Long-Term Benefit-Risk Profiles of Treatments for Moderate-to-Severe Plaque Psoriasis: A Network Meta-Analysis
Por:
Armstrong, AW, Soliman, AM, Betts, KA, Wang, Y, Gao, YW, Stakias, V, Puig, L
Publicada:
1 ene 2022
Ahead of Print:
1 dic 2021
Resumen:
Introduction The long-term benefit-risk profiles of licensed and investigational treatments for moderate-to-severe plaque psoriasis have not been fully characterized. Methods Randomized controlled trials (RCTs) of licensed and investigational treatments for moderate-to-severe plaque psoriasis were identified through a systematic literature review through 2 May 2021. Bayesian network meta-analyses (NMAs) were conducted to compare the efficacy (Psoriasis Area and Severity Index [PASI] 75/90/100 [at least a 75/90/100% reduction in PASI score from baseline] response) and safety outcomes (any adverse event [AE], any serious AE [SAE], and AEs leading to treatment discontinuation) of each treatment evaluated between weeks 48 and 56 after baseline. Surfaces under the cumulative ranking curves (SUCRAs) were calculated to evaluate the relative ranking of treatments. The benefit-risk profiles of treatments were assessed by bidimensional plots of the NMA-estimated efficacy and safety outcomes. Results In the efficacy NMA (N = 14 RCTs), the relative rankings for PASI 75/90/100 responses by weeks 48-56 were the highest for risankizumab (SUCRA: 98.5%) and bimekizumab (83.8% for dosing every 4 weeks [Q4W], 72.7% for dosing Q4W then every 8 weeks). The PASI response rates did not differ significantly between risankizumab and the two bimekizumab regimens. Additionally, risankizumab was associated with significantly higher PASI response rates than brodalumab, guselkumab, ixekizumab, secukinumab, ustekinumab, adalimumab, and etanercept. In the safety NMAs (N = 8 RCTs), risankizumab had the highest relative rankings for all three outcomes (SUCRA: 92.1%, 82.0%, and 91.0% for any AE, any SAE, and AEs leading to treatment discontinuation, respectively). Risankizumab had a significantly lower rate of any AE than bimekizumab, ustekinumab, and secukinumab. Conclusions Risankizumab was associated with the most favorable long-term benefit-risk profile for the treatment of moderate-to-severe plaque psoriasis. Although ixekizumab and bimekizumab had favorable efficacy profiles, both treatments had lower rankings for safety outcomes.
Filiaciones:
Armstrong, AW:
Univ Southern Calif, Keck Sch Med, Dept Dermatol, HC4 2000 1450 San Pablo,Hlth Sci Campus, Los Angeles, CA 90033 USA
Soliman, AM:
AbbVie Inc, 1 N Waukegan Rd, N Chicago, IL 60064 USA
Betts, KA:
Anal Grp Inc, 333 South Hope St 27th Floor, Los Angeles, CA 90071 USA
Wang, Y:
Anal Grp Inc, 333 South Hope St 27th Floor, Los Angeles, CA 90071 USA
Gao, YW:
Anal Grp Inc, 333 South Hope St 27th Floor, Los Angeles, CA 90071 USA
Stakias, V:
AbbVie Inc, 26525 N Riverwoods Blvd, Mettawa, IL 60045 USA
Puig, L:
Univ Autonoma Barcelona, Dept Dermatol, Hosp Santa Creu & St Pau, Carrer St Quinti 89, Barcelona 08041, Spain
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