{"id":7517,"date":"2018-07-04T11:36:05","date_gmt":"2018-07-04T15:36:05","guid":{"rendered":"https:\/\/themedicalxchange.com\/?p=7517"},"modified":"2022-01-25T15:16:39","modified_gmt":"2022-01-25T20:16:39","slug":"les-agents-anti-il-17-gardent-la-maitrise-du-rhumatisme-psoriasique-rps-meme-apres-trois-ans","status":"publish","type":"post","link":"https:\/\/themedicalxchange.com\/fr\/2018\/07\/04\/les-agents-anti-il-17-gardent-la-maitrise-du-rhumatisme-psoriasique-rps-meme-apres-trois-ans\/","title":{"rendered":"Les agents anti-IL-17 gardent la ma\u00eetrise du rhumatisme psoriasique (RPs) m\u00eame apr\u00e8s trois ans"},"content":{"rendered":"

Des agents homologu\u00e9s durablement efficaces<\/h2>\n

\u00ab Nos donn\u00e9es collig\u00e9es \u00e0 3 ans font \u00e9tat d\u2019une am\u00e9lioration soutenue similaire \u00e0 celle rapport\u00e9e dans nos r\u00e9sultats \u00e0 2 ans publi\u00e9s l\u2019an pass\u00e9 \u00bb, a rapport\u00e9 le Dr<\/sup> Peter Nash, de l\u2019Universit\u00e9 du Queensland, \u00e0 Brisbane, en Australie. Il faisait alors r\u00e9f\u00e9rence aux donn\u00e9es recueillies sur le s\u00e9cukinumab qui, avec l\u2019ix\u00e9kizumab, est l\u2019un des deux anti-IL-17 oppos\u00e9s au RPs homologu\u00e9s au Canada et ailleurs. Les taux \u00e9lev\u00e9s d\u2019efficacit\u00e9 observ\u00e9s lors des premiers essais cliniques, beaucoup d\u2019entre eux ayant recrut\u00e9 des patients qui n\u2019avaient pas assez bien r\u00e9pondu aux inhibiteurs du facteur de n\u00e9crose tumorale (TNF), peuvent d\u00e9sormais \u00eatre assimil\u00e9s \u00e0 des bienfaits durables.<\/p>\n

Essai FUTURE 2 : Des bienfaits soutenus confirm\u00e9s par les donn\u00e9es collig\u00e9es \u00e0 3 ans\u00a0<\/h2>\n

L\u2019obtention syst\u00e9matique de bienfaits soutenus est ce qu\u2019il faut retenir des donn\u00e9es collig\u00e9es \u00e0 3 ans lors de l\u2019essai FUTURE 2 sur le s\u00e9cukinumab. \u00c0 preuve, environ 72 % des 200 patients r\u00e9partis al\u00e9atoirement dans les deux groupes (300 mg ou 150 mg de s\u00e9cukinumab administr\u00e9 par voie sous-cutan\u00e9e [s.-c.] toutes les 4 semaines) ont poursuivi leur traitement et \u00e0 la derni\u00e8re visite de suivi, environ 70 % des sujets affichaient une r\u00e9ponse ACR20. \u00c0 3 ans, le taux de r\u00e9ponse ACR50 \u00e9tait plus \u00e9lev\u00e9 avec la plus forte des deux doses (54,3 % vs 38,4 %), mais la proportion de sujets ayant obtenu un indice PASI75 t\u00e9moignait d\u2019une ma\u00eetrise similaire de l\u2019atteinte cutan\u00e9e (74,3 % vs 81,8 %) (Figure 1<\/a>).\u00a0<\/p>\n

Essai SPIRIT-P2<\/h2>\n

Malgr\u00e9 une p\u00e9riode de suivi plus courte, l\u2019essai SPIRIT-P2, un essai de phase III sur l\u2019ix\u00e9kizumab, a lui aussi t\u00e9moign\u00e9 d\u2019un bienfait durable. L\u2019analyse r\u00e9alis\u00e9e \u00e0 42 semaines, qui a \u00e9t\u00e9 pr\u00e9sent\u00e9e lors du congr\u00e8s de 2018 de l\u2019EULAR, a port\u00e9 sur les sujets qui \u00e9taient pass\u00e9s du placebo \u00e0 l\u2019ix\u00e9kizumab \u00e0 la 24e semaine. \u00c0 52 semaines, le taux de r\u00e9ponse ACR20 se chiffrait \u00e0 60 % environ avec la dose de 80 mg d\u2019ix\u00e9kizumab administr\u00e9e par voie s.-c. toutes les 2 ou 4 semaines, que les sujets l\u2019aient re\u00e7ue d\u2019embl\u00e9e ou qu\u2019ils y soient venus en cours de route. La proportion de patients ayant obtenu un indice PASI75 variait davantage (de 48 \u00e0 76 %) et aucun lien \u00e9vident avec la dose n\u2019a \u00e9t\u00e9 observ\u00e9.\u00a0<\/p>\n

