independence Way, Princeton, NJ, 08540, USA
| | - S J Rozzo
- Sun Pharmaceutical Industries, Inc., 2 Independence Way, Princeton, NJ, 08540, USA
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, M, Hamburg, 20246, Germany
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Mrowietz U, Warren R, Leonardi C, Saure D, Petto H, Hartz S, Dossenbach M, Reich K. Network meta-analysis of biologic treatments for psoriasis using absolute Psoriasis Area and Severity Index values ≤1, 2, 3 or 5 derived from a statistical conversion method. J Eur Acad Dermatol Venereol 2021; 35:1161-1175. [PMID: 33480102 PMCID: PMC8248394 DOI: 10.1111/jdv.17130] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 01/14/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND In practice, the goal of treatment for patients with psoriasis is to achieve almost clear or clear skin and maintain disease control, regardless of baseline disease severity. However, identifying absolute Psoriasis Area and Severity Index (PASI) values for new treatment goals is challenging, as most clinical trials report relative PASI 50, 75, 90 or 100 improvements but rarely absolute PASI values achieved. OBJECTIVE Our objective was to illustrate a statistical conversion method that was developed to derive absolute PASI values from available clinical trial data on relative PASI improvements. The results of network meta-analyses (NMAs) based on these derived data were then compared with those of NMAs based on the corresponding relative PASI improvement data for selected biologics for moderate-to-severe psoriasis. METHODS The PASI statistical conversion method was applied to relative PASI improvement data for 11 biologic treatment regimens and placebo at 12 weeks using data from 50 published studies. The respective proportions of patients reaching absolute PASI values ≤1, 2, 3 or 5 were then calculated. Frequentist NMAs (Rücker method) were subsequently used to compare efficacy results across relative and absolute PASI data. RESULTS The ranking of included treatment regimens for patients achieving absolute PASI 0 to 8 was aligned with results for relative PASI scores (from 100 to 60) at end of induction therapy. Across the range of PASI scores considered, the most effective treatment regimens based on both absolute and relative PASI NMAs were brodalumab 210 mg every 2 weeks and ixekizumab 80 mg every 2 weeks, followed by guselkumab 100 mg every 8 weeks and risankizumab 150 mg every 12 weeks. CONCLUSION Data generated using this mathematical model will be useful to inform ongoing scientific discussions on treatment goals in the absence of primary absolute PASI data for all available treatments for moderate-to-severe plaque psoriasis.
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Affiliation(s)
- U. Mrowietz
- Psoriasis‐Center at the Department of DermatologyUniversity Medical Center Schleswig‐HolsteinKielGermany
| | - R.B. Warren
- Dermatology CentreSalford Royal NHS Foundation Trust HospitalManchester NIHR Biomedical Research CentreManchesterUK
| | - C.L. Leonardi
- St. Louis University School of MedicineSt. LouisMOUSA
| | - D. Saure
- Lilly Deutschland GmbHBad HomburgGermany
| | - H. Petto
- Eli Lilly Austria GmbHViennaAustria
| | - S. Hartz
- Eli Lilly and Company LtdWindleshamUK
| | | | - K. Reich
- Translational Research in Inflammatory Skin DiseasesInstitute for Health Services Research in Dermatology and NursingUniversity Medical Center Hamburg‐Eppendorf and Skinflammation CenterHamburgGermany
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Gottlieb AB, Merola JF, Reich K, Behrens F, Nash P, Griffiths CEM, Bao W, Pellet P, Pricop L, McInnes IB. Efficacy of secukinumab and adalimumab in patients with psoriatic arthritis and concomitant moderate-to-severe plaque psoriasis: results from EXCEED, a randomized, double-blind head-to-head monotherapy study. Br J Dermatol 2021; 185:1124-1134. [PMID: 33913511 PMCID: PMC9291158 DOI: 10.1111/bjd.20413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 11/28/2022]
Abstract
Background Secukinumab [an interleukin (IL)‐17A inhibitor] has demonstrated significantly higher efficacy vs. etanercept (a tumour necrosis factor inhibitor) and ustekinumab (an IL‐12/23 inhibitor) in patients with moderate‐to‐severe plaque psoriasis. Objectives To report 52‐week results from a prespecified analysis of patients with active psoriatic arthritis (PsA) having concomitant moderate‐to‐severe plaque psoriasis from the head‐to‐head EXCEED monotherapy study comparing secukinumab with adalimumab. Methods Patients were randomized to receive secukinumab 300 mg via subcutaneous injection at baseline, week 1–4, and then every 4 weeks until week 48 or adalimumab 40 mg via subcutaneous injection every 2 weeks from baseline until week 50. Assessments in patients with concomitant moderate‐to‐severe psoriasis, defined as having affected body surface area > 10% or Psoriasis Area and Severity Index (PASI) ≥ 10 at baseline, included musculoskeletal, skin and quality‐of‐life outcomes. Missing data were handled using multiple imputation. Results Of the 853 patients [secukinumab (N = 426), adalimumab (N = 427)], 211 (24·7%) had concomitant moderate‐to‐severe psoriasis [secukinumab (N = 110, 25·8%), adalimumab (N = 101, 23·7%)]. Up to week 50, 5·5% of patients discontinued secukinumab vs.17·8% in the adalimumab group. The proportion of patients who achieved American College of Rheumatology (ACR) 20 response was 76·4% with secukinumab vs. 68·3% with adalimumab (P = 0·175), PASI 100 response was 39·1% vs. 23·8% (P = 0·013), and simultaneous improvement in ACR 50 and PASI 100 response at week 52 was 28·2% vs. 17·7%, respectively (P = 0·06). Secukinumab demonstrated consistently higher responses vs. adalimumab across skin endpoints. Conclusions This prespecified analysis in PsA patients with concomitant moderate‐to‐severe plaque psoriasis in the EXCEED study provides further evidence that IL‐17 inhibitors offer a comprehensive biological treatment to manage the concomitant features of psoriasis and PsA.
What is already known about this topic?
Secukinumab, an interleukin‐17A inhibitor, has previously been reported to have significantly higher efficacy in head‐to‐head trials vs. etanercept and ustekinumab in patients with moderate‐to‐severe plaque psoriasis.
What does this study add?The results of the study provide valuable head‐to‐head data on the efficacy of two biologics with different mechanisms of action (secukinumab and adalimumab) as first‐line biological monotherapy for patients with psoriatic arthritis and concomitant moderate‐to‐severe plaque psoriasis. The findings of this study can further help physicians to make informed and evidence‐based decisions for the treatment of patients with active psoriatic arthritis who have concomitant moderate‐to‐severe plaque psoriasis.
Linked Comment: E. Sbidian and L. Pina‐Vegas. Br J Dermatol 2021; 185:1085.
