先前接触是否影响记忆？银屑病关节炎中IL-17抑制剂循环的真实世界多中心评估

IF 3.1 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2026-06-01 Epub Date: 2026-03-14 DOI:10.1007/s40744-026-00839-0

Valentino Paci, Alarico Ariani, Eleonora Celletti, Olga Addimanda, Alberto Lo Gullo, Camilla Mazzanti, Myriam Di Penta, Emanuela Sabatini, Francesco Cipollone, Gianluca Santoboni, Claudio Angrisani, Massimiliano De Simone, Valeria Nucera, Aurora Ianniello, Giulia Vallifuoco, Natalia Mansueto, Romina Andracco, Giulio Ferrero, Rosalba Caccavale, Marino Paroli, Patrizia Del Medico, Gianluca Smerilli, Antonella Farina, Palma Scolieri, Vincenzo Bruzzese, Cecilia Giampietro, Francesca Ometto, Gentiana Vukatana, Marica Trevisani, Rita Mulè, Elisa Rossi, Enrica Vandelli, Riccardo Bixio, Alessandro Volpe, Antonio Marchetta, Maddalena Larosa, Dario Camellino, Gerolamo Bianchi, Viviana Ravagnani, Federica Lumetti, Aldo Biagio Molica Colella, Veronica Franchina, Francesco Molica Colella, Elena Bravi, Ilaria Platè, Eugenio Arrigoni, Rosetta Vitetta, Francesca Serale, Alessia Fiorenza, Davide Murgia, Guido Rovera, Gabriele Amati, Elisa Visalli, Giorgio Amato, Francesco De Lucia, Ylenia Dal Bosco, Roberta Foti, Enrico Fusaro, Maria Chiara Ditto, Simone Bernardi, Francesco Girelli, Marta Priora, Alessandra Bezzi, Maria Cristina Focherini, Fabio Mascella, Andrea Becciolini, Eleonora Di Donato, Giuditta Adorni, Gianluca Lucchini, Daniele Santilli, Beatrice Gabrielli, Dilia Giuggioli, Bernd Raffeiner, Massimo Reta, Mirco Magnani, Luca Idolazzi, Gilda Sandri, Rosario Foti, Simone Parisi, Michele Maria Luchetti Gentiloni, Gianluca Moroncini

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引用次数: 0

摘要

白介素-17抑制剂（IL-17i）是银屑病关节炎（PsA）的关键治疗选择，但缺乏关于该类循环策略有效性的现实证据。本研究评估了白细胞介素17i在PsA中的实际滞留，重点关注先前暴露于白细胞介素17i是否会影响随后的白细胞介素17i滞留。方法：这项多中心、回顾性、观察性研究纳入了意大利24个风湿病中心连续接受IL-17i治疗的PsA患者。主要终点是药物保留，使用Kaplan-Meier方法分析，通过log-rank检验评估IL-17i-naïve和il -17i经验患者之间的差异。次要结局包括基线临床特征和停药预测因素。结果：共纳入868例患者，其中女性59.3%，男性40.7%，中位年龄56[48-63]岁，89.3% IL-17i-naïve)。6个月时IL-17i总体中位留置率为90.7% [95% CI 88.7-92.8]， 12个月时为77.5% [95% CI 74.6-80.6]， 24个月时为60.9% [95% CI 57.3-64.8]， 36个月时为52.1% [95% CI 48.1-56.4]。IL-17i-naïve患者在6个月、12个月、24个月和36个月的保留率分别为90.5%、77.6%、61.7%和53.9%。有il -17i经验的患者相应的保留率分别为92.2%、77.0%、54.0%和33.9%。在多变量Cox回归中，男性和既往IL-17抑制剂暴露与较低的停药风险相关，而轴向受损伤、既往生物/靶向合成抗风湿药物（b/tsDMARDs）数量较多以及IL-17i起始年份较晚预示较差的保留。结论：IL-17i在真实PsA中表现出较高的长期滞留，在naïve和先前暴露的患者之间没有显着差异。这些发现支持了IL-17i治疗的持续有效性，并提示对于选定的病例，在同类内循环可能仍然是一个合理的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Does Prior Exposure Affect Retention? A Real-World, Multicentre Assessment of IL-17 Inhibitor Cycling in Psoriatic Arthritis.

Introduction: Interleukin-17 inhibitors (IL-17i) represent a key therapeutic option for psoriatic arthritis (PsA), but real-world evidence regarding the effectiveness of cycling strategies within this class is lacking. This study evaluated the real-world retention of IL-17i in PsA, focusing on whether prior IL-17i exposure affects subsequent IL-17i persistence.

Methods: This multicentre, retrospective, observational study included consecutive patients with PsA treated with an IL-17i across 24 Italian rheumatology centres. The primary outcome was drug retention, analysed using Kaplan-Meier methods, with differences between IL-17i-naïve and IL-17i-experienced patients assessed with the log-rank test. Secondary outcomes included baseline clinical characteristics and predictors of discontinuation.

Results: A total of 868 patients were included (59.3% female, 40.7% male; median age 56 [48-63] years; 89.3% IL-17i-naïve). The overall median IL-17i retention rate was 90.7% [95% CI 88.7-92.8] at 6 months, 77.5% [95% CI 74.6-80.6] at 12 months, 60.9% [95% CI 57.3-64.8] at 24 months, and 52.1% [95% CI 48.1-56.4] at 36 months. Among IL-17i-naïve patients, retention rates were 90.5%, 77.6%, 61.7%, and 53.9% at 6, 12, 24, and 36 months, respectively. Among IL-17i-experienced patients, the corresponding retention rates were 92.2%, 77.0%, 54.0%, and 33.9%. In multivariable Cox regression, male sex and prior IL-17 inhibitor exposure were associated with a lower risk of discontinuation, whereas axial involvement, a higher number of previous biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs), and later calendar year of IL-17i initiation predicted poorer retention.

Conclusions: IL-17i showed high long-term retention in real-world PsA, with no significant difference between naïve and previously exposed patients. These findings support the sustained effectiveness of IL-17i therapy and suggest that cycling within the class may remain a reasonable option for selected cases.

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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). For more information on our publishing ethics policies, please see here: https://www.springer.com/gp/editorial-policies Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of rheumatologic therapies. 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