BACKGROUND: Although biologic agents are very effective, long-term comparative studies demonstrating their safety relative to one another are still lacking. METHODS: A total of 124 patients with psoriasis were followed up for 30 months; 74 received anti-TNF-alpha inhibitors (adalimumab, etanercept, infliximab), 33 were on ustekinumab, and 17 were treated with secukinumab. The rates of adverse events in these groups were recorded and statistically analyzed. RESULTS: Infliximab-treated patients showed a high occurrence of asymptomatic, but increased liver enzymes, fatigue, and respiratory as well as dermatologic infections. Adalimumab-treated patients were more often affected by musculoskeletal disorders and infections of all types. Patients treated with secukinumab presented with higher rates of cardiovascular disorders as well as respiratory and dermatologic infections. The group receiving etanercept was more often diagnosed with musculoskeletal and reproductive disorders, specifically menstrual disorders. The rates of therapy discontinuation and serious adverse events did not reach statistically significant values. CONCLUSION: A higher incidence of adverse events was observed among adalimumab-, and infliximab-treated patients, with ustekinumab found to have the safest profile. Our results demonstrate that a personalized approach, including evaluation of a patient's risk profile, is necessary before commencing a biologic. Further research is warranted to confirm the findings of our study.
- MeSH
- adalimumab * škodlivé účinky terapeutické užití MeSH
- dermatologické látky škodlivé účinky terapeutické užití MeSH
- dospělí MeSH
- etanercept * škodlivé účinky terapeutické užití MeSH
- humanizované monoklonální protilátky * škodlivé účinky terapeutické užití MeSH
- infliximab * škodlivé účinky terapeutické užití MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- monoklonální protilátky škodlivé účinky terapeutické užití MeSH
- prospektivní studie MeSH
- psoriáza * farmakoterapie MeSH
- ustekinumab * terapeutické užití škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- MeSH
- adalimumab * aplikace a dávkování škodlivé účinky MeSH
- antirevmatika aplikace a dávkování MeSH
- axiální spondyloartritida farmakoterapie MeSH
- biosimilární léčivé přípravky terapeutické užití MeSH
- farmakoterapie metody MeSH
- inhibitory TNF aplikace a dávkování MeSH
- injekce subkutánní MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- revmatické nemoci * farmakoterapie MeSH
- revmatoidní artritida farmakoterapie MeSH
- riziko MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Klíčová slova
- secukinumab,
- MeSH
- adalimumab aplikace a dávkování škodlivé účinky MeSH
- antirevmatika aplikace a dávkování MeSH
- axiální spondyloartritida * farmakoterapie MeSH
- biologická terapie MeSH
- dospělí MeSH
- humanizované monoklonální protilátky * aplikace a dávkování MeSH
- inhibitory TNF aplikace a dávkování škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- psoriáza chemicky indukované epidemiologie farmakoterapie patofyziologie MeSH
- terapie neúspěšná MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
OBJECTIVE: The adalimumab biosimilars FKB327 and GP2017 were approved for the therapy of patients with inflammatory bowel disease (IBD). Relatively few prospective studies with biosimilar adalimumab in patients with IBD have been published. The aim of this prospective observational study was to evaluate the effectiveness and safety of the biosimilar adalimumab. MATERIAL AND METHODS: Adalimumab biosimilars FKB327 (Hulio®) and GP2017 (Hyrimoz®) were indicated to 50 naive patients in terms of biological therapy with Crohn's disease (CD) or ulcerative colitis (UC). Effectiveness of therapy was evaluated via the Crohn's Disease Activity Index [CDAI] or the Mayo Scoring System [MSS] in patients with CD or UC, respectively, before and after 12 weeks. Additional goals were to evaluate weight changes, laboratory tests and complications or adverse events of this therapy. RESULTS: In CD patients, remission (CDAI <150) was achieved in 73.5% of cases, partial response (≥70-point decrease in CDAI score from baseline) in 11.8%, no response in 11.8% and 2.9% patients discontinued therapy. In UC patients, remission (total score on partial Mayo index ≤2 points) was achieved only in 18.8% of cases, partial response (≥2-point decrease in partial Mayo score from baseline) in 43.8%, no response in 25.0% and 12.5% patients discontinued therapy. There were statistically significant improvements in CDAI, MSS, haemoglobin, fecal calprotectin, albumin and CRP serum levels after 12 weeks of therapy. Seven adverse events were identified, three of which resulted in therapy being discontinued. CONCLUSIONS: This prospective observational study proved the effectiveness of the adalimumab biosimilars FKB327 and GP2017 in IBD.
