Lebrikizumab与其他系统性单药治疗中重度特应性皮炎:疗效网络荟萃分析

IF 3.5 3区 医学 Q1 DERMATOLOGY
Dermatology and Therapy Pub Date : 2025-03-01 Epub Date: 2025-02-14 DOI:10.1007/s13555-025-01357-7
Jonathan I Silverberg, Thomas Bieber, Amy S Paller, Lisa Beck, Masahiro Kamata, Luis Puig, Marni Wiseman, Khaled Ezzedine, Alan D Irvine, Peter Foley, James Del Rosso, Linda Stein Gold, Erin Johansson, Martin Dossenbach, Gaia Gallo, Buelent Akmaz, Marta Casillas, Andrei Karlsson, Tristan Curteis, Raj Chovatiya
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引用次数: 0

摘要

通过系统的文献综述和网络荟萃分析(NMA),比较了lebrikizumab与其他生物和Janus激酶(JAK)抑制剂单药治疗成人和青少年中重度特应性皮炎的短期疗效。方法:NMA包括随机、双盲、安慰剂对照的单药2期和3期试验,生物制剂(lebrikizumab 250 mg /2周[Q2W], dupilumab 300 mg Q2W, tralokinumab 300 mg Q2W)和JAK抑制剂(abrocitinib 100/200 mg /天,baricitinib 2/4 mg /天,upadacitinib 15/30 mg /天)的批准剂量。疗效结果包括湿疹面积和严重程度指数(EASI)改善的患者比例,研究者总体评估为0或1 (IGA 0/1),以及在12周(阿布替尼)或16周(其他治疗)时瘙痒/瘙痒数值评定量表评分改善≥4分。瘙痒也在第4周进行评估。采用基线风险调整随机效应模型的贝叶斯NMA来估计治疗差异。结果:22项单药治疗研究共纳入8531例患者。到第12/16周,与巴西替尼和曲罗单抗相比,来布单抗达到IGA 0/1和瘙痒改善的几率更高;与dupilumab, abrocitinib和upadacitinib (15mg)相似;而更新达他替尼30mg的几率更低。此外,lebrikizumab改善EASI的可能性高于baricitinib 2mg;与baricitinib 4mg、tralokinumab、dupilumab、abrocitinib和upadacitinib 15mg的概率相似;概率低于每日30毫克的upadacitinib。在第4周,与曲洛单抗相比,来布单抗改善瘙痒的几率更高;与baricitinib, dupilumab和abrocitinib 100 mg的几率相似;而阿布昔替尼200mg和upadacitinib的赔率更低。结论:在生物制剂中,lebrikizumab在改善第16周的缓解率方面与dupilumab相当,优于tralokinumab。Upadacitinib 30mg是唯一一个与lebrikizumab相比具有更高反应率的JAK抑制剂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lebrikizumab vs Other Systemic Monotherapies for Moderate-to-Severe Atopic Dermatitis: Network Meta-analysis of Efficacy.

Introduction: A systematic literature review and network meta-analysis (NMA) were conducted to compare the short-term efficacy of lebrikizumab to other biologic and Janus kinase (JAK) inhibitor monotherapies approved for moderate-to-severe atopic dermatitis in adults and adolescents.

Methods: The NMA included randomized, double-blind, placebo-controlled monotherapy phase 2 and 3 trials of biologics (lebrikizumab 250 mg every 2 weeks [Q2W], dupilumab 300 mg Q2W, and tralokinumab 300 mg Q2W) and JAK inhibitors (abrocitinib 100/200 mg daily, baricitinib 2/4 mg daily, and upadacitinib 15/30 mg daily) at approved doses. Efficacy outcomes included the proportions of patients achieving Eczema Area and Severity Index (EASI) improvement, an Investigator Global Assessment of 0 or 1 (IGA 0/1), and a ≥ 4-point improvement in pruritus/itch numeric rating scale score at 12 weeks (abrocitinib) or 16 weeks (other treatments). Itch was also assessed at week 4. A Bayesian NMA employing baseline risk-adjusted random effects models was used to estimate treatment differences.

Results: Twenty-two monotherapy studies involving 8531 patients were included in the NMA. By week 12/16, lebrikizumab had superior odds of achieving IGA 0/1 and itch improvement compared to baricitinib and tralokinumab; similar odds to dupilumab, abrocitinib, and upadacitinib 15 mg; and inferior odds to upadacitinib 30 mg. Additionally, lebrikizumab had a higher probability of improving EASI than baricitinib 2 mg; similar probability to baricitinib 4 mg, tralokinumab, dupilumab, abrocitinib, and upadacitinib 15 mg; and lower probability than upadacitinib 30 mg daily. At week 4, lebrikizumab had superior odds of improving itch compared to tralokinumab; similar odds to baricitinib, dupilumab, and abrocitinib 100 mg; and inferior odds to abrocitinib 200 mg and upadacitinib.

Conclusion: Among biologics, lebrikizumab was comparable to dupilumab and superior to tralokinumab in improving response rates at week 16. Upadacitinib 30 mg was the only JAK inhibitor with superior response rates compared to lebrikizumab.

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology 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 quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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