司库奇尤单抗治疗中重度斑块状银屑病20例临床观察

Clinical observation of secukinumab in the treatment of 20 cases of moderate to severe plaque psoriasis

目的:观察司库奇尤单抗注射液治疗中重度斑块状银屑病的临床疗效及安全性。方法:纳入20例中重度斑块状银屑病患者,给予司库奇尤单抗注射液皮下注射治疗,300 mg/次,分别于第0、1、2、3、4周注射1次,随后每4周1次,于第4、8、12周时记录患者银屑病皮损面积和严重度指数(PASI)、中性粒细胞和淋巴细胞比值(NLR),观察药物不良反应。结果:20例患者治疗4周时,PASI均值为2.52±0.91,6例达PASI 90,2例达PASI 100;8周时,PASI均值为0.99±0.55,8例达PASI 90,5例达PASI 100;12周时,PASI均值为0.13±0.16,10例达PASI 90,7例达PASI 100。患者治疗前、治疗后4、8、12周NLR水平分别为2.42±0.08、2.17±0.05、2.14±0.03和2.12±0.03,第4周NLR水平明显低于治疗前,差异有统计学意义(t=11.66,P<0.01),但与第8周和12周比较差异无统计学意义(t值分别为1.78、1.79,P值分别为0.083、0.081)。患者治疗前NLR和PASI评分呈正相关(r=0.88,P<0.01),治疗后NLR下降值和PASI下降值明显相关(4周、8周、12周时r值分别为0.93、0.97、0.98,P值均<0.05)。所有患者均未发生严重不良反应。结论:司库奇尤单抗注射液治疗中重度斑块状银屑病起效迅速,疗效明显,不良反应较少且轻微,是中重度斑块状银屑病患者新的治疗选择。

Objective:To observe the clinical efficacy and safety of secukinumab in the treatment of moderate to severe plaque psoriasis.Methods:Twenty patients with moderate to severe psoriasis received subcutaneous injection of secukinumab at a dose of 300 mg once weekly for 5 weeks,followed by once every 4 weeks.Psoriasis area and severity index(PASI)and neutrophil to lymphocyte ratio(NLR)were assessed at weeks 4,8 and 12.Adverse drug reactions were also recorded during the treatment.Results:At week 4,the mean PASI was 2.52±0.91,including PASI 90 in 6 patients and PASI 100 in 2 patients.At week 8,the mean PASI was 0.99±0.55(PASI 90 in 8 cases and PASI 100 in 5 cases).At week 12,the mean PASI was 0.13±0.16(PASI 90 in 10 cases and PASI 100 in 7 cases).The NLR at weeks 0,4,8 and 12 were 2.42±0.08,2.17±0.05,2.14±0.03 and 2.12±0.03,respectively.The NLR at week 4 was significantly lower than that at week 0(t=11.66,P<0.01),but did not differ significantly from that at weeks 8(t=1.78,P=0.083)and that at week 12(t=1.79,P=0.081).Following the treatment,the reductions in NLR and PASI were correlated positively(week 4,r=0.93;week 8,r=0.97;week 12,r=0.98;P<0.05 for all).No serious adverse drug reactions were observed.Conclusions:Secukinumab is effective and safe for the treatment of moderate to severe plaque psoriasis,and is a new option for the treatment of moderate to severe plaque psoriasis.