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릴리 건선치료제 '탈츠', 얀센 '트렘피어' 대비 "우수" - 바이오스펙테이터

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릴리 건선치료제 '탈츠', 얀센 '트렘피어' 대비 "우수"

입력 2019-08-19 06:28 수정 2019-08-19 06:28

바이오스펙테이터 이승환 기자

일라이릴리, 얀센의 건선치료제 '트렘피어' 대비 건선 중증도 지수(PASI) 개선 임상4상 결과 공개

일라이릴리(Eli Lilly)가 건선치료제 '탈츠(Taltz, 성분명 ixekizumab)' 임상4상(IXORA-R, NCT03573323)에서 얀센(Janssen)의 '트렘피어(Tremfya, 성분명 guselkumab)' 보다 우수한 결과를 얻었다고 지난 13일(현지시간) 발표했다.

일라이릴리에 따르면 12주간 진행된 IXORA-R 연구에서 건선 중증도 지수(Psoriasis Area Severity Index, PASI)가 100에 도달한 환자 비율은 IL-17A 억제 항체 탈츠 투여그룹이 IL-23/p19 억제 항체 트렘피어 투여그룹보다 높았다. 2주차 PASI 75, 4~8주차 PASI 90에 도달한 환자 비율 등 여러 평가지표에서도 탈츠가 더 높았다. 일라이릴리는 정확한 수치에 대해선 공개하지 않았다. 가까운 시일 내에 학회와 학술지 발표를 통해 결과를 공개할 계획이다.

피부에 은백색 표면과 원형의 홍반성 구진이 생기는 건선은 전 세계 1~5%의 인구에게서 나타나는 만성염증성 피부병이다. 정확한 발병원인은 알려지지 않았으며, 유전, 환경, 면역 등의 요인이 관여하는 것으로 추정한다. 건선을 앓고 있는 환자의 특징 중 하나는 건선성 관절염이 동반되는 것이다. 이는 건선을 유발한 만성염증이 관절에도 염증을 유발하는 것으로 알려졌다.

건선 치료에 가장 일반적으로 사용되는 치료제는 코르티코스테로이드 계열의 항염증제이며, 면역억제제를 사용하기도 한다. 인터루킨을 억제하는 탈츠, 트렘피어 등의 건선 치료 항체도 면역세포의 분화와 증식이 일어나지 않도록 인터루킨과 같은 면역세포 촉진제의 활성을 조절해 건선 부위에 생겨나는 염증반응을 막는다.

PASI는 건선 치료의 성공여부를 판단하는 기준이다. PASI는 75, 90, 100으로 분류된다. PASI 75는 PASI 점수가 치료전 보다 75%이상 감소한 것이며, PASI 100의 경우 건선이 제거되어 피부가 완전히 깨끗해진 것으로 판단한다.

한편, 얀센은 트렘피어가 노바티스(Novartis)의 '코센틱스(Cosentyx, 성분명 secukinumab)'보다 건선 중증도 지수를 개선하는 것에 효과적이라고 2018년 12월 발표한 바 있다. 얀센이 발표한 임상3상(ECLIPSE, NCT03090100)에서 트렘피어는 IL-17 억제 항체 코센틱스보다 PASI 90을 넘긴 환자 비율이 더 높았다. ECLIPSE 연구에서 48주간 투여 이후에 PASI 90이상 개선한 환자 비율은 트렘피어 84.5%, 코센틱스 70%로 나타났다.

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