基于真实世界数据的2020—2021年银屑病患者生物制剂应用及转换的回顾性分析

Retrospective analysis of application and conversion of biological agents in patients with psoriasis based on real world data from 2020 to 2021

目的:总结和分析真实世界中银屑病患者生物制剂的应用情况及转换影响因素。方法:回顾性分析2020年6月-2021年9月纳入中国银屑病规范化诊疗中心数据库中应用生物制剂治疗的2 529例银屑病患者资料。统计和分析银屑病患者使用生物制剂的情况及转换的影响因素。结果:2 529例患者中2 362例患者(93.40%)有银屑病面积和严重程度指数(PASI)评分,其中中、重度患者1 776例(75.19%)。根据患者自主评价的结果示司库奇尤单抗既往疗效评价最好(1 140/1 218,93.60%)。司库奇尤单抗主要的停药原因是病情控制后停药(67/172,38.95%)。1 049例随访患者中,19例在治疗期间转换了生物制剂,其中转换为司库奇尤单抗者15例。Logistic回归分析示疾病严重程度是患者转换生物制剂的主要影响因素。结论:该数据库2020-2021年数据分析显示,司库奇尤单抗使用量最多,且疗效较好,是银屑病患者转换治疗可选择的药物之一。

Objective:To summarize and analyze the application of biologic agents in patients with psoriasis in the real world and underlying influencing factors of the conversion.Methods:Relying on the data collected from June 2020 to September 2021 in the database of China Psoriasis Standardized Diagnosis and Treatment Center,2529 cases of psoriasis patients treated with biologic agents were retrospectively analyzed.According to the collected information,the usage of each category of biologics and influencing factor of biologics replacement were analyzed.Results:Within these patients,2362 of them(93.40%)had a psoriasis area and severity index(PASI)score,and 1776 of these patients had moderate to severe conditions(75.19%).According to the patient's self-evaluation of the past efficacy of biological agents,secukinumab was chosen by the most patients to have the highest efficacy(1140 cases,93.60%).The main reason for the withdrawal of secukinumab was that the disease had already been well controlled(67 cases,38.95%).Among all patients with follow-up records(1049 cases),19 patients changed their biologic agents during treatment,including 15 patients who changed the original biological agent to secukinumab.The statistical results showed that severity of psoriasis was the main factor determining the conversion of biological agents.Conclusions:Based on the database of China Psoriasis Standardized Diagnosis and Treatment Center from 2020 to 2021,our analysis showed that secukinumab is the most commonly used biotherapy of psoriasis,and the efficacy of secukinumab is thought better by most of patients.Secukinumab is one choice when the biologics needs to be changed.