Safety and Efficacy of Etanercept Monotherapy for Moderate-to-severe Plaque Psoriasis:A Prospective 12-week Follow-up Study

Etanercept has been shown to be effective for the treatment of moderate-to-severe plaque psoriasis. Since most clinical trials examined etanercept in combination with other drugs, the efficacy and safety of etanercept monotherapy for moderate-to-severe plaque psoriasis have not been well established. This prospective study enrolled 61 Chinese patients with moderate-to-severe plaque psoriasis to explore the efficacy and safety of etanercept monotherapy. These patients were treated with etanercept at a subcutaneous dose of 25 mg, twice a week, for 12 weeks. All the 61 patients completed the treatment and showed significant improvement in psoriasis area and severity index（PASI） scores. At 4, 8, and 12 weeks after treatment, the response rates（PASI75） were 0%, 21.31%, and 40.98%, respectively. It was concluded that etanercept monotherapy is efficacious and safe for patients with moderate-to-severe plaque psoriasis.

Tildrakizumab for moderate-to-severe plaque psoriasis in Chinese patients:A 12-week randomized placebo-controlled phase III trial with long-term extension

Background:There is a need for effective and safe therapies for psoriasis that provide sustained benefits.The aim of this study was to assess the efficacy and safety of tildrakizumab,an anti-interleukin-23p19 monoclonal antibody,for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods:In this multi-center,double-blind,phase III trial,patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned(1:1)to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4.Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12,16,and every 12 weeks thereafter.Patients in the tildrakizumab group continued with tildrakizumab at week 16,and every 12 weeks until week 52.The primary endpoint was the Psoriasis Area and Severity Index(PASI 75)response rate at week 12.Results:At week 12,tildrakizumab demonstrated significantly higher PASI 75 response rates(66.4%[73/110]vs.12.7%[14/110];difference,51.4%[95%confidence interval(CI),40.72,62.13];P<0.001)and Physician’s Global Assessment(60.9%[67/110]vs.10.0%[11/110];difference,49.1%[95%CI,38.64,59.62];P<0.001)compared to placebo.PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups,reaching maximal efficacy after 28 weeks(86.8%[92/106]vs.82.4%[89/108])and maintained up to 52 weeks(91.3%[95/104]vs.87.4%[90/103]).Most treatment-emergent adverse events were mild and not related to tildrakizumab.Conclusion:Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration:ClinicalTrials.gov,NCT05108766.

Impact of Adverse Events Associated With Acitretin Treatment of Moderate-to-Severe Plaque Psoriasis:Based on an Observational,Single-Center Study in Shanghai,China

Objective:Acitretin is a widely used systemic retinoid that is to treat psoriasis but has significant variations in efficacy and adverse events(AEs)among individuals.This study aimed to determine the impact of AEs associated with acitretin treatment of moderate-to-severe plaque psoriasis on the Dermatology Life Quality Index(DLQI)and Hospital Anxiety and Depression Scale(HADS)scores.Methods:This prospective,observational,single-center study was conducted from March 2021 to June 2022 and analyzed 116 patients with moderate-to-severe plaque psoriasis treated with acitretin who were followed up for 12 weeks.The primary outcome was the incidence of AEs related to acitretin,and the secondary objective was to investigate the effect of AEs on the DLQI and HADS scores.The generalized linear models were used to assess the association between AEs related to acitretin and DLQI scores or HADS scores,and the association between the involved system/tissue and DLQI scores or HADS scores.Results:A final total of 45 patients were included in the analysis,and a total of 157 treatment-related AEs involving nine organs or systems were reported in 41 patients.The most common AE was skin-or mucosa-related,with 72 cumulative events in 31 patients.AEs also commonly affected the endocrine,digestive,and genitourinary systems.Compared with the group with 0-2 AEs,the group with 3-5 AEs had a significantly increased DLQI score by 5.49 points(95%CI,1.47-9.51)(P=0.0089).Compared with AEs involving 0 to 1 system,AEs affecting 2 to 3 systems resulted in a significant increase in the DLQI score by 5.75 points(95%CI,1.67-9.83)(P=0.0071).Generalized linear models showed no statistically significant associations between AEs and the HADS scores.Conclusion:Our study demonstrates a high incidence of acitretin-related AEs.These AEs may affect quality of life but rarely cause psychological problems such as anxiety and depression.

