Matching-Adjusted Indirect Comparison of the 52-Week Efficacy of Bimekizumab Versus Secukinumab and Ixekizumab for the Treatment of Radiographic Axial Spondyloarthritis.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-25 DOI:10.1007/s40744-024-00684-z

Walter P Maksymowych, Howard Thom, Michael F Mørup, Vanessa Taieb, Damon Willems, Nikos Lyris, Karl Gaffney

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Abstract

Introduction: A previous network meta-analysis established 16-week relative efficacy with bimekizumab, an inhibitor of interleukin (IL)-17F in addition to IL-17A, versus other treatments for patients with radiographic axial spondyloarthritis (r-axSpA; i.e., ankylosing spondylitis), including the IL-17A inhibitors secukinumab and ixekizumab. This matching-adjusted indirect comparison (MAIC) assessed 52-week relative efficacy of bimekizumab versus secukinumab and ixekizumab.

Methods: Individual patient data from BE MOBILE 2 (bimekizumab 160 mg; N = 220) were matched to pooled summary data from MEASURE 1/2/3/4 (secukinumab 150 mg), MEASURE 3 (secukinumab 300 mg; escalated dose for inadequate responders), COAST-V (ixekizumab) and COAST-V/-W (ixekizumab). BE MOBILE 2 patients were reweighted using propensity score weights based on age, sex, ethnicity, tumor necrosis factor inhibitor (TNFi) exposure, weight, baseline ASDAS and BASFI (secukinumab) and baseline BASDAI (ixekizumab), and 52-week efficacy outcomes from the trial recalculated. Odds ratios (OR) or mean difference for unanchored comparisons are reported with 95% confidence intervals (CI).

Results: At week 52, MAIC demonstrated that patients may have higher likelihood of improvement in key efficacy outcomes with bimekizumab versus secukinumab 150 mg (e.g., ASAS40: [OR (95% CI): 1.48 (1.05, 2.10); p = 0.026]; effective sample size [ESS] = 177). Differences in 52-week efficacy outcomes between bimekizumab and secukinumab 300 mg dose escalation were non-significant (ESS = 120). Bimekizumab versus ixekizumab 80 mg comparisons (COAST-V only; ESS = 84) also suggested that differences were non-significant for most key efficacy outcomes. Other ixekizumab comparisons (COAST-V/-W; ESS = 45) suggested bimekizumab may have higher comparative efficacy for many of the same efficacy outcomes, however ixekizumab analyses were limited by poor population overlap, likely due to the greater proportion of patients with previous TNFi exposure.

Conclusions: Patients treated with bimekizumab may have a higher likelihood of achieving improved longer-term efficacy versus secukinumab 150 mg, suggesting bimekizumab may be a favorable therapeutic option for r-axSpA. Differences in efficacy outcomes with bimekizumab versus ixekizumab 80 mg were mostly non-significant, depending on the populations considered.

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比美单抗与塞库单抗和伊克珠单抗治疗轴性脊柱关节炎 52 周疗效的匹配调整间接比较。

前言先前的一项网络荟萃分析确定了bimekizumab（一种IL-17A之外的白细胞介素（IL）-17F抑制剂）与其他治疗方法（包括IL-17A抑制剂secukinumab和ixekizumab）对放射性轴性脊柱关节炎（r-axSpA；即强直性脊柱炎）患者的16周相对疗效。这项匹配调整间接比较（MAIC）评估了bimekizumab与secukinumab和ixekizumab的52周相对疗效：将 BE MOBILE 2（bimekizumab 160 mg；N = 220）的单个患者数据与 MEASURE 1/2/3/4（secukinumab 150 mg）、MEASURE 3（secukinumab 300 mg；针对应答不足者的升级剂量）、COAST-V（ixekizumab）和 COAST-V/-W （ixekizumab）的汇总数据进行匹配。使用基于年龄、性别、种族、肿瘤坏死因子抑制剂（TNFi）暴露、体重、基线ASDAS和BASFI（secukinumab）以及基线BASDAI（ixekizumab）的倾向得分权重对BE MOBILE 2患者进行了重新加权，并重新计算了试验的52周疗效结果。报告了非锚定比较的比值比（OR）或平均差，以及95%置信区间（CI）：第52周时，MAIC显示，患者使用bimekizumab与使用secukinumab 150 mg相比，主要疗效结果改善的可能性更高（例如，ASAS40：[OR (95% CI)：1.48 (1.05, 2.10)；p = 0.026]；有效样本量[ESS] = 177）。bimekizumab 和 secukinumab 300 毫克剂量递增疗法的 52 周疗效差异不显著（ESS = 120）。比美单抗与ixekizumab 80毫克的比较（仅COAST-V；ESS = 84）也表明，大多数关键疗效结果的差异不显著。其他ixekizumab比较（COAST-V/-W；ESS = 45）表明，在许多相同的疗效结果中，bimekizumab的比较疗效可能更高，但ixekizumab的分析因人群重叠性差而受到限制，这可能是由于既往接受过TNFi治疗的患者比例更高：结论：与secukinumab 150 mg相比，接受bimekizumab治疗的患者更有可能获得更好的长期疗效，这表明bimekizumab可能是治疗r-axSpA的有利选择。bimekizumab与ixekizumab 80毫克在疗效结果上的差异大多不显著，这取决于所考虑的人群。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). 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