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Affiliation(s)
- A B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J F Merola
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg- Eppendorf, Hamburg, Germany
| | - F Behrens
- Rheumatology University Hospital and Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP and Fraunhofer Cluster of Excellence for Immune-Mediated Diseases CIMD, Goethe University, Frankfurt, Germany
| | - P Nash
- Department of Medicine, Griffith University, Brisbane, QLD, Australia
| | - C E M Griffiths
- The Dermatology Centre, Salford Royal NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - W Bao
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - P Pellet
- Novartis Pharma AG, Basel, Switzerland
| | - L Pricop
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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Maul JT, Augustin M, Sorbe C, Conrad C, Anzengruber F, Mrowietz U, Reich K, French LE, Radtke M, Häusermann P, Maul LV, Boehncke WH, Thaçi D, Navarini AA. Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study. Br J Dermatol 2021; 185:1160-1168. [PMID: 33837519 DOI: 10.1111/bjd.20387] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few systematic data on sex-related treatment responses exist for psoriasis. OBJECTIVES To evaluate sex differences with respect to systemic antipsoriatic treatment. METHODS Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI ≤ 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) ≤ 1 and delta DLQI ≥ 4]. RESULTS In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67·3% male, 69·8% female). Women showed slightly higher PASI response rates after 3 (54·8% vs. 47·2%; P ≤ 0·001), 6 (70·8% vs. 63·8%; P ≤ 0·001) and 12 months (72·3% vs. 66·1%; P ≤ 0·004). A significantly higher proportion of women achieved a reduction in DLQI ≥ 4 [month 3: 61·4% vs 54·8% (P ≤ 0·001); month 6: 69·6% vs. 62·4% (P ≤ 0·001); month 12: 70·7% vs. 64·4% (P ≤ 0·002)]. Regarding PASI ≤ 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57·8% vs. 48·5%; P ≤ 0·004) and 6 months (69·2% vs. 60·9%; P ≤ 0·018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI ≤ 3) over 12 months compared with men. CONCLUSIONS We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.
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Affiliation(s)
- J-T Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Sorbe
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - C Conrad
- Department of Dermatology, University Hospital Lausanne, Lausanne, Switzerland
| | - F Anzengruber
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - U Mrowietz
- Department of Dermatology, University Hospital Kiel, Kiel, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L E French
- Department of Dermatology and Allergy, University Hospital LMU Munich, Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - M Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - P Häusermann
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - L V Maul
- Department of Dermatology, University Hospital Basel, Basel, Switzerland.,Department of Dermatology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - W-H Boehncke
- Division of Dermatology and Venereology, Geneva University Hospital, Geneva, Switzerland
| | - D Thaçi
- Institute and Comprehensive Center Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - A A Navarini
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Basel, Basel, Switzerland
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Langenbruch A, Mohr N, Kirsten N, Reich K, von Kiedrowski R, Strömer K, Mrowietz U, Augustin M. Quality of psoriasis care in Germany - results from the nationwide health care studies PsoHealth 2004-2017. J Eur Acad Dermatol Venereol 2021; 35:1536-1542. [PMID: 33714231 DOI: 10.1111/jdv.17220] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the study series PsoHealth first data from 2004/05 showed a poor quality of health care for psoriasis in Germany. Most patients lacked sufficient care and only a minor proportion received systemic drugs. Since 2007, a national psoriasis programme has been conducted. OBJECTIVES (1) To analyse the quality of health care for psoriasis in the most recent PsoHealth4 survey 2016/17, (2) to compare health care quality indicators with prior assessments since 2004/05. MATERIALS AND METHODS The recent cross-sectional PsoHealth4 survey was conducted 2016/17, and three preceding studies were performed in 2004/05, 2007 and 2013/14, each including at least 1500 patients. The common set of quality indicators included disease severity (PASI and proportion of patients with PASI > 20, indicating high severity), quality of life (DLQI and proportion of patients with DLQI > 10, indicating strong impairments in quality of life), systemic therapy and inpatient treatment of the last five years. RESULTS Between December 2015 and December 2017, n = 1827 patients from 93 dermatological centres were included in the most recent survey (mean age: 50.8 ± 14.6 years, 45.2% female). 7.3% showed a PASI > 20, compared to 17.8% in 2004/05. 21.4% reported a DLQI > 10, compared to 34.0% in 2004/05. 57.6% of all participants stated to have received a systemic therapy at least once within the last five years, compared to 32.9% in 2004/05. 18.0% received inpatient hospital treatment at least once within the last five years, compared to 26.9% in 2004/05. CONCLUSION A remarkable improvement in the health care quality for psoriasis patients in Germany within the past 12 years can be assumed. Major determinants could be the innovation shift which included programmes such as the S3 guideline, a consensus on treatment goals, national health care goals for psoriasis and higher utilisation of innovative drugs.
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Affiliation(s)
- A Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Mohr
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - N Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Reich
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - K Strömer
- Gemeinschaftspraxis für Dermatologie und Allergologie, Mönchengladbach, Germany
| | - U Mrowietz
- Center for Inflammatory Skin Diseases, Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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25
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Nast A, Smith C, Spuls P, Avila Valle G, Bata‐Csörgö Z, Boonen H, De Jong E, Garcia‐Doval I, Gisondi P, Kaur‐Knudsen D, Mahil S, Mälkönen T, Maul J, Mburu S, Mrowietz U, Reich K, Remenyik E, Rønholt K, Sator P, Schmitt‐Egenolf M, Sikora M, Strömer K, Sundnes O, Trigos D, Van Der Kraaij G, Yawalkar N, Dressler C. EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations. J Eur Acad Dermatol Venereol 2021; 35:281-317. [DOI: 10.1111/jdv.16926] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022]
Affiliation(s)
- A. Nast
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - C. Smith
- St John’s Institute of Dermatology London UK
| | - P.I. Spuls
- Academic Medical Centre Amsterdam Amsterdam Netherlands
| | - G. Avila Valle
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | | | - H. Boonen
- Office‐Based Dermatology Practice Geel Belgium
| | - E. De Jong
- Radboud University Medical Centre Nijmegen Nijmegen Netherlands
| | - I. Garcia‐Doval
- Unidad de Investigación. Fundación Piel Sana AEDV Madrid Spain
| | | | | | - S. Mahil
- Guy's and St Thomas' NHS Foundation Trust London UK
| | - T. Mälkönen
- Helsinki University Central Hospital Helsinki Finland
| | - J.T. Maul
- Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - S. Mburu
- International Federation of Psoriasis Associations (IFPA)
| | - U. Mrowietz
- Universitätsklinikum Schleswig‐Holstein Kiel Germany
| | - K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | | | | | - P.G. Sator
- Municipal Hospital Hietzing Vienna Austria
| | - M. Schmitt‐Egenolf
- Dermatology Department of Public Health & Clinical Medicine Umeå University Umeå Sweden
| | - M. Sikora
- Department of Dermatology Medical University of Warsaw Warsaw Poland
| | - K. Strömer
- Office‐Based Dermatology Practice Mönchengladbach Germany
| | | | - D. Trigos
- International Federation of Psoriasis Associations (IFPA)
| | | | - N. Yawalkar
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - C. Dressler
- Charité – Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Department of Dermatology, Venereology and Allergology Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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26
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Reich K, Sorbe C, Griese L, Reich JLK, Augustin M. The value of subcutaneous vs. oral methotrexate: real-world data from the German psoriasis registry PsoBest. Br J Dermatol 2020; 184:765-767. [PMID: 33220078 DOI: 10.1111/bjd.19690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 01/11/2023]
Affiliation(s)
- K Reich
- Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Sorbe
- Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Griese
- Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J L K Reich
- University of Oxford, Oxford University Clinical Academic Graduate School, Oxford, UK
| | - M Augustin
- Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pinter A, Hoffmann M, Reich K, Augustin M, Kaplan K, Gudjónsdóttir SD, Delvin T, Mrowietz U. A phase 4, randomized, head-to-head trial comparing the efficacy of subcutaneous injections of brodalumab to oral administrations of fumaric acid esters in adults with moderate-to-severe plaque psoriasis (CHANGE). J Eur Acad Dermatol Venereol 2020; 35:701-711. [PMID: 32939860 DOI: 10.1111/jdv.16932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/13/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Brodalumab is a fully human monoclonal immunoglobulin IgG2 antibody that binds to the human IL-17 receptor subunit A and by that inhibits the biologic action of IL-17A, IL-17F, IL-17C and IL-17E. Therapy with fumaric acid esters (FAE) is a well established and widely used first-line systemic treatment for subjects with moderate-to-severe plaque psoriasis. OBJECTIVES To compare brodalumab to FAE in terms of clinical efficacy, patient-reported outcomes and safety in subjects with moderate-to-severe plaque psoriasis who were naïve to systemic treatment. METHODS Eligible subjects were randomized 1 : 1 to 210 mg brodalumab injections or oral FAE according to product label in this 24-week, open-label, assessor-blinded, multi-centre, head-to-head phase 4 trial. The primary endpoints were having PASI75 and having sPGA score of 0 or 1 (sPGA 0/1). Subjects with missing values for the primary endpoints were considered non-responders. RESULTS A total of 210 subjects were randomized. 91/105 subjects completed brodalumab treatment and 58/105 subjects completed FAE treatment. At Week 24, significantly more subjects in the brodalumab group compared to the FAE group had PASI75 (81.0% vs. 38.1%, P < 0.001) and sPGA 0/1 (64.8% vs. 20.0%, P < 0.001). In the brodalumab group, the median time to both PASI75 and to PASI90 was significantly shorter than in the FAE group (4.1 weeks vs. 16.4 weeks, and 7.4 weeks vs. 24.4 weeks, respectively, P < 0.0001 for both). The rate of adverse events was lower in subjects treated with brodalumab compared to subjects treated with FAE (616.4 vs. 1195.8 events per 100 exposure years). No new safety signals were detected for brodalumab. CONCLUSIONS Brodalumab was associated with rapid and significant improvements in signs and symptoms of moderate-to-severe plaque psoriasis, with a superior efficacy profile to what was observed with FAE in systemic-naïve subjects over 24 weeks.