\u00c0 l\u2019instar du Dr<\/sup>\u00a0Nash, auteur principal de l\u2019\u00e9tude SPIRIT-P2, le Dr<\/sup>\u00a0Mark C. Genovese, de l\u2019Universit\u00e9 Stanford, en Californie, a insist\u00e9 sur les bienfaits soutenus. L\u2019innocuit\u00e9 n\u2019a pas soulev\u00e9 de nouvelles inqui\u00e9tudes pendant ces 52 semaines (Figure 2<\/a>).\u00a0<\/p>\n

Donn\u00e9es de l\u2019essai FUTURE 5<\/h2>\n

Selon la Dre<\/sup>\u00a0D\u00e9sir\u00e9e Van der Heijde, du Centre m\u00e9dical universitaire de Leyde, aux Pays-Bas, les donn\u00e9es issues de l\u2019essai FUTURE 5, qui sont au moins aussi importantes, ont reli\u00e9 les anti-IL-17 \u00e0 une protection contre l\u2019atteinte structurelle. Les m\u00e9decins qui ont interpr\u00e9t\u00e9, \u00e0 l\u2019insu, les radiographies prises au d\u00e9but, puis aux 16e et 24e semaines de l\u2019\u00e9tude, ont constat\u00e9 des taux d\u2019\u00e9volution plus bas avec toutes les doses de s\u00e9cukinumab qu\u2019avec le placebo. \u00ab Les faibles taux d\u2019\u00e9volution de la maladie enregistr\u00e9s avec le traitement actif ont \u00e9t\u00e9 observ\u00e9s que les patients aient d\u00e9j\u00e0 \u00e9t\u00e9 trait\u00e9s par un inhibiteur du TNF ou non \u00bb, a-t-elle pr\u00e9cis\u00e9.<\/p>\n

Conclusion<\/h2>\n

L\u2019homologation des agents anti-IL-17 a d\u2019abord repos\u00e9 sur la ma\u00eetrise rapide de la maladie. Or ces donn\u00e9es \u00e0 long terme montrent qu\u2019ils ont aussi une incidence sur l\u2019\u00e9volution naturelle du RPs.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

Amsterdam <\/b>\u2013 Le r\u00f4le jou\u00e9 par la voie de signalisation de l\u2019IL-17 dans la cascade inflammatoire li\u00e9e au RPs serait encore plus d\u00e9terminant pour la pathogen\u00e8se de cette maladie que ce que l\u2019on avait d\u2019abord cru. De nouvelles donn\u00e9es pr\u00e9sent\u00e9es lors du congr\u00e8s de 2018 de l\u2019EULAR ont en effet \u00e9tabli un lien entre l\u2019inhibition de l\u2019IL 17, une ma\u00eetrise du RPs d\u2019une dur\u00e9e ind\u00e9finie et l\u2019inhibition de l\u2019\u00e9volution objectiv\u00e9e \u00e0 la radiographie. Les donn\u00e9es d\u2019essais cliniques de phase III recueillies \u00e0 3 ans r\u00e9v\u00e8lent qu\u2019environ 50 % des sujets affichent une suppression de leur arthropathie \u00e9quivalant \u00e0 une r\u00e9ponse ACR50 et que l\u2019enth\u00e9site n\u2019est pas r\u00e9apparue chez pr\u00e8s de la moiti\u00e9 des patients.<\/p>\n","protected":false},"author":9,"featured_media":7519,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"tags":[522,517,428,523,346],"class_list":["post-7517","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","tag-2018-fr","tag-eular-fr-2","tag-eular-fr","tag-extract-fr","tag-rhumatologie","area_tag-allergie-immunologie","area_tag-rhumatologie"],"acf":[],"yoast_head":"\nLes agents anti-IL-17 gardent la ma\u00eetrise du rhumatisme psoriasique (RPs) m\u00eame apr\u00e8s trois ans - The Medical Xchange<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/themedicalxchange.com\/fr\/2018\/07\/04\/les-agents-anti-il-17-gardent-la-maitrise-du-rhumatisme-psoriasique-rps-meme-apres-trois-ans\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les agents anti-IL-17 gardent la ma\u00eetrise du rhumatisme psoriasique (RPs) m\u00eame apr\u00e8s trois ans - The Medical Xchange\" \/>\n<meta property=\"og:description\" content=\"Amsterdam \u2013 Le r\u00f4le jou\u00e9 par la voie de signalisation de l\u2019IL-17 dans la cascade inflammatoire li\u00e9e au RPs serait encore plus d\u00e9terminant pour la pathogen\u00e8se de cette maladie que ce que l\u2019on avait d\u2019abord cru. 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De nouvelles donn\u00e9es pr\u00e9sent\u00e9es lors du congr\u00e8s de 2018 de l\u2019EULAR ont en effet \u00e9tabli un lien entre l\u2019inhibition de l\u2019IL 17, une ma\u00eetrise du RPs d\u2019une dur\u00e9e ind\u00e9finie et l\u2019inhibition de l\u2019\u00e9volution objectiv\u00e9e \u00e0 la radiographie. 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