Длительное лечение гофликицептом пациентов с идиопатическим рецидивирующим перикардитом: данные промежуточного анализа открытого продленного исследования
Длительное лечение гофликицептом пациентов с идиопатическим рецидивирующим перикардитом: данные промежуточного анализа открытого продленного исследования
Myachikova VYu, Maslyanskiy AL, Moiseeva OM, Schedrova ML, Egorova AN, Ponomar EG, Samsonov MYu. Long-term goflkicept therapy for patients with idiopathic recurrent pericarditis: results of the interim analysis of an ongoing open-label extension study. Terapevticheskii Arkhiv (Ter. Arkh.). 2024;96(9):892–900.
DOI: 10.26442/00403660.2024.09.202984
Длительное лечение гофликицептом пациентов с идиопатическим рецидивирующим перикардитом: данные промежуточного анализа открытого продленного исследования
Цель. Оценить безопасность и эффективность гофликицепта при длительном применении у пациентов с идиопатическим рецидивирующим перикардитом (ИРП). Материалы и методы. Оценивали промежуточные результаты открытого продленного (open-label extension – OLE) исследования гофликицепта у пациентов с ИРП (NCT05673902), являющегося продолжением основного исследования NCT04692766. Изучали частоту рецидивов и время до рецидива через 12 и 60 нед терапии гофликицептом, динамику С-реактивного белка, интенсивность боли в грудной клетке, размер перикардиального выпота, а также нежелательные явления (НЯ). Результаты. У всех пациентов на фоне длительной 60-недельной терапии гофликицептом сохранялась клинико-лабораторная ремиссия. Частота рецидивов после отмены терапии, по завершении 60 нед терапии гофликицептом, в OLE-исследовании составила 31,3% (n=5/16), в то время как после 12 нед лечения рецидивы возникли у 90% пациентов (n=9/10); p<0,001. У 16 (94,1%) пациентов зарегистрировано 64 НЯ, в большинстве случаев легкой и умеренной тяжести, наиболее частыми НЯ стали инфекции – у 11 (64,7%) человек. У 5 пациентов зарегистрировано 9 серьезных НЯ. Все серьезные НЯ расценивали как не связанные с препаратом. Смертельных случаев не выявлено. Заключение. Длительная терапия гофликицептом приводила к снижению риска рецидива и увеличению длительности ремиссии, а также не ассоциировалась с увеличением частоты НЯ.
Aim. To evaluate the long-term safety and efficacy of goflkicept treatment in patients with idiopathic recurrent pericarditis (IRP). Materials and methods. This report presents the interim analysis of an ongoing open-label extension (OLE) clinical trial of goflkicept in patients with IRP (NCT 05673902), as a continuation of the core study (NCT04692766). The study assessed the frequency of pericarditis recurrence, time to recurrence after 12 and 60 weeks of goflkicept therapy, changes in C-reactive protein level, chest pain intensity, pericardial effusion size, and adverse events (AEs). Results. All patients remained in clinical-laboratory remission during the 60 weeks of goflkicept treatment. The recurrence frequency was 31.3% (5/16) after 60 weeks and 90% (9/10) after 12 weeks of goflkicept treatment (p<0.001). A total of 64 AEs were reported in 16 patients (94.1%), mostly of mild to moderate severity. The most common AEs were infections, occurring in 11 patients (64.7%). Nine serious adverse events were reported in 5 patients, none of which were considered drug-related. There were no deaths. Conclusion. Long-term goflkicept therapy resulted in a significant reduction in the risk of recurrence and prolonged remission without an increase in adverse events.