- MeSH
- adalimumab škodlivé účinky MeSH
- biosimilární léčivé přípravky * škodlivé účinky MeSH
- Crohnova nemoc * MeSH
- idiopatické střevní záněty * farmakoterapie MeSH
- indukce remise MeSH
- lidé MeSH
- prospektivní studie MeSH
- ulcerózní kolitida * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
Lupus erythematodes indukovaný biologiky se odlišuje od klasického polékového lupusu a spíše připomíná idiopatický systémový lupus erythematodes s mírnějším průběhem. Autoři popisují případ pacientky s těžkou lupénkou, u níž se při léčbě adalimumabem objevil zvýšený titr ANA protilátek společně s bolestí svalů a paresteziemi. Po změně biologické léčby potíže odezněly. V současnosti je pacientka již 2,5 roku léčena úspěšně guselkumabem.
Lupus erythematosus induced by biologics is clinically distinct from drug-induced lupus and resembles more idiopathic systemic lupus erythematosus with milder clinical manifestation. The authors describe a case of a patient, who developed increased ANAs' titre along with paresthesias under adalimumab treatment. After exchange of biologic treatment her symptoms resolved. Currently, she has been successfully treated for 2,5 years by guselkumab.
- Klíčová slova
- guselkumab,
- MeSH
- adalimumab škodlivé účinky MeSH
- antinukleární protilátky krev účinky léků MeSH
- dospělí MeSH
- humanizované monoklonální protilátky terapeutické užití MeSH
- inhibitory TNF terapeutické užití MeSH
- lidé MeSH
- psoriáza * farmakoterapie komplikace MeSH
- systémový lupus erythematodes * chemicky indukované farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: Two antitumor necrosis factor therapies (infliximab [IFX] and adalimumab [ADA]) have been approved for the treatment of pediatric Crohn's disease (CD) but have not been compared in head-to-head trials. The aim of this study was to compare the efficacy and safety of ADA and IFX by propensity score matching in a prospective cohort of pediatric patients with luminal CD and at least a 24-month follow-up. METHODS: Among 100 patients, 75 met the inclusion criteria, and 62 were matched by propensity score. We evaluated time to treatment escalation as the primary outcome and primary nonresponse, predictors of treatment escalation and relapse, serious adverse events, pharmacokinetics, and effect of concomitant immunomodulators as secondary outcomes. RESULTS: There was no difference between ADA and IFX in time to treatment escalation (HR = 0.63 [95% CI 0.31-1.28] P = 0.20), primary nonresponse (P = 0.95), or serious adverse events. The median (interquartile range) trough levels at the primary outcome were 14.05 (10.88-15.40) and 6.15 (2.08-6.58) μg/mL in the ADA and IFX groups, respectively. On a multivariate analysis, the combination of anti-Saccharomyces cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity was a strong independent predictor of treatment escalation (HR 5.19, [95% CI 2.41-11.18], P < 0.0001). The simple endoscopic score for CD, L3 disease phenotype, and use of concomitant immunomodulators for at least the first 6 months revealed a trend toward significance on a univariate analysis. DISCUSSION: Propensity score matching did not reveal substantial differences in efficacy or safety between ADA and IFX. The anti-S. cerevisiae antibody negativity and antineutrophil cytoplasmic antibody positivity combination is a strong predictor of treatment escalation.
- MeSH
- adalimumab škodlivé účinky MeSH
- Crohnova nemoc * diagnóza farmakoterapie MeSH
- dítě MeSH
- imunologické faktory MeSH
- infliximab terapeutické užití MeSH
- lidé MeSH
- prospektivní studie MeSH
- protilátky proti cytoplazmě neutrofilů MeSH
- tendenční skóre MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- adalimumab * farmakologie klasifikace škodlivé účinky terapeutické užití MeSH
- biosimilární léčivé přípravky farmakologie klasifikace škodlivé účinky terapeutické užití MeSH
- inhibitory TNF farmakologie klasifikace škodlivé účinky terapeutické užití MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- revmatoidní artritida * farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND/AIMS: Originator-adalimumab, an established treatment for patients with Crohn's disease (CD), showed no difference in efficacy or adverse events versus adalimumab biosimilar SB5 (SB5-adalimumab) over 10 weeks (W) of treatment. To understand the long-term effectiveness of SB5-adalimumab in CD, patients switched from originator-adalimumab to SB5-adalimumab were compared with patients remaining on originator-adalimumab over 104 W. METHODS: Data on patients aged ≥18 years, diagnosed with CD and treated at ISCARE, were collected prospectively from July 2018 to January 2021. Primary outcome: clinical disease activity at W52, measured by Harvey-Bradshaw index (HBI). Secondary outcomes: C-reactive protein (CRP), faecal calprotectin (FC) and adalimumab concentrations at W10, 26, 52 and 104, and treatment persistence. To ensure comparable cohorts, patients were propensity score (PS)-matched for age, gender and disease activity. RESULTS: After matching, 54 patients remained per cohort. At W52, mean (SD) HBI score was 3.2 (2.5) for originator-adalimumab and 4.0 [3.6] for SB5-adalimumab (difference [95% CI] -0.78 [-2.8, 1.3]; n = 18/cohort); no clinically meaningful differences in CRP, FC or drug concentrations were noted. Kaplan-Meier's estimates (95% CI) of remaining on treatment were originator-adalimumab: 0.870 (0.785-0.965) versus SB5-adalimumab: 0.648 (0.533-0.789) at W52 and significantly lower for SB5-adalimumab versus originator-adalimumab (p < .001) over 104 W. Local skin reaction events/pain was the main reason for treatment discontinuation in the SB5-adalimumab cohort (n = 20/54 [37%]). CONCLUSIONS: These long-term results of CD patients receiving originator-adalimumab or following nonmedical switch to SB5-adalimumab show similar therapeutic effects on clinical disease activity, biological parameters and pharmacokinetic profile in both cohorts from 52 to 104 W. A separation in persistence was observed beyond W26, mainly due to differences in local reactions at the injection site.