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Affiliation(s)
- A Pinter
- Department of Dermatology, Venereology and Allergology, Clinical Research Division, University of Frankfurt, Frankfurt/Main, Germany
| | - M Hoffmann
- Dermatological Practice, Witten, Germany
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| | - M Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - K Kaplan
- LEO Pharma A/S, Ballerup, Denmark
| | | | - T Delvin
- LEO Pharma A/S, Ballerup, Denmark
| | - U Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
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Nast A, Smith C, Spuls P, Avila Valle G, Bata‐Csörgö Z, Boonen H, De Jong E, Garcia‐Doval I, Gisondi P, Kaur‐Knudsen D, Mahil S, Mälkönen T, Maul J, Mburu S, Mrowietz U, Reich K, Remenyik E, Rønholt K, Sator P, Schmitt‐Egenolf M, Sikora M, Strömer K, Sundnes O, Trigos D, Van Der Kraaij G, Yawalkar N, Dressler C. EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 1: treatment and monitoring recommendations. J Eur Acad Dermatol Venereol 2020; 34:2461-2498. [DOI: 10.1111/jdv.16915] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022]
Affiliation(s)
- A. Nast
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin BerlinCorporate Member of Freie Universität BerlinHumboldt‐Universität zu BerlinBerlin Institute of Health Berlin Germany
| | - C. Smith
- St John’s Institute of Dermatology London UK
| | - P.I. Spuls
- Academic Medical Centre Amsterdam Amsterdam Netherlands
| | - G. Avila Valle
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin BerlinCorporate Member of Freie Universität BerlinHumboldt‐Universität zu BerlinBerlin Institute of Health Berlin Germany
| | | | - H. Boonen
- Office‐Based Dermatology Practice Geel Belgium
| | - E. De Jong
- Radboud University medical centre Nijmegen Netherlands
| | - I. Garcia‐Doval
- Unidad de InvestigaciónFundación Piel Sana AEDV Madrid España
| | | | | | - S. Mahil
- Guy's and St Thomas' NHS Foundation Trust London UK
| | - T. Mälkönen
- Helsinki University Central Hospital Helsinki Finland
| | - J.T. Maul
- Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - S. Mburu
- International Federation of Psoriasis Associations (IFPA)
| | - U. Mrowietz
- Universitätsklinikum Schleswig‐Holstein Kiel Germany
| | - K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and Nursing University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | | | | | - P.G. Sator
- Municipal Hospital Hietzing Vienna Austria
| | - M. Schmitt‐Egenolf
- Dermatology Department of Public Health & Clinical Medicine Umeå University Umeå Sweden
| | - M. Sikora
- Department of Dermatology Medical University of Warsaw Warszawa Poland
| | - K. Strömer
- Office‐Based Dermatology Practice Mönchengladbach Germany
| | | | - D. Trigos
- International Federation of Psoriasis Associations (IFPA)
| | | | - N. Yawalkar
- Department of Dermatology, Inselspital Bern University HospitalUniversity of Bern Bern Switzerland
| | - C. Dressler
- Department of Dermatology, Venereology and Allergology Charité – Universitätsmedizin BerlinCorporate Member of Freie Universität BerlinHumboldt‐Universität zu BerlinBerlin Institute of Health Berlin Germany
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29
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Reich K, Sullivan J, Arenberger P, Jazayeri S, Mrowietz U, Augustin M, Elewski B, You R, Regnault P, Frueh JA. Secukinumab shows high and sustained efficacy in nail psoriasis: 2.5-year results from the randomized placebo-controlled TRANSFIGURE study. Br J Dermatol 2020; 184:425-436. [PMID: 32479641 DOI: 10.1111/bjd.19262] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin-17A, a cornerstone cytokine in psoriasis, has shown long-lasting efficacy and safety in the complete spectrum of psoriasis manifestations. OBJECTIVES To report the long-term (2·5-year) efficacy and safety of secukinumab in nail psoriasis. METHODS TRANSFIGURE, a double-blind, randomized, placebo-controlled, parallel-group, multicentre phase IIIb study in 198 patients, investigated secukinumab 150 mg and 300 mg in patients with moderate-to-severe nail psoriasis. RESULTS At week 16, the primary endpoint Nail Psoriasis Severity Index (NAPSI) was met, demonstrating superiority of secukinumab to placebo. The effect was sustained over 2·5 years with a large benefit for nail clearance, with mean NAPSI improvement of -73·3% and -63·6% with secukinumab 300 mg and 150 mg, respectively. At 2·5 years, secukinumab demonstrated sustained clinically significant reductions in total mean Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA) quality-of-life (QoL) scores of -52·4% and -18·1%, and 70% and 71% of patients achieved a weighted NAPPA Patient Benefit Index global score of ≥ 2 with secukinumab 300 mg and 150 mg, respectively. Patients showed considerable improvements in the EuroQol 5-Dimension health status questionnaire at 2·5 years, reporting a decrease in pain and discomfort. No new safety findings were observed. CONCLUSIONS Secukinumab demonstrated strong and clinically meaningful efficacy for up to 2·5 years in nail psoriasis, with significant sustained QoL improvements and a favourable safety profile.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Skinflammation® Center, Hamburg, Germany
| | - J Sullivan
- Sutherland Hospital, University of New South Wales, Sydney, NSW, Australia
| | - P Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - S Jazayeri
- Alliance Dermatology and Mohs Center, Phoenix, AZ, USA
| | - U Mrowietz
- Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | | | - B Elewski
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - R You
- China Novartis Institutes for BioMedical Research, Shanghai, China
| | | | - J A Frueh
- Novartis Pharma AG, Basel, Switzerland
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Reich K, Kabashima K, Peris K, Kolodsick J, Yang F, Gamalo M, Brinker D, Delozier A, Janes J, Nunes F, Thyssen J, Simpson E, Lacour J. Efficacité et sécurité du baricitinib associé à des corticostéroïdes topiques (TCS) dans le traitement de la dermatite atopique (DA) modérée à sévère : étude de phase 3 de 16 semaines en double aveugle, randomisée et contrôlée vs placebo (BREEZE-AD7). Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Reich K, Ghislain PD, Schoenenberger A, Ryzhkova A. Profil de sécurité à long terme du tildrakizumab : Incidence des événements cardiovasculaires majeurs étendus et confirmés après 5 ans de traitement chez les patients atteints de psoriasis modérée à sévère des essais de phase 3 reSURFACE 1/reSURFACE 2. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reich K, DeLozier AM, Nunes FP, Thyssen JP, Eichenfield LF, Wollenberg A, Ross Terres JA, Watts SD, Chen YF, Simpson EL, Silverberg JI. Baricitinib improves symptoms in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: patient-reported outcomes from two randomized monotherapy phase III trials. J DERMATOL TREAT 2020; 33:1521-1530. [DOI: 10.1080/09546634.2020.1839008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- K. Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Skinflammation® Center, Hamburg and Dermatologikum Berlin, Berlin, Germany
| | | | - F. P. Nunes
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J. P. Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital and University of Copenhagen, Copenhagen, Denmark
| | - L. F. Eichenfield
- Departments of Dermatology and Pediatrics, University of California, San Diego and Rady Children’s Hospital, San Diego, CA, USA
| | - A. Wollenberg
- Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany
| | | | - S. D. Watts