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2. Imazio M, Lazaros G, Gattorno M, et al. Anti-interleukin-1 agents for pericarditis: a primer for cardiologists. Eur Heart J. 2022;43(31):2946-97. DOI:10.1093/eurheartj/ehab452
3. Peet CJ, Rowczenio D, Omoyinmi E, et al. Pericarditis and Autoinflammation: A Clinical and Genetic Analysis of Patients With Idiopathic Recurrent Pericarditis and Monogenic Autoinflammatory Diseases at a National Referral Center. J Am Heart Assoc. 2022;11(11):e024931. DOI:10.1161/JAHA.121.024931
4. Feldman JM, Frishman WH, Aronow WS. Goflikicept and Related IL-1 Inhibitors in the Treatment of Recurrent Pericarditis. Cardiol Rev. 2024. DOI:10.1097/CRD.0000000000000704
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10. Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(1):76-92. DOI:10.1016/j.jacc.2019.11.021
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12. Алекберова З.С., Насонов Е.Л. Перспективы применения колхицина в медицине: новые данные. Научно-практическая ревматология. 2020;58(2):183-90 [Alekberova ZS, Nasonov EL. Prospects for using colchicine in medicine: new evidence. Rheumatology Science and Practice. 2020;58(2):183-90 (in Russian)]. DOI:10.14412/1995-4484-2020-183-190
13. Колесова Е.П., Маслянский А.Л., Ротарь О.П., и др. Новые подходы к патогенетической противовоспалительной терапии сердечно-сосудистых заболеваний. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2023;15(2):19-32 [Kolesova EP, Maslyanskiy AL, Rotar OP, et al. New approaches to pathogenetic anti-inflammatory therapy of cardiovascular diseases. Herald of North-Western State Medical University named after I.I. Mechnikov. 2023;15(2):19-32 (in Russian)]. DOI:10.17816/mechnikov296331
14. Stamp LK, Horsley C, Te Karu L, et al. Colchicine: the good, the bad, the ugly and how to minimize the risks. Rheumatology (Oxford). 2024;63(4):936-44. DOI:10.1093/rheumatology/kead625
15. Özen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach. Rheumatology (Oxford). 2021;60(8):3799-808. DOI:10.1093/rheumatology/keaa863
16. Imazio M, Brucato A, Cumetti D, et al. Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation. Circulation. 2008;118(6):667-71. DOI:10.1161/CIRCULATIONAHA.107.761064
17. Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol. 2001;33(4):289-94. DOI:10.1097/00004836-200110000-00006
18. Imazio M, Lazaros G, Brucato A, Gaita F. Recurrent pericarditis: new and emerging therapeutic options. Nat Rev Cardiol. 2016;13(2):99-105. DOI:10.1038/nrcardio.2015.115
19. Adler Y, Finkelstein Y, Guindo J, et al. Colchicine treatment for recurrent pericarditis. A decade of experience. Circulation. 1998;97(21):2183-5. DOI:10.1161/01.cir.97.21.2183
20. Lazaros G, Antonatou K, Vassilopoulos D. The Therapeutic Role of Interleukin-1 Inhibition in Idiopathic Recurrent Pericarditis: Current Evidence and Future Challenges. Front Med (Lausanne). 2017;4:78. DOI:10.3389/fmed.2017.00078
21. Myachikova VY, Maslyanskiy AL, Moiseeva OM, et al. Treatment of Idiopathic Recurrent Pericarditis With Goflikicept: Phase II/III Study Results. J Am Coll Cardiol. 2023;82(1):30-40. DOI:10.1016/j.jacc.2023.04.046
22. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Available at: https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x.... Accessed: 24.07.2024.
23. Imazio M, Lazaros G. Corticosteroids for pericarditis: a warning but don’t throw the baby out with the bathwater. Hellenic J Cardiol. 2019;60(6):364-6. DOI:10.1016/j.hjc.2019.04.002
24. Imazio M, Andreis A, Lubian M, et al. The Torino Pericarditis Score: a new-risk stratification tool to predict complicated pericarditis. Intern Emerg Med. 2021;16(7):1921-96. DOI:10.1007/s11739-021-02803-y
25. Duru N, van der Goes MC, Jacobs JW, et al. EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2013;72(12):1905-3. DOI:10.1136/annrheumdis-2013-203249
26. Imazio M, Andreis A, De Ferrari GM, et al. Anakinra for corticosteroid-dependent and colchicine-resistant pericarditis: The IRAP (International Registry of Anakinra for Pericarditis) study. Eur J Prev Cardiol. 2020;27(9):956-64. DOI:10.1177/2047487319879534
27. Klein AL, Imazio M, Cremer P, et al. Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. N Engl J Med. 2021;384(1):31-41. DOI:10.1056/NEJMoa2027892
28. Highlights of prescribing information. ARCALYST® (rilonacept) for injection, for subcutaneous use. Initial U.S. Approval. 2008. Available at: https://www.arcalyst.com/sites/arcalyst.com/files/2023-11/PI_IFU.pdf. Accessed: 03.06.2024.