- MeSH
- adalimumab škodlivé účinky MeSH
- biosimilární léčivé přípravky * škodlivé účinky MeSH
- Crohnova nemoc * chemicky indukované farmakoterapie MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé MeSH
- mladiství MeSH
- tendenční skóre MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
Background: BI 695501 is an approved biosimilar to Humira® reference product (RP). Research design and methods: In this randomized Phase III trial (VOLTAIRE-PSO), patients with moderate-to-severe chronic plaque psoriasis received BI 695501 or adalimumab RP (24-week treatment). Primary efficacy endpoint: the proportion of patients with ≥75% reduction in Psoriasis Area and Severity Index (PASI 75) response at week 16 (±18% equivalence limits for two-sided 95% confidence interval between treatment groups). Safety, pharmacokinetics, and immunogenicity were also assessed. Results: Baseline characteristics were balanced between treated groups (BI 695501, n = 159; adalimumab RP, n = 158). PASI 75 response rates (full analysis set, n = 158; n = 157) were 68.2% (BI 695501) and 70.4% (adalimumab RP) at week 16 (95% CI: -14.4%, 8.7%), and 75.3% and 72.4%, at week 24, respectively. At week 24, 41.5% (BI 695501) and 44.9% (adalimumab RP) of treated patients had treatment-emergent adverse events (AEs), 3.1% and 4.4% had serious AEs, and 0.0% and 1.9% had AEs of special interest. Of treated patients, 75.3% (BI 695501) and 77.9% (adalimumab RP) were anti-drug antibody-positive. Conclusion: These data demonstrate equivalent efficacy and highly similar safety and immunogenicity between BI 695501 and adalimumab RP in patients with chronic plaque psoriasis. Study identifier: NCT02850965.
- MeSH
- adalimumab škodlivé účinky MeSH
- biosimilární léčivé přípravky * škodlivé účinky MeSH
- dvojitá slepá metoda MeSH
- lidé MeSH
- psoriáza * farmakoterapie MeSH
- stupeň závažnosti nemoci MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
Psoriatická artritida (PsA) je heterogenní onemocnění zahrnující muskuloskeletální i kožní složku. Sekukinumab je plně humánní monoklonální protilátka, která selektivně neutralizuje působení interleukinu (IL) 17A a je schválena k léčbě PsA, psoriázy a ankylozující spondylitidy. V současné době je k dispozici rozsáhlá evidence o účinnosti sekukinumabu v terapii PsA. Studie EXCEED měla za cíl prokázat, že monoterapie sekukinumabem je superiorní oproti léčbě adalimumabem namířené proti tumor nekrotizujícímu faktoru alfa u biologicky naivních pacientů s PsA a plakovou psoriázou. Studie nesplnila svůj primární cíl, tedy průkaz superiority sekukinumabu nad adalimumabem, pokud jde o účinnost léku hodnocenou podle odpovědi na léčbu. Ve skupině léčené sekukinumabem byl ve srovnání s léčbou adalimumabem doložen vyšší podíl pacientů setrvávajících u léčby.
Psoriatic arthritis (PsA) is a heterogeneous disease comprising of musculoskeletal and dermatological manifestations. Secukinumab, a fully human monoclonal antibody that selectively neutralizes IL‑17A, is approved in many countries for the treatment of PsA, psoriasis and ankylosing spondylitis. There is now an extensive body of evidence demonstrating the efficacy of secukinumab in PsA. The objective of the EXCEED study was to investigate whether secukinumab (SEC) is superior to adalimumab (ADA), a TNF inhibitor, as monotherapy in biologic‑naive active PsA patients with active plaque psoriasis. Secukinumab did not meet statistical significance for superiority versus adalimumab in the primary endpoint of ACR20 (American College of Rheumatology) response at week 52. However, secukinumab was associated with a higher treatment retention rate than adalimumab.
- MeSH
- adalimumab * škodlivé účinky terapeutické užití MeSH
- humanizované monoklonální protilátky * škodlivé účinky terapeutické užití MeSH
- interleukin-17 * analogy a deriváty škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- psoriatická artritida * farmakoterapie MeSH
- psoriáza farmakoterapie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH