4.Comparative efficacy of secukinumab against adalimumab and infliximab in patients with moderate-to-severe plaque psoriasis.
Ran PAN ; Xiaolun WANG ; Min SHU ; Jaydeep DAS ; Manik KALRA ; Zhidong WANG
Chinese Medical Journal 2021;135(1):11-19
BACKGROUND:
Psoriasis is a common, chronic, immune-mediated inflammatory skin disease with increased epidermal proliferation. The objective of this review was to systematically identify the evidence and perform a network meta-analysis (NMA) to estimate the relative efficacy of secukinumab (SEC) against adalimumab (ADA) and infliximab (INF) for the treatment of moderate-to-severe plaque psoriasis.
METHODS:
A systematic literature review (SLR) was conducted according to a pre-specified protocol to identify relevant studies. Initially, the databases were searched from database inception till June 2013, and the SLR was updated in April 2020. The eligibility criteria included adult patients (≥18 years old) with moderate-to-severe plaque psoriasis, and the SLR included randomized controlled trials (RCTs). The comparators of interest were SEC, ADA, INF, and placebo (PLA), while outcomes of interest were Psoriasis Area and Severity Index (PASI) (50, 75, and 90) at weeks 12, 16, and 24. A Bayesian NMA for PASI was utilized with a framework that evaluated the probability of PASI responses in different categories of PASI thresholds within a single model.
RESULTS:
A total of 23 RCTs that assessed the efficacy of SEC, ADA, and INF in patients with moderate-to-severe plaque psoriasis were identified. At 12 weeks, SEC was associated with a significantly better response compared with PLA and ADA for PASI 75 and 90, while response results were comparable against INF. At 12 weeks, risk ratio (95% confidence interval) derived from NMA for SEC vs. ADA and INF for PASI 75 was 1.35 (1.19, 1.57) and 1.01 (0.90, 1.18), respectively. At the 16-week and 24-week time interval, SEC was significantly better than PLA, ADA, and INF for PASI 75 and 90.
CONCLUSION
Efficacy of SEC in the treatment of patient populations with moderate-to-severe plaque psoriasis is well demonstrated through NMA.
Adalimumab/therapeutic use*
;
Adolescent
;
Adult
;
Antibodies, Monoclonal, Humanized
;
Humans
;
Infliximab/therapeutic use*
;
Psoriasis/drug therapy*
;
Severity of Illness Index
;
Treatment Outcome
6.Treatment of 11 cases of juvenile idiopathic arthritis by intra-articular injection of adalimumab.
Ying CHI ; Jian Ming LAI ; Gai Xiu SU ; Min KANG ; Sheng Nan LI ; Dan ZHANG ; Xin Ning WANG
Chinese Journal of Pediatrics 2022;60(3):237-241
Objective: To evaluate the efficacy and safety of intra-articular injection of adalimumab (ADA) in the treatment of refractory oligoarticular juvenile idiopathic arthritis (JIA). Methods: This was a retrospective study. Clinical data on age, gender, and symptoms of joint swelling and pain were collected from 11 children with refractory oligoarticular JIA involving only knee joints admitted to Department of Rheumatism and Immunology of Children's Hospital, Capital Institute of Pediatrics from November 2019 to October 2020. The physician and parent-child evaluation of disease activity, the number of active joints, and the level of erythrocyte sedimentation rate (ESR) at different treatment time points were analyzed at every 4-week observation point after drug administration, and the non-parametric Kruskal-Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at different treatment times. The follow-up period was 6 months. Results: Among the 11 children, 5 were boys and 6 were girls. The age was 3.0 (2.8) years. All 11 children had symptoms of joint swelling and pain as well as limitation of movement. After 3 intra-articular injections of ADA, the joint symptoms of 11 children were better than before treatment; the joint symptoms of 7 children disappeared completely, and no recurrence occurred during the 6-month follow-up period. At different treatment times, physician and parent-child evaluation of disease activity, a gradual decrease in the number of active joints in the children, ESR, and juvenile arthritis disease activity score with 27 joints were all statistically significant (χ2=53.99, 59.37, 32.87, 40.07, 54.00, all P<0.001).No significant adverse drug reactions were observed in any of the 11 children during treatment and follow-up. Conclusion: Intra-articular injection of ADA in the treatment of refractory oligoarticular JIA has a significant effect in controlling joint symptoms and is relatively safe.
Adalimumab/therapeutic use*
;
Arthritis, Juvenile/drug therapy*
;
Child
;
Child, Preschool
;
Female
;
Glucocorticoids/therapeutic use*
;
Humans
;
Injections, Intra-Articular
;
Male
;
Retrospective Studies
;
Treatment Outcome
7.Novel biologics in treatment of psoriatic arthritis.
Journal of Zhejiang University. Medical sciences 2009;38(4):404-408
Psoriatic arthritis is an inflammatory joint disease associated with psoriasis. Due to difficulty for early diagnosis and lack of effective therapy, the disease leads to chronic course and frequent relapse. Patients may suffer from ankylosis,disability and even death. The past treatments neither can control the disease effectively, nor be capable of inhibiting the development of structural joint damage. Based on the current psoriasis pathogenesis, novel biologics have been developed,which can aim the specific targets, resulting in more effective and safer management for psoriatic arthritis.