29. Luis S, Cremer P, Raisinghani A, et al. Rilonacept utilization in a steroid-sparing paradigm for recurrent pericarditis: real world evidence demonstrating increased adoption. JACC. 2024;83 (Suppl. 13):408. DOI:10.1016/S0735-1097(24)02398-2
30. FDA approves first treatment for disease that causes recurrent inflammation in sac surrounding heart. Available at: https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-first-treatment-disease-causes-recurr.... Accessed: 03.06.2024.
31. Samsonov M, Bogin V, Van Tassell BW, Abbate A. Interleukin-1 blockade with RPH-104 in patients with acute ST-elevation myocardial infarction: study design and rationale. J Transl Med. 2021;19(1):169. DOI:10.1186/s12967-021-02828-z
32. Pharmacokinetics and Pharmacodynamics of RPH-104 in Healthy Subjects. Available at: https://classic.clinicaltrials.gov/ct2/show/results/NCT02667639?term=RPH-104&draw=2&rank=8. Accessed: 03.06.2024.
33. Imazio M, Klein AL, Brucato A, et al. Sustained Pericarditis Recurrence Risk Reduction With Long-Term Rilonacept. J Am Heart Assoc. 2024;13(6):e032516. DOI:10.1161/JAHA.123.032516
34. Popa C, van den Hoogen FH, Radstake TR, et al. Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis. Ann Rheum Dis. 2007;66(11):1503-7. DOI:10.1136/ard.2006.066191
35. Kawashiri SY, Kawakami A, Yamasaki S, et al. Effects of the anti-interleukin-6 receptor antibody, tocilizumab, on serum lipid levels in patients with rheumatoid arthritis. Rheumatol Int. 2011;31(4):451-6. DOI:10.1007/s00296-009-1303-y
36. Charles-Schoeman C, Gonzalez-Gay MA, Kaplan I, et al. Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist. Semin Arthritis Rheum. 2016;46(1):71-80. DOI:10.1016/j.semarthrit.2016.03.004
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1. Myachikova VYu, Maslyanskiy AL. Moiseeva OM. Idiopathic recurrent pericarditis – a new orphan autoinflammatory disease? A retrospective analysis of cases of idiophatic recurrent pericarditis and design of a double-blind, randomized, placebo-controlled study to evaluate the efficacy and safety of RPH-104 treatment in patients with idiopathic recurrent pericarditis. Kardiologiia. 2021;61(1):72-7 (in Russian). DOI:10.18087/cardio.2021.1.n1475
2. Imazio M, Lazaros G, Gattorno M, et al. Anti-interleukin-1 agents for pericarditis: a primer for cardiologists. Eur Heart J. 2022;43(31):2946-97. DOI:10.1093/eurheartj/ehab452
3. Peet CJ, Rowczenio D, Omoyinmi E, et al. Pericarditis and Autoinflammation: A Clinical and Genetic Analysis of Patients With Idiopathic Recurrent Pericarditis and Monogenic Autoinflammatory Diseases at a National Referral Center. J Am Heart Assoc. 2022;11(11):e024931. DOI:10.1161/JAHA.121.024931
4. Feldman JM, Frishman WH, Aronow WS. Goflikicept and Related IL-1 Inhibitors in the Treatment of Recurrent Pericarditis. Cardiol Rev. 2024. DOI:10.1097/CRD.0000000000000704
5. Perechen’ redkikh (orfannykh) zabolevanii. Available at: https://minzdrav.gov.ru/documents/9773-perechen-redkih-orfannyh-zabolevaniy. Accessed: 25.07.2024 (in Russian).