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Y.-F. Chen
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E. L. Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA
| | - J. I. Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA
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33
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Leutz A, Pinter A, Thaçi D, Augustin M, Schuster C, Fotiou K, Hundemer H, Saure D, Mrowietz U, Reich K. Efficacy and safety of ixekizumab after switching from fumaric acid esters or methotrexate in patients with moderate‐to‐severe plaque psoriasis naïve to systemic treatment. Br J Dermatol 2020; 184:548-550. [DOI: 10.1111/bjd.19558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 01/22/2023]
Affiliation(s)
- A. Leutz
- Lilly Deutschland GmbH Bad Homburg Germany
| | - A. Pinter
- University Clinic of Frankfurt am Main Department of Dermatology Venereology and Allergology Frankfurt am Main Germany
| | - D. Thaçi
- Institute and Comprehensive Center Inflammation Medicine University zu LübeckUniversity Hospital Schleswig‐Holstein Campus Lübeck Lübeck Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | | | - K. Fotiou
- Lilly Deutschland GmbH Bad Homburg Germany
| | | | - D. Saure
- Lilly Deutschland GmbH Bad Homburg Germany
| | - U. Mrowietz
- Psoriasis‐Center Department of Dermatology University Medical Center Schleswig‐Holstein Campus Kiel Kiel Germany
| | - K. Reich
- Translational Research in Inflammatory Skin Diseases Institute for Health Services Research in Dermatology and NursingUniversity Medical Center Hamburg‐Eppendorf, and Skinflammation Center Hamburg Germany
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Warren RB, Carrascosa JM, Fumero E, Schoenenberger A, Lebwohl MG, Szepietowski JC, Reich K. Time to relapse after tildrakizumab withdrawal in patients with moderate-to-severe psoriasis who were responders at week 28: post hoc analysis through 64 weeks from reSURFACE 1 trial. J Eur Acad Dermatol Venereol 2020; 35:919-927. [PMID: 32979235 DOI: 10.1111/jdv.16964] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND As treatment interruptions occur during psoriasis management in clinical practice, it is important to know the duration of clinical response after treatment withdrawal. OBJECTIVES To report time to and predictors of relapse in patients who were tildrakizumab 100 and 200 mg responders (≥75% improvement in Psoriasis Area and Severity Index, PASI 75) at week 28 re-randomized to placebo from reSURFACE 1 trial. METHODS Post hoc analysis of adult patients with moderate-to-severe plaque psoriasis from a 64-week phase 3 trial. Relapse was primarily defined as loss of PASI 75 response. Both relapses defined as loss of PASI 90 and loss of absolute PASI < 2 response were included as sensitivity analyses. PASI 75, PASI 90 and PASI < 2 responders re-randomized to placebo at week 28 and followed up until week 64 were included. The Kaplan-Meier (KM) estimates of the 64-week relapse rate were calculated. The log-rank test to compare KM curves from responders to tildrakizumab 100 and 200 mg was used. Independent predictors of relapse were explored. RESULTS Median time to loss of PASI 75/PASI 90/PASI < 2 response from week 28 was 142/111/112 days with tildrakizumab 100 mg and 172/140/113 days with tildrakizumab 200 mg, respectively (all not significant). Around 20% of patients did not relapse (either maintained a PASI 75 response or were lost to follow-up) during the 36-week period. Increase in body mass index (BMI) (hazard ratio, HR [95% confidence interval, CI] for loss of PASI 75 response: 1.0345 [1.0112-1.0582]) and increase in disease duration (HR [95% CI]: 1.0151 [1.0028-1.0275] for loss of PASI 75 response) were associated with an increased risk of relapse, regardless of the relapse definition. CONCLUSIONS When treatment is interrupted, tildrakizumab provides durable maintenance of efficacy with a median time to loss of PASI 75 response of 5-6 months, irrespective of the dose. Interventions on modifiable risk factors for relapse, such as BMI, may improve personalized long-term psoriasis management.
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Affiliation(s)
- R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - J M Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | | | | | - M G Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, Skinflammation® Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Reich K, Papp K, Blauvelt A, Langley R, Armstrong A, Warren RB, Gordon K, Merola JF, Madden C, Wang M, Vanvoorden V, Lebwohl M. Efficacy and Safety of Bimekizumab in Patients with Moderate to Severe Plaque Psoriasis: Results from BE VIVID, a 52-Week Phase 3, Randomized, Double-Blinded, Ustekinumab- and Placebo-Controlled Study. ACTA ACUST UNITED AC 2020. [DOI: 10.25251/skin.4.supp.82] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Abstract not available.
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Gordon K, Foley P, Krueger JG, Pinter A, Reich K, Vender R, Vanvoorden V, Madden C, Peterson L, Blauvelt A. Efficacy and Safety of Bimekizumab in Patients with Moderate to Severe Plaque Psoriasis: Results from BE READY, a 56-Week Phase 3, Randomized, Double-Blinded, Placebo-Controlled Study with Randomized Withdrawal. ACTA ACUST UNITED AC 2020. [DOI: 10.25251/skin.4.supp.83] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Abstract not available.
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Tsakok T, Rispens T, Spuls P, Nast A, Smith C, Reich K. Immunogenicity of biologic therapies in psoriasis: Myths, facts and a suggested approach. J Eur Acad Dermatol Venereol 2020; 35:329-337. [PMID: 33030275 DOI: 10.1111/jdv.16980] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023]
Abstract
With biologic drugs dominating the therapeutic space for severe immune-mediated inflammatory disease, it is critical for clinicians to be familiar with the concept of drug immunogenicity, with the potential for our patients to develop antidrug antibodies (ADA) of clinical relevance. Whilst there are clear differences between different therapeutic biologics in terms of reported ADA rates, there is no accepted dermatology guideline or grouping of drugs by risk of clinically relevant ADA, nor a consensus on approach to ADA management. This is partly because making valid comparisons of immunogenicity across drugs is fundamentally flawed: the differing types of ADA assay, trial design and included patient population - as well as the molecular structure of the biologic molecules themselves - are all highly influential on reported ADA prevalence and impact on clinical response. Therefore, the first part of this article aims to give an overview of ADA that also clarifies common misconceptions on the subject, whilst the second part of this article outlines Phase III immunogenicity data on commonly used biologics for psoriasis, the most common dermatological indication. Based on this, and acknowledging current limitations in available evidence, we propose a working categorization of biologics together with a broad approach to management: Group 1 - biologics with higher risk of clinically relevant ADA; Group 2 - biologics with lower risk of clinically relevant ADA; and Group 3 - biologics with no established risk of clinically relevant ADA. However, these groupings represent a working concept only; more research is required, using comparable ADA assays and consistent reporting of related outcomes. Finally, there is an urgent need for better characterization of individuals at particular risk of developing ADA to inform future clinical decision-making.
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Affiliation(s)
- T Tsakok
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - T Rispens
- Department of Immunopathology, Sanquin Research and Landsteiner Laboratory Academic Medical Centre, Amsterdam, Netherlands
| | - P Spuls
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Nast
- Department of Dermatology, Venereology und Allergy, Division of Evidence-based Medicine (dEBM), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - C Smith
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Medical and Molecular Genetics, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Skinflammation Center, Hamburg, Germany
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Bieber T, Thyssen JP, Reich K, Simpson EL, Katoh N, Torrelo A, De Bruin-Weller M, Thaci D, Bissonnette R, Gooderham M, Weisman J, Nunes F, Brinker D, Issa M, Holzwarth K, Gamalo M, Riedl E, Janes J. Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials. J Eur Acad Dermatol Venereol 2020; 35:476-485. [PMID: 32926462 DOI: 10.1111/jdv.16948] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Janus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late-stage development for adult patients with moderate-to-severe AD. OBJECTIVE To report pooled safety data for baricitinib in patients with moderate-to-severe AD in the clinical development program including long-term extension (LTE) studies. METHODS This analysis included patient-level safety data from six double-blinded, randomized, placebo-controlled studies (one phase 2 and five phase 3), one double-blinded, randomized, LTE study and one open-label LTE study, reported in three data sets: placebo-controlled, 2-mg - 4-mg extended and All-bari AD. Safety outcomes include treatment-emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated. RESULTS Data were collected for 2531 patients who were given baricitinib for 2247 patient-years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo-controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo-controlled period in baricitinib-treated patients. Frequency of herpes simplex was higher in the 4-mg group (6.1%) vs. the 2-mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2-mg IR = 9.6; 4-mg IR = 14.5) were lower vs. the placebo-controlled data set (2-mg IR = 12.4; 4-mg IR = 21.3). In the All-bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2-mg group): two venous thrombosis events (4-mg group) and one death. CONCLUSION This integrated safety analysis in patients with moderate-to-severe AD confirms the established safety profile of baricitinib.
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Affiliation(s)
- T Bieber
- University Hospital of Bonn, Bonn, Germany
| | - J P Thyssen
- Department of Dermatology and Allergy, Herlev-Gentofte Hospital University of Copenhagen, Copenhagen, Denmark
| | - K Reich
- University Med Cen Hamburg-Eppendorf, Hamburg, Germany
| | - E L Simpson
- Oregon Health & Science University, Portland, OR, USA
| | - N Katoh
- Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - D Thaci
- Comprehensive Center for Inflammation Medicine, University Hospital Schleswig Holstein, Luebeck, Germany
| | | | - M Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
| | - J Weisman
- Medical Dermatology Specialists, Atlanta, GA, USA
| | - F Nunes
- Eli Lilly and Company, Indianapolis, IN, USA
| | - D Brinker
- Eli Lilly and Company, Indianapolis, IN, USA
| | - M Issa
- Eli Lilly and Company, Indianapolis, IN, USA
| | - K Holzwarth
- Eli Lilly and Company, Indianapolis, IN, USA
| | - M Gamalo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - E Riedl
- Eli Lilly and Company, Indianapolis, IN, USA
| | - J Janes
- Eli Lilly and Company, Indianapolis, IN, USA
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Reich K. A new treatment option for paediatric psoriasis. Br J Dermatol 2020; 183:606-607. [PMID: 33015876 DOI: 10.1111/bjd.19403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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40
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Gordon KB, Warren RB, Gottlieb AB, Blauvelt A, Thaçi D, Leonardi C, Poulin Y, Boehnlein M, Brock F, Ecoffet C, Reich K. Long-term efficacy of certolizumab pegol for the treatment of plaque psoriasis: 3-year results from two randomized phase III trials (CIMPASI-1 and CIMPASI-2). Br J Dermatol 2020; 184:652-662. [PMID: 32652544 PMCID: PMC8247431 DOI: 10.1111/bjd.19393] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Abstract
Background Certolizumab pegol (CZP) is an Fc‐free, PEGylated anti‐tumour necrosis factor biologic. Objectives To report the 3‐year efficacy of CZP in plaque psoriasis, pooled from the CIMPASI‐1 (NCT02326298) and CIMPASI‐2 (NCT02326272) phase III trials. Methods Adults with moderate‐to‐severe psoriasis for ≥ 6 months were randomized 2 : 2 : 1 to CZP 200 mg, CZP 400 mg or placebo, every 2 weeks (Q2W) for up to 48 weeks. Patients entering the open‐label period (weeks 48–144) from double‐blinded CZP initially received CZP 200 mg Q2W. Patients not achieving ≥ 50% improvement in Psoriasis Area and Severity Index (PASI 50) at week 16 entered an open‐label CZP 400 mg Q2W escape arm (weeks 16–144). Dose adjustments based on PASI response were permitted during open‐label treatment. Outcomes included PASI 75, PASI 90 and Physician’s Global Assessment (PGA) 0/1 responder rates, based on a logistic regression model (missing data imputed using Markov Chain Monte Carlo methodology). Results In total, 186 patients were randomized to CZP 200 mg Q2W and 175 to CZP 400 mg Q2W. At week 48, PASI 75/90 was achieved by 72·7%/51·3% of patients randomized to CZP 200 mg and 84·4%/62·7% randomized to CZP 400 mg. Patients entering the open‐label period at week 48, from blinded treatment, received CZP 200 mg Q2W. At week 144, PASI 75/90 was achieved by 70·6%/48·7% patients randomized to CZP 200 mg and 72·9%/42·7% randomized to CZP 400 mg. At week 16, 72 placebo‐randomized patients entered the CZP 400 mg Q2W escape arm; 75.7%/58.5% achieved PASI 75/90 at week 144. Conclusions Both CZP 200 mg and 400 mg Q2W demonstrated sustained, durable efficacy, with numerically higher responses for some outcomes with 400 mg Q2W.
What is already known about this topic?
Certolizumab pegol is an Fc‐free, PEGylated, anti‐tumour necrosis factor biologic approved for adults with moderate‐to‐severe plaque psoriasis. Efficacy data from the first 48 weeks of phase III trials have shown significant improvements in the signs and symptoms of psoriasis with certolizumab pegol dosed at either 400 mg or 200 mg every 2 weeks. Numerically greater improvements were observed for patients treated with the higher dose.
What does this study add?
Plaque psoriasis is a chronic, systemic disease that requires long‐term management and sustained efficacy of therapies. Three‐year efficacy data pooled from the CIMPASI‐1 and CIMPASI‐2 phase III trials demonstrate a sustained and durable response to certolizumab pegol dosed at either 400 mg or 200 mg every 2 weeks. Additional long‐term clinical benefits may be obtained from the higher dose.
Linked Comment: Johnson et al. Br J Dermatol 2021; 184:588–589.