Adalimumab
;
Anti-Inflammatory Agents, Non-Steroidal
;
therapeutic use
;
Antibodies, Monoclonal
;
therapeutic use
;
Antibodies, Monoclonal, Humanized
;
Arthritis, Psoriatic
;
drug therapy
;
etiology
;
Dermatologic Agents
;
therapeutic use
;
Etanercept
;
Humans
;
Immunoglobulin G
;
therapeutic use
;
Receptors, Tumor Necrosis Factor
;
therapeutic use
;
Recombinant Fusion Proteins
;
therapeutic use
8.Development of Crescentic Immunoglobulin A Nephritis and Multiple Autoantibodies in a Patient during Adalimumab Treatment for Rheumatoid Arthritis.
Xia LI ; Jie MA ; Yan ZHAO ; Hai-Yun WANG ; Xue-Mei LI
Chinese Medical Journal 2015;128(18):2555-2556
Adalimumab
;
adverse effects
;
therapeutic use
;
Antirheumatic Agents
;
adverse effects
;
therapeutic use
;
Arthritis, Rheumatoid
;
drug therapy
;
immunology
;
Asian Continental Ancestry Group
;
Autoantibodies
;
immunology
;
Female
;
Humans
;
Immunoglobulin A
;
immunology
;
Middle Aged
;
Nephritis
;
etiology
;
immunology
9.Efficacy and Safety of Adalimumab in Moderately to Severely Active Cases of Ulcerative Colitis: A Meta-Analysis of Published Placebo-Controlled Trials.
Zong Mei ZHANG ; Wei LI ; Xue Liang JIANG
Gut and Liver 2016;10(2):262-274
BACKGROUND/AIMS: To evaluate the efficacy and safety of adalimumab (ADA) in moderately to severely active ulcerative colitis (UC) patients who are unresponsive to traditional therapy. METHODS: Electronic databases, including the PubMed, Embase, and Cochrane databases, were searched to April 20, 2014. UC-related randomized controlled trials (RCTs) that compared ADA with placebo were eligible. Review Manager 5.1 was used for data analysis. RESULTS: This meta-analysis included three RCTs. ADA was considerably more effective compared with a placebo, and it increased the ratio of patients with clinical remission, clinical responses, mucosal healing and inflammatory bowel disease questionnaire responses in the induction and maintenance phases (p<0.05), as well as patients with steroid-free remission (p<0.05) during the maintenance phase. Clinical remission was achieved in a greater number of UC cases in the ADA 160/80/40 mg groups (0/2/4 week, every other week) compared with the placebo group at week 8 (p=0.006) and week 52 (p=0.0002), whereas the week 8 clinical remission rate was equivalent between the ADA 80/40 mg groups and the placebo group. Among the patients who received immunomodulators (IMM) at baseline, ADA was superior to the placebo in terms of inducing clinical remission (p=0.01). Between-group differences were not observed in terms of serious adverse events (p=0.61). CONCLUSIONS: ADA, particularly at doses of 160/80/40 mg (0/2/4 week, every other week), is effective and safe in patients with moderate-to-severe UC who are unresponsive to traditional treatment. Concomitant IMM therapy may improve the short-term therapeutic efficacy of ADA.
Adalimumab/*therapeutic use
;
Adult
;
Anti-Inflammatory Agents/*therapeutic use
;
Colitis, Ulcerative/*drug therapy/pathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Randomized Controlled Trials as Topic
;
Remission Induction/methods
;
Severity of Illness Index
10.Efficacy of Adalimumab in Korean Patients with Crohn's Disease.
Il Woong SOHN ; Sung Tae KIM ; Bun KIM ; Hyun Jung LEE ; Soo Jung PARK ; Sung Pil HONG ; Tae Il KIM ; Won Ho KIM ; Jae Hee CHEON
Gut and Liver 2016;10(2):255-261
BACKGROUND/AIMS: Adalimumab is effective for both remission induction and the maintenance of Crohn's disease (CD) in Western countries. We evaluated the efficacy of adalim-umab in the conventional step-up treatment approach for CD in Korea. METHODS: We retrospectively reviewed 62 patients with CD who were treated with adalimumab. Their Crohn's disease activity index (CDAI) was measured at weeks 4, 8, and 52. Clinical remission was defined as a CDAI score <150. Induction and maintenance outcomes were analyzed. RESULTS: Forty-one patients (66.1%) achieved a reduction of 70 CDAI points at week 8. Among them, 28 (45.2%) achieved clinical remission at week 8, 20 (32.3%) maintained remission at week 52. The absence of prior anti-tumor necrosis factor (TNF) therapy and Montreal classification L1 at baseline predicted clinical remission at week 8 in the multivariate logistic regression analysis. In the Cox proportional hazards model, the hazard ratio for the secondary loss of response during maintenance therapy after clinical remission induction was significantly higher in patients who showed initial mild CDAI severity or Montreal classification A3. CONCLUSIONS: In our study, anti-TNF therapy-naive and Montreal classification L1 were associated with adalimumab efficacy as induction therapy in CD. Further studies are warranted to determine the prognostic factors for the long-term response after adalimumab therapy.
Adalimumab/*therapeutic use
;
Adolescent
;
Adult
;
Anti-Inflammatory Agents/*therapeutic use
;
Crohn Disease/*drug therapy
;
Female
;
Humans
;
Male
;
Middle Aged
;
Proportional Hazards Models
;
Remission Induction/methods
;
Republic of Korea
;
Retrospective Studies
;
Severity of Illness Index
;
Treatment Outcome
;
Young Adult