6. Klein A, Cremer P, Kontzias A, et al. US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis. J Am Heart Assoc. 2021;10(15):e018950. DOI:10.1161/JAHA.120.018950
7. LeWinter M, Kontzias A, Lin D, et al. Burden of Recurrent Pericarditis on Health-Related Quality of Life. Am J Cardiol. 2021;141:113-1. DOI:10.1016/j.amjcard.2020.11.018
8. Adler Ye, Charron P, Imazio M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases. Russian Journal of Cardiology. 2016;(5):117-62 (in Russian). DOI:10.15829/1560-4071-2016-5-117-162
9. Arutyunov GP, Paleev FN, Tarlovskaya EI, et al. Pericarditis. Clinical Guidelines 2022. Russian Journal of Cardiology. 2023;28(3):5398 (in Russian). DOI:10.15829/1560-4071-2023-5398
10. Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(1):76-92. DOI:10.1016/j.jacc.2019.11.021
11. Karateev AE, Nasonov EL, Ivashkin VT, et al. Rational use of nonsteroidal anti-inflammatory drugs. Clinical guidelines. Rheumatology Science and Practice. 2018;56:1-29 (in Russian). DOI:10.14412/1995-4484-2018-1-29
12. Alekberova ZS, Nasonov EL. Prospects for using colchicine in medicine: new evidence. Rheumatology Science and Practice. 2020;58(2):183-90 (in Russian).
DOI:10.14412/1995-4484-2020-183-190
13. Kolesova EP, Maslyanskiy AL, Rotar OP, et al. New approaches to pathogenetic anti-inflammatory therapy of cardiovascular diseases. Herald of North-Western State Medical University named after I.I. Mechnikov. 2023;15(2):19-32 (in Russian). DOI:10.17816/mechnikov296331
14. Stamp LK, Horsley C, Te Karu L, et al. Colchicine: the good, the bad, the ugly and how to minimize the risks. Rheumatology (Oxford). 2024;63(4):936-44. DOI:10.1093/rheumatology/kead625
15. Özen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach. Rheumatology (Oxford). 2021;60(8):3799-808. DOI:10.1093/rheumatology/keaa863
16. Imazio M, Brucato A, Cumetti D, et al. Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation. Circulation. 2008;118(6):667-71. DOI:10.1161/CIRCULATIONAHA.107.761064
17. Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol. 2001;33(4):289-94. DOI:10.1097/00004836-200110000-00006
18. Imazio M, Lazaros G, Brucato A, Gaita F. Recurrent pericarditis: new and emerging therapeutic options. Nat Rev Cardiol. 2016;13(2):99-105. DOI:10.1038/nrcardio.2015.115
19. Adler Y, Finkelstein Y, Guindo J, et al. Colchicine treatment for recurrent pericarditis. A decade of experience. Circulation. 1998;97(21):2183-5. DOI:10.1161/01.cir.97.21.2183
20. Lazaros G, Antonatou K, Vassilopoulos D. The Therapeutic Role of Interleukin-1 Inhibition in Idiopathic Recurrent Pericarditis: Current Evidence and Future Challenges. Front Med (Lausanne). 2017;4:78. DOI:10.3389/fmed.2017.00078
21. Myachikova VY, Maslyanskiy AL, Moiseeva OM, et al. Treatment of Idiopathic Recurrent Pericarditis With Goflikicept: Phase II/III Study Results. J Am Coll Cardiol. 2023;82(1):30-40. DOI:10.1016/j.jacc.2023.04.046
22. Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Available at: https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x.... Accessed: 24.07.2024.