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Affiliation(s)
- K B Gordon
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - A B Gottlieb
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - D Thaçi
- Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - C Leonardi
- Central Dermatology and Saint Louis University School of Medicine, St Louis, MO, USA
| | - Y Poulin
- Centre de Recherche Dermatologique du Québec Métropolitain, Québec, QC, Canada
| | | | | | | | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf and Skinflammation® Center, Hamburg, Germany
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Blauvelt A, Paul C, van de Kerkhof P, Warren RB, Gottlieb AB, Langley RG, Brock F, Arendt C, Boehnlein M, Lebwohl M, Reich K. Long-term safety of certolizumab pegol in plaque psoriasis: pooled analysis over 3 years from three phase III, randomized, placebo-controlled studies. Br J Dermatol 2020; 184:640-651. [PMID: 32531798 PMCID: PMC8246928 DOI: 10.1111/bjd.19314] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2020] [Indexed: 12/12/2022]
Abstract
Background Certolizumab pegol (CZP) is an Fc‐free, PEGylated anti‐tumour necrosis factor biologic. Objectives To report 3‐year safety data from three phase III trials of CZP in adults with plaque psoriasis. Methods Data were pooled from CIMPASI‐1 (NCT02326298), CIMPASI‐2 (NCT02326272) and CIMPACT (NCT02346240). Included patients had moderate‐to‐severe plaque psoriasis of ≥ 6 months’ duration; had been randomized to CZP 200 mg every 2 weeks (Q2W) (400 mg at weeks 0, 2 and 4) or CZP 400 mg Q2W; and had received at least one dose of CZP with up to 144 weeks of exposure. Treatment‐emergent adverse events (TEAEs) were classified using MedDRA v18·1. Reported incidence rates (IRs) are incidence of new cases per 100 patient‐years (PY). Results Over 144 weeks, 995 patients received at least one dose of CZP (exposure: 2231·3 PY); 731 and 728 received at least one dose of CZP 200 mg Q2W (1211·4 PY) and/or 400 mg Q2W (1019·9 PY), respectively. The IR [95% confidence interval (CI)] of TEAEs was 144·9 (135·3–155·0) for all patients, 134·1 (123·2–145·7) for CZP 200 mg Q2W and 158·3 (145·5–171·9) for CZP 400 mg Q2W. The IR (95% CI) of serious TEAEs for all patients was 7·5 (6·4–8·8); the IRs were 6·7 (5·2–8·3) and 8·7 (6·9–10·8) for CZP 200 mg and 400 mg Q2W, respectively. Overall, 3·2% of patients reported serious infections (2·2% within each of the CZP 200 and 400 mg Q2W groups). Overall, there was one case of active tuberculosis, 16 malignancies in 14 patients and seven deaths (two considered treatment‐related). The cumulative IR of TEAEs did not increase over time. Conclusions No new safety signals were identified compared with previously reported data. Risk did not increase with longer or higher CZP exposure.
What is already known about this topic?
Certolizumab pegol is an Fc‐free, PEGylated, anti‐tumour necrosis factor biologic approved for adults with moderate‐to‐severe plaque psoriasis. Safety data from phase III trials in plaque psoriasis have found the incidence of adverse events to be generally similar over 16 weeks of treatment between the evaluated certolizumab pegol doses 200 mg and 400 mg every 2 weeks and placebo. Additionally, the safety profile was in line with the class over 48 weeks.
What does this study add?
Plaque psoriasis is a chronic disease for which patients require lifetime management; long‐term safety data are important to understand the benefits and risks of prolonged treatment. Here, 3‐year data from a pooled analysis of three phase III trials of certolizumab pegol in plaque psoriasis are presented, representing 2231·3 patient‐years of exposure. No new safety signals were identified and the risk of treatment‐emergent adverse events did not increase with longer or higher certolizumab pegol exposure.
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Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, USA
| | - C Paul
- Paul Sabatier University, Toulouse, France
| | | | - R B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester NIHR Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - A B Gottlieb
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | | | - M Lebwohl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Skinflammation® Center, Hamburg, Germany
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Warren RB, Hansen JB, Reich K, Paul C, Puig L. Complete clearance and psoriasis area and severity index response for brodalumab and ustekinumab in AMAGINE-2 and -3. J Eur Acad Dermatol Venereol 2020; 35:450-457. [PMID: 32662540 DOI: 10.1111/jdv.16816] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Modern biologics achieve complete skin clearance [100% improvement in psoriasis area and severity index (PASI 100)] in 30-45% of psoriasis patients. Cumulative benefit considering rapidity, frequency and sustainability of response has not been thoroughly investigated. OBJECTIVES Compare the frequency, rapidity and sustainability of PASI 90 and 100 response in patients with moderate-to-severe psoriasis treated with brodalumab or ustekinumab. METHODS Integrated analyses of the brodalumab Phase III AMAGINE-2 (NCT01708603) and -3 (NCT01708629) trials were performed to determine proportion of patients achieving PASI response per visit; corresponding odds ratios (OR) were calculated. Cumulative clinical benefit of treatment was determined with area-under-the-curve (AUC) analysis. Cumulative incidence of response was analysed using a competing risk model of PASI response or rescue. Sustained response was evaluated by time to inadequate response using Kaplan-Meier methods. Proportion of time spent in different response states was descriptively analysed. Association between PASI response and health-related quality of life [Dermatology Life Quality Index (DLQI)] was assessed using data from all treatment groups from AMAGINE-1, -2 and -3. RESULTS A significantly higher proportion of patients treated with brodalumab achieved PASI 100 vs. ustekinumab (Week 52: 51% vs. 28%; OR [95% CI] 2.8 [2.1, 3.7]; P < 0.0001), with significant differences observed from Week 4. Cumulative benefit through 52 weeks was 69% higher with brodalumab (AUC ratio: 1.69; P < 0.001). Brodalumab patients were also significantly more likely to achieve a PASI 100 at least once over 52 weeks vs. ustekinumab (76% vs. 52%; P < 0.0001). Once response was achieved, brodalumab patients had a low likelihood of failure or need for rescue. There was significant positive association between PASI response level and DLQI0/1 achievement (P < 0.0001). CONCLUSION Brodalumab treatment resulted in significantly higher levels of skin clearance, longer sustained response and greater cumulative treatment benefit vs. ustekinumab.
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Affiliation(s)
- R B Warren
- Dermatology Centre, The University of Manchester, Salford Royal NHS Foundation Trust, NIHR Manchester BRC Centre, Manchester, UK
| | | | - K Reich
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Skinflammation® Center, Hamburg, Germany
| | - C Paul
- Toulouse University and Larrey Hospital, Toulouse, France
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona School of Medicine, Barcelona, Spain
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Reich K, Körber A, Mrowietz U, Sticherling M, Sieder C, Früh J, Bachhuber T. Secukinumab 2-weekly vs. 4-weekly dosing in patients with plaque-type psoriasis: results from the randomized GAIN study. Br J Dermatol 2020; 184:849-856. [PMID: 32652528 DOI: 10.1111/bjd.19398] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Secukinumab is a fully human monoclonal antibody that selectively neutralizes interleukin-17A and shows long-lasting efficacy and safety in plaque psoriasis. More evidence is required to optimize secukinumab dosing according to clinical response. OBJECTIVES GAIN compared the efficacy and safety of secukinumab 300 mg every 2 weeks (q2w) with 300 mg every 4 weeks (q4w) in patients achieving ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) but not PASI 90 after 16 weeks. METHODS In total, 772 patients with moderate-to-severe plaque psoriasis received secukinumab 300 mg subcutaneously at baseline and weeks 1, 2, 3 and 4, then q4w until week 16. At week 16, patients with PASI ≥ 75 to PASI < 90 were randomized 1: 1 to continue q4w dosing (n = 162) or switch to q2w (n = 163) to week 32. The primary endpoint was superiority of q2w to q4w dosing for PASI 90 response at week 32. RESULTS PASI 90 response at week 32 was numerically greater with secukinumab 300 mg q2w than with secukinumab 300 mg q4w in suboptimal responders, but this did not reach statistical significance (64·4% vs. 57·4%; odds ratio 0·64, 95% confidence interval 0·39-1·07; P = 0·087). Although the primary endpoint was not met, absolute PASI was significantly lower at week 32 in q2w vs. q4w patients (2·11 vs. 2·84, P = 0·024). Significantly more patients with q2w vs. q4w dosing showed minimal disease activity (Investigator's Global Assessment score 0 or 1: 73·0% vs. 64·1%, P < 0·05) and improved quality of life (Dermatology Life Quality Index score 0 or 1: 58·9% vs. 50·6%, P < 0·05) at week 32. No new or unexpected safety signals arose. CONCLUSIONS Most patients achieved PASI 90 response with secukinumab q4w. There was potential benefit of q2w dosing in some suboptimal responders. Continued q4w treatment can improve response even after 16 weeks.