Comparative efficacy of secukinumab against adalimumab and infliximab in patients with moderate-to-severe plaque psoriasis

Background: Psoriasis is a common, chronic, immune-mediated inflammatory skin disease with increased epidermal proliferation. The objective of this review was to systematically identify the evidence and perform a network meta-analysis (NMA) to estimate the relative efficacy of secukinumab (SEC) against adalimumab (ADA) and infliximab (INF) for the treatment of moderate-to-severe plaque psoriasis.Methods: A systematic literature review (SLR) was conducted according to a pre-specified protocol to identify relevant studies. Initially, the databases were searched from database inception till June 2013, and the SLR was updated in April 2020. The eligibility criteria included adult patients (≥18 years old) with moderate-to-severe plaque psoriasis, and the SLR included randomized controlled trials (RCTs). The comparators of interest were SEC, ADA, INF, and placebo (PLA), while outcomes of interest were Psoriasis Area and Severity Index (PASI) (50, 75, and 90) at weeks 12, 16, and 24. A Bayesian NMA for PASI was utilized with a framework that evaluated the probability of PASI responses in different categories of PASI thresholds within a single model.Results: A total of 23 RCTs that assessed the efficacy of SEC, ADA, and INF in patients with moderate-to-severe plaque psoriasis were identified. At 12 weeks, SEC was associated with a significantly better response compared with PLA and ADA for PASI 75 and 90, while response results were comparable against INF. At 12 weeks, risk ratio (95% confidence interval) derived from NMA for SECvs. ADA and INF for PASI 75 was 1.35 (1.19, 1.57) and 1.01 (0.90, 1.18), respectively. At the 16-week and 24-week time interval, SEC was significantly better than PLA, ADA, and INF for PASI 75 and 90.Conclusion: Efficacy of SEC in the treatment of patient populations with moderate-to-severe plaque psoriasis is well demonstrated through NMA.

Plaque Psoriasis: Understanding Risk Factors of This Inflammatory Skin Pathology

Covering the entire human body, the skin is considered to be one of the most important organs, since it is the first line of protection against chemical and biological external agents. Although the skin protects tissues and organs against external aggression, it can still be unbalanced by various skin diseases, such as psoriasis. This non-contagious inflammatory dermatosis is characterized by the occurrence of erythematous lesions of various sizes covered with whitish scales. This scaling of the skin is the result of a rapid renewal of the epidermis, occurring over five to seven days instead of 28 days. Psoriasis vulgaris, or plaque psoriasis, is the most common form of this disease and is therefore commonly referred to by the term “psoriasis”. This work is a review of the literature on plaque psoriasis, aiming at a better comprehension of the pathology at the histological level, but also to understand the genetic and environmental factors associated with this inflammatory dermatosis.

Therapeutic Effect and Safety of Ustekinumab for Plaque Psoriasis: A Meta-analysis

Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis. Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index （PASI） 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1. Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group （all P〈0.00001）. Furthermore, ustekinumab 90 mg group was more effective than ustekinumab 45 mg group （P=0.01）. Adverse effects in the 6 trials were mentioned including headache, upper respiratory tract infection, nasopharyngtis, infection, serious infection, cardiovascular events, and malignant tumors. There were no statistically significant differences of these adverse effects among three groups （all P〉0.0S）, except that infection rate in ustekinumab 45 mg group was higher than the placebo group （P=0.02）. Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.

Therapeutic effect of plaque psoriasis by fire acupuncture based on theory of midnight-noon ebb-flow

Objective:To observe the clinical efficacy,immune inflammatory factors and hemorheology of patients with plaque psoriasis by using fire acupuncture combined with the theory of midnight-noon ebb-flow.Methods:Sixty-two patients with plaque psoriasis who met the diagnosis and inclusion criteria were randomly divided into control group and fire acupuncture with midnight-noon ebb-flow,with 31 cases in each group.The control group was treated with carpotriol ointment for external use,while the fire acupuncture group was treated with fire acupuncture with midnight-noon ebb-flow on the basis of the former and selected points by the opening method through midnight-noon ebb-flow theory.The patients in both groups were treated for 8 weeks and followed up for 4 weeks.The levels of PASI,DLQI,PSQI,HAMA,hs-CRP,TNF-αand hemorheology indexes in 2 groups before and after treatment were observed,including the comparison of whole blood viscosity,plasma viscosity and hematocrit.Results:PASI,DLQI,PSQI,HAMA,hs-CRP,TNF-α,blood viscosity and hematocrit levels were significantly improved after treatment(P<0.05,P<0.01),and the group in fire acupuncture with midnight-noon ebb-flow was significantly better than control group after treatment(P<0.01).Conclusion:fire acupuncture with midnight-noon ebb-flow can improve the sleep quality of patients with psoriasis,relieve anxiety and effectively improve the blood cell rheology and microcirculation,alleviate clinical symptoms and improve the quality of life.

