[随机双盲安慰剂对照临床试验BCD-132-2中divozilimab治疗多发性硬化症患者24周的疗效和安全性]。

Q3 Medicine
A N Boyko, V M Alifirova, I G Lukashevich, Z A Goncharova, I V Greshnova, L G Zaslavsky, S V Kotov, N A Malkova, G N Mishin, E V Parshina, I Ye Poverennova, L N Prakhova, S A Sivertseva, I V Smagina, N A Totolyan, Yu V Trinitatsky, T N Trushnikova, F A Khabirov, S G Shchur, A V Artemyeva, D D Bolsun, A V Zinkina-Orikhan, Yu N Linkova
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引用次数: 1

摘要

目的:根据125mg或500mg静脉给药治疗复发缓解型多发性硬化症(RRMS)患者的疗效和安全性数据,与安慰剂(PBO)和特立氟米特(TRF)相比,寻找抗b细胞单抗divozilimab (DIV)的最佳治疗剂量。研究DIV在治疗24周内的疗效和安全性。材料和方法:一项多中心、随机、双盲、双盲、安慰剂对照的2期临床试验(CT) BCD-132-2,涉及来自俄罗斯25个中心的271例成年RRMS患者。患者随机分为4组(2:2:2:1):TRF、DIV 125 mg、DIV 500 mg和PBO。筛选后进入主要治疗期,一个周期治疗24周。主要终点是24周后脑MRI扫描中观察到的钆增强T1病变(Gd+)的总数(每次扫描-包括对研究中每个参与者进行的所有MRI评估的评分的平均值)。结果:263例患者完成了24周的治疗。DIV组大多数患者在治疗24周后t1加权MRI未见病变(125 mg组94.44%,500 mg组93.06%)。在TRF组和PBO组中,这一数值显著降低,分别为68.06%和56.36%(均为p)。结论:24周的治疗评估表明,DIV是治疗RRMS患者的一种高效、安全、方便的选择,无论是初治组还是既往接受过疾病改善治疗的患者。建议在第三期CT期间进一步进行疗效和安全性评估,剂量为500mg。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Efficacy and safety of divozilimab during 24-week treatment of multiple sclerosis patients in randomized double-blind placebo-controlled clinical trial BCD-132-2].

Objective: To find the optimal therapeutic dose of the anti-B cell mAb divozilimab (DIV) based on the efficacy and safety data of intravenous administration at a dose of 125 mg or 500 mg in patients with relapsing remitting multiple sclerosis (RRMS) compared to placebo (PBO) and teriflunomide (TRF). To study the efficacy and safety of DIV within 24 weeks of treatment.

Material and methods: A multicenter, randomized, double-blind and double-masked, placebo-controlled phase 2 clinical trial (CT) BCD-132-2 involved 271 adult patients with RRMS from 25 centres In Russia. Patients were randomly assigned (2:2:2:1) into 4 groups: TRF, DIV 125 mg, DIV 500 mg and PBO. After screening patients entered to the main period, which consisted of one cycle of therapy for 24 weeks. The primary endpoint was the total number of gadolinium-enhancing T1 lesions (Gd+) observed on brain MRI scans after 24 weeks (per scan - involves estimating the mean value of the score from all the MRI assessments performed for each participant in the study).

Results: 263 patients completed 24 weeks of treatment. Most of the patients in the DIV groups had no lesions on T1-weighted MRI after 24 weeks of treatment (94.44% on 125 mg and 93.06% on 500 mg). In the TRF and PBO groups the values were significantly lower: 68.06% and 56.36% respectively (both p<0.05). The proportions of relapse-free patients in the DIV groups were 93.06% and 97.22% (125 mg and 500 mg, respectively). As expected, DIV reduced the CD19+ B-cells. However, the repopulation rate of CD19+ B-cells in the 125 mg group was more pronounced (mainly due to the recovering pool of CD27-naive B-cells) compared to the 500 mg group. DIV showed a favorable safety profile at both doses.

Conclusion: Thus, the assessment of 24 weeks treatment demonstrated that DIV is a highly effective, safe and convenient option for the treatment of RRMS patients, both naive and previously treated with disease modifying therapy. A dose of 500 mg is recommended for further efficacy and safety evaluation during phase 3 CT.

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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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