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Affiliation(s)
- K Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, and Skinflammation® Center, Hamburg, Germany
| | - A Körber
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - U Mrowietz
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - M Sticherling
- Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - C Sieder
- Novartis Pharma GmbH, Nürnberg, Germany
| | - J Früh
- Novartis Pharma AG, Basel, Switzerland
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Reich K, Papp KA, Armstrong AW, Wasfi Y, Li S, Shen YK, Randazzo B, Song M, Kimball AB. Safety of guselkumab in patients with moderate-to-severe psoriasis treated through 100 weeks: a pooled analysis from the randomized VOYAGE 1 and VOYAGE 2 studies. Br J Dermatol 2020; 180:1039-1049. [PMID: 30485400 DOI: 10.1111/bjd.17454] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Long-term evaluation is required to confirm the safety profile of newer biologic agents. OBJECTIVES To report on pooled safety data from the ongoing VOYAGE 1 (NCT02207231) and VOYAGE 2 (NCT02207244) trials through 100 weeks of follow-up. METHODS Patients were randomized to either guselkumab 100 mg at weeks 0 and 4 and every 8 weeks thereafter; placebo at weeks 0, 4, 12 followed by guselkumab 100 mg at weeks 16 and 20 and every 8 weeks thereafter; or adalimumab 80 mg at week 0, 40 mg at week 1, and 40 mg every 2 weeks thereafter. Patients who received adalimumab crossed over to guselkumab at week 52 (VOYAGE 1) and at/after week 28 based on clinical response (VOYAGE 2). Open-label extensions, in which all patients received guselkumab, started at week 52 (VOYAGE 1) and week 76 (VOYAGE 2). Rates of adverse events (AEs) per 100 patient-years (PYs) are presented through 100 weeks of follow-up. RESULTS Through week 52, observed rates for guselkumab- and adalimumab-treated patients, respectively, were 262·45 per 100 PYs and 328·28 per 100 PYs for AEs, 6·20 per 100 PYs and 7·77 per 100 PYs for serious AEs (SAEs), 1·22 per 100 PYs and 1·79 per 100 PYs for serious infections (SIs), 0·28 per 100 PYs and 0·40 per 100 PYs for malignancies other than nonmelanoma skin cancers (NMSCs), 0·56 per 100 PYs and 0·40 per 100 PYs for NMSCs, and 0·47 per 100 PYs and 0·40 per 100 PYs for major adverse cardiovascular events (MACEs). Rates among patients treated with guselkumab through week 52 and week 100, respectively, were 262·45 per 100 PYs and 210·41 per 100 PYs for AEs, 6·20 and 6·29 per 100 PYs, for SAEs, 1·22 per 100 PYs and 1·06 per 100 PYs for SIs, 0·28 per 100 PYs and 0·38 per 100 PYs for malignancies, 0·56 per 100 PYs and 0·39 per 100 PYs for NMSCs, and 0·47 per 100 PYs and 0·38 per 100 PYs for MACEs. Among patients treated with adalimumab, rates of AEs, SAEs, SIs, malignancies, NMSCs, and MACEs showed some variability before and after crossover to guselkumab, although no new safety signals were noted after crossover. CONCLUSIONS The safety profile for guselkumab remains favourable through 100 weeks of treatment in patients with moderate-to-severe psoriasis.
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Affiliation(s)
- K Reich
- Dermatologikum Berlin and SCIderm Research Institute, Hamburg, Germany
| | - K A Papp
- K Papp Clinical Research and Probity Research, Inc., Waterloo, Canada
| | - A W Armstrong
- University of Southern California, Los Angeles, CA, U.S.A
| | - Y Wasfi
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - S Li
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - Y K Shen
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - B Randazzo
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - M Song
- Janssen Research & Development, LLC, Spring House, PA, U.S.A
| | - A B Kimball
- Harvard Medical School and Beth Israel Deaconess Medical Center, Inc., Boston, MA, U.S.A
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Konrad R, Nickoloff B, Higgs R, Ferris L, Reich K, Elmaraghy H, Gallo G, Renda L, Park S, Krueger J. 500 Ixekizumab achieves more rapid reduction of circulating interleukin-19 compared to guselkumab in a psoriasis head-to-head study. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Deodhar A, Mcinnes I, Baraliakos X, Reich K, Gottlieb AB, Lebwohl M, Schreiber S, Bao W, Marfo K, Richards H, Pricop L, Shete A, Safi J, Mease PJ. FRI0272 SECUKINUMAB DEMONSTRATES A CONSISTENT SAFETY PROFILE IN PATIENTS WITH PSORIASIS, PSORIATIC ARTHRITIS AND ANKYLOSING SPONDYLITIS OVER LONG TERM: UPDATED POOLED SAFETY ANALYSES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Pooled safety data has been reported with secukinumab (SEC) in patients (pts) with Psoriatic arthritis (PsA), Ankylosing Spondylitis (AS) and Psoriasis (PsO).1Objectives:To report longer-term safety data of SEC treatment in PsA, AS, PsO pts up to 5 years.Methods:The integrated clinical trial safety dataset included data pooled from 28 randomised controlled clinical trials of SEC 300 or 150 or 75 mg in PsO (11 Phase 3 and 8 Phase 4 trials), PsA (5 Phase 3 trials), and AS (4 Phase 3 trials), along with post-marketing safety surveillance data with a cut-off date of 25 December 2018. Adverse events (AEs) were reported as exposure-adjusted incident rates (EAIRs) per 100 pt-years. Analyses included all pts who received ≥1 dose of SEC.Results:A total of 12637 pts (8819, 2678 and 1140 pts with PsO, PsA and AS, with an exposure of 15063.1, 5984.6 and 3527.2 pt-years, respectively) were included. The most frequent AE was upper respiratory tract infection and EAIR per 100 pt-years for IBD, malignancies and MACE remained low. The EAIR per 100 pt-years for adverse events (AEs) of special interest are reported in Table 1. The cumulative post-marketing exposure to SEC was estimated to be ~285,811 pt-years across the approved indications. Safety data from post-marketing surveillance are reported in Table 2.Table 1.Selected AEs of interest with SEC across pooled clinical trialsVariablePsOPsAASSECN=8819SECN=2678SECN=1140Exposure (Days), Mean (SD)623.9 (567.7)816.2 (580.7)1130.1 (583.0)Death, n (%)15 (0.2)13 (0.5)10 (0.9)Selected AE’s of interest, EAIR (95% CI)Serious infections11.4 (1.2, 1.6)1.8 (1.5, 2.2)1.2 (0.9, 1.6)Candidainfections22.9 (2.7, 3.2)1.5 (1.2, 1.9)0.7 (0.5, 1.1)IBD3Crohn’s disease3Ulcerative colitis30.01 (0.0, 0.05)0.1 (0.05, 0.2)0.1 (0.08, 0.2)0.03 (0.0, 0.1)0.1 (0.04, 0.2)0.1 (0.04, 0.2)0.03 (0.0, 0.2)0.4 (0.24, 0.7)0.2 (0.1, 0.5)MACE40.4 (0.31, 0.5)0.4 (0.3, 0.6)0.7 (0.4, 1.0)Uveitis30.01 (0.0, 0.05)0.1 (0.04, 0.2)1.2 (0.9, 1.7)Malignancy50.9 (0.7, 1.0)1.0 (0.77, 1.3)0.5 (0.3, 0.8)1Rates for system organ class;2Rates for high level term;3Rates for preferred term (PT; IBD for unspecified IBD);4Rates for Novartis MedDRA Query term;5Rates for standardized MedDRA query term – ‘malignancies and unspecified tumour’; EAIR, exposure adjusted incidence rate per 100 pt-years; N, number of pts in the analysisTable 2.Summary of SEC post-marketing safetyExposure (PTY)PSUR126Dec14 -25Jun15PSUR226 Jun - 25Dec15PSUR326Dec15 -25Jun16PSUR426Jun -25Dec16PSUR526Dec16 -25Dec17PSUR626Dec17 -25Dec18Cumulative18387450168712854993744137325285811 n (Reporting rate PTY)Serious infections89 (4.8)149 (2.0)232 (1.4)475 (1.7)649 (0.7)1841 (1.3)3980 (1.4)Malignancy2 (0.1)15 (0.2)21 (0.1)50 (0.2)225 (0.2)422 (0.3)788 (0.3)Total IBD4 (0.2)12 (0.2)37(0.2)46 (0.2)185 (0.2)340 (0.3)693 (0.2)MACE6 (0.3)15 (0.2)16 (0.1)39 (0.1)151 (0.2)238 (0.2)504 (0.2)PSUR, periodic safety update report; PTY, pt-treatment yearsConclusion:In this long-term analysis across clinical trials and post-marketing surveillance, of pts with PsO, PsA and AS, SEC was well tolerated, with a safety profile consistent with previous reports.1Reference:[1]Deodhar et al. Arthritis Research & Therapy (2019) 21:111.Disclosure of Interests:Atul Deodhar Grant/research support from: AbbVie, Eli Lilly, GSK, Novartis, Pfizer, UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myer Squibb (BMS), Eli Lilly, GSK, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myer Squibb (BMS), Eli Lilly, GSK, Janssen, Novartis, Pfizer, UCB, Iain McInnes Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, Janssen, Novartis, Pfizer, and UCB, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Kristian Reich Grant/research support from: Affibody; Almirall; Amgen; Biogen; Boehringer Ingelheim; Celgene; Centocor; Covagen; Eli Lilly; Forward Pharma; Fresenius Medical Care; GlaxoSmithKline; Janssen; Kyowa Kirin; LEO Pharma; Medac; Merck; Novartis; Miltenyi Biotec; Ocean Pharma; Pfizer; Regeneron; Samsung Bioepis; Sanofi Genzyme; Takeda; UCB; Valeant and Xenoport., Consultant of: Affibody; Almirall; Amgen; Biogen; Boehringer Ingelheim; Celgene; Centocor; Covagen; Eli Lilly; Forward Pharma; Fresenius Medical Care; GlaxoSmithKline; Janssen; Kyowa Kirin; LEO Pharma; Medac; Merck; Novartis; Miltenyi Biotec; Ocean Pharma; Pfizer; Regeneron; Samsung Bioepis; Sanofi Genzyme; Takeda; UCB; Valeant and Xenoport., Speakers bureau: Affibody; Almirall; Amgen; Biogen; Boehringer Ingelheim; Celgene; Centocor; Covagen; Eli Lilly; Forward Pharma; Fresenius Medical Care; GlaxoSmithKline; Janssen; Kyowa Kirin; LEO Pharma; Medac; Merck; Novartis; Miltenyi Biotec; Ocean Pharma; Pfizer; Regeneron; Samsung Bioepis; Sanofi Genzyme; Takeda; UCB; Valeant and Xenoport., Alice B Gottlieb Grant/research support from:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Consultant of:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Speakers bureau:: Research grants, consultation fees, or speaker honoraria for lectures from: Pfizer, AbbVie, BMS, Lilly, MSD, Novartis, Roche, Sanofi, Sandoz, Nordic, Celltrion and UCB., Mark Lebwohl Grant/research support from: AbbVie, Amgen, Arcutis, AstraZeneca, Boehringer Ingelheim, Celgene, Clinuvel, Eli Lilly, Incyte, Janssen Research & Development, LLC, Kadmon Corp., LLC, Leo Pharmaceutucals, Medimmune, Novartis, Ortho Dermatologics, Pfizer, Sciderm, UCB, Inc., and ViDac, Consultant of: Allergan, Almirall, Arcutis, Inc., Avotres Therapeutics, BirchBioMed Inc., Boehringer-Ingelheim, Bristol-Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Foundation for Research and Education in Dermatology, Inozyme Pharma, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr. Reddy’s Laboratories, Theravance, and Verrica, Stefan Schreiber Consultant of: AbbVie, Arena, BMS, Biogen, Celltrion, Celgene, IMAB, Gilead, MSD, Mylan, Pfizer, Fresenius, Janssen, Takeda, Theravance, provention Bio, Protagonist and Falk, Weibin Bao Shareholder of: Novartis, Employee of: Novartis, Kwaku Marfo Shareholder of: Novartis, Employee of: Novartis, Hanno Richards Shareholder of: Novartis, Employee of: Novartis, Luminita Pricop Shareholder of: Novartis, Employee of: Novartis, Abhijit Shete Shareholder of: Novartis, Employee of: Novartis, Jorge Safi Shareholder of: Novartis, Employee of: Novartis, Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau
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Kimball A, Papp K, Reich K, Gooderham M, Li Q, Cichanowitz N, La Rosa C, Blauvelt A. A study of the drug tildrakizumab for plaque psoriasis. Br J Dermatol 2020. [DOI: 10.1111/bjd.19075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kimball A, Papp K, Reich K, Gooderham M, Li Q, Cichanowitz N, La Rosa C, Blauvelt A. 药物 Tildrakizumab 治疗斑块型银屑病的研究. Br J Dermatol 2020. [DOI: 10.1111/bjd.19087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Blauvelt A, Papp K, Gottlieb A, Jarell A, Reich K, Maari C, Gordon K, Ferris L, Langley R, Tada Y, Lima R, Elmaraghy H, Gallo G, Renda L, Park S, Burge R, Bagel J. A study comparing the biologic drugs ixekizumab and guselkumab for the treatment of moderate‐to‐severe plaque psoriasis. Br J Dermatol 2020. [DOI: 10.1111/bjd.19072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Blauvelt A, Papp K, Gottlieb A, Jarell A, Reich K, Maari C, Gordon K, Ferris L, Langley R, Tada Y, Lima R, Elmaraghy H, Gallo G, Renda L, Park S, Burge R, Bagel J. 生物药物 ixekizumab 和 guselkumab 治疗中度至重度斑块型银屑病的比较研究. Br J Dermatol 2020. [DOI: 10.1111/bjd.19084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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