背景:银屑病患者肝功能异常的风险增加。
目的:探讨比马单抗治疗的银屑病患者肝脏治疗引起的不良事件(TEAE)的发生率和肝脏参数的变化。
方法:数据来自5个为期2年的3/3b期试验。肝脏TEAE,丙氨酸氨基转移酶(ALT)或天冬氨酸氨基转移酶(AST)的实验室升高,和肝纤维化的临床标志物的变化(纤维化-4[FIB-4]指数和AST血小板比指数[APRI])被报道。TEAE使用暴露调整发生率(EAIR)每100患者年(PY)呈现。
结果:2,186例患者接受了≥1次bimekizumab剂量。超过2年,肝脏TEAE的EAIR为3.5/100PY,从第1年到第2年没有增加.ALT/AST升高>3倍和>5倍ULN的2年EAIR分别为2.3和0.6/100PY;比率与安慰剂相似,阿达木单抗,苏金单抗,和ustekinumab在对照研究期间。FIB-4和APRI分数在两年内没有增加,无论基线时的纤维化风险如何。
结论:肥胖,糖尿病,血脂异常,长期饮酒,和药物改变是肝功能障碍的混杂因素。
结论:bimekizumab的肝脏不良事件发生率在2年内是一致的;在3/3b期对照研究期间,转氨酶升高的发生率与比较者相似。
BACKGROUND: Patients with psoriasis are at increased risk of liver function abnormalities.
OBJECTIVE: Explore rates of hepatic treatment-emergent adverse events (TEAEs) and changes in liver parameters in bimekizumab-treated patients with psoriasis.
METHODS: Data are reported from 5 phase 3/3b trials over 2 years. Hepatic TEAEs, laboratory elevations in alanine aminotransferase (ALT) or aspartate aminotransferase (AST), and changes in clinical markers of liver fibrosis (Fibrosis-4 [FIB-4] Index and AST to Platelet Ratio Index [APRI]) are reported. TEAEs are presented using exposure-adjusted incidence rates (EAIRs) per 100 patient-years (PY).
RESULTS: 2186 patients received ≥1 bimekizumab dose. Over 2 years, the EAIR of hepatic TEAEs was 3.5/100 PY and did not increase from first to second year. 2-year EAIRs of ALT/AST elevations >3x and >5x the upper limit of normal were 2.3 and 0.6/100 PY; rates were similar to placebo, adalimumab, secukinumab, and ustekinumab during controlled study periods. FIB-4 and APRI scores did not increase through 2 years, regardless of fibrosis risk at baseline.
CONCLUSIONS: Obesity, diabetes, dyslipidemia, chronic alcohol consumption, and medication changes are confounding factors for hepatic dysfunction.
CONCLUSIONS: Rates of hepatic adverse events (AEs) with bimekizumab were consistent through 2 years; incidences of
transaminase elevations were similar to comparators during phase 3/3b controlled study periods.