巴瑞替尼联合糖皮质激素治疗天疱疮的疗效及安全性评价

Efficacy and Safety of Baritinib Combined with Corticosteroid in the Treatment of Pemphigus

目的探讨巴瑞替尼联合糖皮质激素治疗天疱疮的疗效及安全性。方法回顾性分析海南省人民医院皮肤科2021年1月—2022年6月使用巴瑞替尼联合糖皮质激素治疗天疱疮患者共23例,比较治疗前后皮肤ABSIS评分、口腔黏膜ABSIS评分、抗桥粒芯糖蛋白1(抗Dsg1)和抗桥粒芯糖蛋白3(抗Dsg3)抗体值变化。结果经过系统治疗后在23例患者中,痊愈11例(47.83%),显效9例(39.13%),好转2例(8.69%),无效1例(4.35%)。巴瑞替尼治疗后皮肤ABSIS评分平均(21.04±5.18)分,明显低于治疗前(57.20±12.78)分(P<0.01)。治疗前口腔ABSIS评分(受累部位)的中位数4分,明显高于治疗后口腔ABSIS评分(受累部位)的中位数2分(P<0.01)。治疗前口腔ABSIS评分(症状严重程度)的中位数15分,明显高于治疗后口腔ABSIS评分(症状严重程度)的中位数8.5分(P<0.01)。治疗后抗Dsg1抗体值平均为(70.76±12.57)U/mL,明显低于治疗前的(132.50±11.46)U/mL(P<0.01)。治疗前抗Dsg3抗体值的中位数124.120 U/mL明显高于治疗后抗Dsg3抗体值的中位数63.420 U/mL(P<0.01)。结论巴瑞替尼是一个有效且安全的治疗天疱疮的药物,对于使用免疫抑制剂及生物制剂有禁忌的患者可考虑联合本药治疗。

Objective To investigate the efficacy and safety of baritinib combined with corticosteroid in the treatment of pemphigus.Methods A total of 23 pemphigus patients treated with baritinib combined with corticosteroid were analyzed in the Department of Dermatology of Hainan General Hospital from January 2021 to June 2022.The changes of skin ABSIS score,oral mucosa ABSIS score,anti-desmocoprotein 1 and anti-desmocoprotein 3 antibodies before and after treatment were compared.Results After systemic treatment,11 cases(47.83%)were cured,9 cases(39.13%)were effective,2 cases(8.69%)were improved,and 1 case(4.35%)was ineffective.The ABSIS score of skin after baritinib treatment(21.04±5.18)points was significantly lower than before treatment(57.20±12.78)points(P<0.01).The median oral ABSIS score(affected site)was 4 points before treatment,significantly higher than the median oral ABSIS score(affected site)of 2 points after treatment(P<0.01).The median oral ABSIS score(symptom severity)was 15 points before treatment,significantly higher than the median oral ABSIS score(symptom severity)of 8.5 points after treatment(P<0.01).The value of anti-Dsg1 antibody after treatment(70.76±12.57)U/mL was significantly lower than that before treatment(132.50±11.46)U/mL(P<0.01).The median anti-Dsg3 antibody value of 124.120 U/mL before treatment was significantly higher than that of 63.420 U/mL after treatment(P<0.01).Conclusion Baritinib is an effective and safe drug for the treatment of pemphigus,which may be considered in combination with baritinib for patients with contraindications in immunosuppressant and biologics.