23. Imazio M, Lazaros G. Corticosteroids for pericarditis: a warning but don’t throw the baby out with the bathwater. Hellenic J Cardiol. 2019;60(6):364-6. DOI:10.1016/j.hjc.2019.04.002
24. Imazio M, Andreis A, Lubian M, et al. The Torino Pericarditis Score: a new-risk stratification tool to predict complicated pericarditis. Intern Emerg Med. 2021;16(7):1921-96. DOI:10.1007/s11739-021-02803-y
25. Duru N, van der Goes MC, Jacobs JW, et al. EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2013;72(12):1905-3. DOI:10.1136/annrheumdis-2013-203249
26. Imazio M, Andreis A, De Ferrari GM, et al. Anakinra for corticosteroid-dependent and colchicine-resistant pericarditis: The IRAP (International Registry of Anakinra for Pericarditis) study. Eur J Prev Cardiol. 2020;27(9):956-64. DOI:10.1177/2047487319879534
27. Klein AL, Imazio M, Cremer P, et al. Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. N Engl J Med. 2021;384(1):31-41. DOI:10.1056/NEJMoa2027892
28. Highlights of prescribing information. ARCALYST® (rilonacept) for injection, for subcutaneous use. Initial U.S. Approval. 2008. Available at: https://www.arcalyst.com/sites/arcalyst.com/files/2023-11/PI_IFU.pdf. Accessed: 03.06.2024.
29. Luis S, Cremer P, Raisinghani A, et al. Rilonacept utilization in a steroid-sparing paradigm for recurrent pericarditis: real world evidence demonstrating increased adoption. JACC. 2024;83 (Suppl. 13):408. DOI:10.1016/S0735-1097(24)02398-2
30. FDA approves first treatment for disease that causes recurrent inflammation in sac surrounding heart. Available at: https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-first-treatment-disease-causes-recurr.... Accessed: 03.06.2024.
31. Samsonov M, Bogin V, Van Tassell BW, Abbate A. Interleukin-1 blockade with RPH-104 in patients with acute ST-elevation myocardial infarction: study design and rationale. J Transl Med. 2021;19(1):169. DOI:10.1186/s12967-021-02828-z
32. Pharmacokinetics and Pharmacodynamics of RPH-104 in Healthy Subjects. Available at: https://classic.clinicaltrials.gov/ct2/show/results/NCT02667639?term=RPH-104&draw=2&rank=8. Accessed: 03.06.2024.
33. Imazio M, Klein AL, Brucato A, et al. Sustained Pericarditis Recurrence Risk Reduction With Long-Term Rilonacept. J Am Heart Assoc. 2024;13(6):e032516. DOI:10.1161/JAHA.123.032516
34. Popa C, van den Hoogen FH, Radstake TR, et al. Modulation of lipoprotein plasma concentrations during long-term anti-TNF therapy in patients with active rheumatoid arthritis. Ann Rheum Dis. 2007;66(11):1503-7. DOI:10.1136/ard.2006.066191
35. Kawashiri SY, Kawakami A, Yamasaki S, et al. Effects of the anti-interleukin-6 receptor antibody, tocilizumab, on serum lipid levels in patients with rheumatoid arthritis. Rheumatol Int. 2011;31(4):451-6. DOI:10.1007/s00296-009-1303-y
36. Charles-Schoeman C, Gonzalez-Gay MA, Kaplan I, et al. Effects of tofacitinib and other DMARDs on lipid profiles in rheumatoid arthritis: implications for the rheumatologist. Semin Arthritis Rheum. 2016;46(1):71-80. DOI:10.1016/j.semarthrit.2016.03.004
1ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России, Санкт-Петербург, Россия; 2НЦМУ «Центр персонализированной медицины», Санкт-Петербург, Россия; 3ФГБОУ ВО «Санкт-Петербургский государственный университет», Санкт-Петербург, Россия; 4ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия; 5АО «Р-Фарм», Москва, Россия
*v.myachikova@gmail.com
________________________________________________
Valentina Yu. Myachikova*1,2, Alexey L. Maslyanskiy1,3,4, Olga M. Moiseeva1, Margarita L. Schedrova5, Alina N. Egorova5, Ekaterina G. Ponomar5, Mikhail Yu. Samsonov5
1Almazov National Medical Research Centre, Saint Petersburg, Russia; 2World-Class Research Centre for Personalized Medicine, Saint Petersburg, Russia; 3Saint Petersburg State University, Saint Petersburg, Russia; 4Nasonova Research Institute of Rheumatology, Moscow, Russia; 5R-Pharm JSC, Moscow, Russia
*v.myachikova@gmail.com