Identification of signal pathways and biomarkers of plaque psoriasis and prediction of potential microRNA targets via comprehensive strategies

Psoriasis is a complex skin disease and the pathogenesis of psoriasis is not clear.The purpose of this study is to identify the key driving genes and signal pathways involved in psoriasis and to predict the potential miRNA,for further understanding the pathogenesis of psoriasis.Methods:Three gene expression profiling chips,including GSE67853,GSE78097,and GSE136757 with a total of 120 samples were collected and analyzed with R software.The protein-protein interaction network of differentially expressed genes was constructed with STRING database and Cytoscape.CIBERSORT was used to evaluate the infiltration of immune cells in psoriasis tissues,and the correlation between diagnostic markers and infiltrating immune cells was analyzed.Further,the key biomarkers were identified and the targeting miRNA of crucial genes was predicted.Results:A total of 201 differentially expressed genes(163 upregulated genes and 38 downregulated genes)were determined.CXCL1,CXCL2,and CXCL8,the critical biomarkers of psoriasis,were identified by different calculation methods.The potential critical signal pathway NOD-like receptor signaling pathway of psoriasis was explored by gene expression profiling chip gene enrichment analysis and differentially expressed gene enrichment analysis.Immune cell infiltration analysis found that CXCL1,CXCL2,CXCL8 was positively correlated with macrophages M1 and T cells CD4 memory activated and negatively correlated with macrophages M2 and mast cells resting.At the same time,through miRNA prediction,we found that hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.Conclusions:This research proposes a new comprehensive strategy to identify psoriasis’s potential biomarkers through cross-validation and significant scores of different calculation methods.In this research,we identified CXCL1,CXCL2,and CXCL8 as potential key biomarkers of psoriasis,and the NOD-like receptor signaling pathway is the critical signal pathway of psoriasis.Hsa-miR-216a-3p and hsa-miR-6750-5p can be used as potential psoriasis targets.

Cholangiosepsis Caused by Neutrophilic Cholangitis in Plaque Psoriasis

Psoriasis is a common inflammatory skin disease with many comorbid conditions. We present a 37-year-old male patient with a history of plaque psoriasis, status febrilis, violent umbilical pain, elevated inflammatory markers and liver parameters. Blood cultures were tested positive for E. coli. Diagnostic findings indicated that mechanical icterus and cholangiosepsis in the context of neutrophilic cholangitis were caused by inflammatory stenosis. Neutrophilic cholangitis is often found in combination with skin diseases with intense cutaneous infiltration with polymorphonuclear leucocytes and peripherial blood neutrophilia. Interleukin-8 may play a role in the pathogenesis of neutrophilic cholangitis occurring in patients with psoriasis [1]. We showed that complications of psoriasis can also occur at unusual locations. To date no case of neutrophilic cholangitis as an elicitor of cholangiosepsis has been reported.

Psoriasis treatment: Unconventional and non-standard modalities in the era of biologics

Psoriasis is a potentially debilitating inflammatory dermatosis affecting 0.2%-4.8% of the population worldwide causing a significant occupational, personal or psychosocial morbidity to these patients for life. The basic aim of psoriasis therapy is to control the disease to maximum possible extent and improve the patient's quality of life. Management of triggers for flareups, lifestyle modifications, and dietary supplements are often recommended. Intermittent or rotational therapy with frequent alterations in treatment options is usually needed to reduce toxicity of anti-psoriatic drugs in the absence of safer alternatives. Currently, several biological agents categorized as either T-cell targeted(e.g., Alefacept, Efalizumab) or cytokine modulating(e.g., Adalimumab, Infliximab, Etanercept) are available for treating severe psoriasis. However, their high cost is often precluding for most patients. The usefulness of systemic(methotrexate, cyclosporine, acitretin or several other therapeutic agents) or topical(tar, anthralin, corticosteroids or calcipotriol ointments, phototherapy with or without psoralens) therapies has been well established for the management of psoriasis. The literature is also replete with benefits of less used non-standard and unconventional treatment modalities(hydroxycarbamide, azathioprine, leflunomide, mycophenolate mofetil, isotretinoin, fumarates, topical calcineurin inhibitors, peroxisome proliferator-activated receptors agonists, statins, sulfasalazine, pentoxifylline, colchicine, grenz ray therapy, excimer laser, climatotherapy and balneophototherapy, peritoneal dialysis, tonsillectomy, ichthyotherapy, etc.). These can be used alternatively to treat psoriasis patients who have mild/minimal lesions, are intolerant to conventional drugs, have developed side effects or achieved recommended cumulative dose, where comorbidities pose unusual therapeutic challenges, or may be as intermittent, rotational or combination treatment alternatives.

走罐疗法对寻常型斑块状银屑病患者皮损面积和严重程度评分的影响

目的分析走罐疗法对寻常型斑块状银屑病患者皮损面积和严重程度评分的影响。方法选取2020年12月至2022年12月新疆医科大学附属中医医院收治的100例寻常型斑块状银屑病患者,按随机信封法分为研究组和对照组,每组50例。对照组采用常规干预措施,研究组则在常规干预措施的基础上增加走罐疗法治疗。比较2组患者干预前后的皮损面积和严重程度、症状表现评分、生活质量评价和不良反应发生率。结果干预8周后,研究组的银屑病皮损面积与严重程度评估量表(PASI)评分,皮损颜色、瘙痒、皮肤甲错和舌症各项证候评分,以及世界卫生组织生活质量评价简表(WHOQOL-BREF)各维度评分均优于对照组,差异均有统计学意义(P均<0.05)。2组在干预期间所出现的不良反应发生率无统计学差异(P>0.05)。结论走罐疗法可缓解寻常型斑块状银屑病患者的皮损症状,减轻严重程度,提高生活质量,并且无明显不良反应。

司库奇尤单抗治疗中重度斑块状银屑病的临床疗效

目的分析司库奇尤单抗治疗中重度斑块状银屑病的临床疗效。方法选取某院2021年5月~2023年5月收治的60例中重度斑块状银屑病患者,根据随机数字表法分为两组。对照组(30例)采用常规治疗,研究组(30例)采用司库奇尤单抗注射液治疗。比较两组患者治疗前后炎症因子水平、银屑病皮损面积和严重程度指数(PASI)、皮肤病生活质量指数(DLQI)、瘙痒程度(VAS评分)及药物不良反应。结果治疗前,两组IL-17、IL-17A和IL-23水平、PASI评分、DLQI评分和VAS评分差异无统计学意义(P>0.05);与对照组相比,研究组治疗后IL-17、IL-17A、IL-23水平均更低,治疗4、8和16周后PASI评分、DLQI评分和VAS评分均更低(P<0.05);两组总不良反应发生率差异无统计学意义(P>0.05)。结论司库奇尤单抗治疗可有效降低中重度斑块状银屑病患者的炎症反应、皮损面积和严重程度、瘙痒程度,提高患者生活质量且具有较高的安全性。

依奇珠单抗联合甲氨蝶呤对中重度难治性斑块型银屑病的疗效及对睡眠质量的影响

目的:探讨依奇珠单抗联合甲氨蝶呤治疗中重度难治性斑块型银屑病的临床应用、安全性、不良反应情况及对睡眠质量的影响。方法:选取2019年4月至2023年1月福清市医院皮肤科,和厦门长庚医院皮肤科收治的中重度难治性斑块型银屑病患者60例作为研究对象,随机分为对照组和观察组,每组30例。对照组采用甲氨蝶呤,每周服药1次,顿服,疗程12周;观察组在对照组基础上,采用依奇珠单抗治疗,皮下注射300 mg,1次/周,连续5次,之后每个月1次,疗程12周。通过银屑病变面积和严重程度指数(PASI)、体表受累面积(BSA)和瘙痒数字评定量表(PNRS)评估患者银屑病严重程度和疗效;采用皮肤病生命质量指标(DLQI)和汉密尔顿抑郁量表(HAMD)评估中重度难治性银屑病对患者生活的影响;采用匹兹堡睡眠质量指数(PSQI)评估患者的睡眠质量。结果:观察组未见脱落,对照组脱落3例,均因久未见明显疗效,1例放弃治疗,2例患者情绪焦虑,改用生物制剂治疗,均按脱落处理。治疗后,观察组PASI 50、PASI 75、PASI 90均明显高于对照组(P<0.001);治疗后,患者PASI、BSA、DLQI、HAMD评分均得到明显改善;依奇珠单抗安全性较高,不良反应率较低;治疗后,患者的PSQI评分明显得到改善,且观察组患者的睡眠质量改善程度高于对照组(P<0.001)。结论:依奇珠单抗在治疗中重度难治性斑块型银屑病的疗效较为明确,可有效改善患者银屑病皮损面积,抑制皮肤瘙痒,提高其生命质量,缓解抑郁情绪,提高睡眠质量,安全性较好,不良反应率较低,可为临床治疗中重度难治性斑块型银屑病提供参考依据。

司库奇尤单抗和阿达木单抗治疗中重度斑块状银屑病的疗效及安全性对比

目的 分析对比司库奇尤单抗和阿达木单抗治疗中重度斑块状银屑病的效果和安全性。方法 94例中重度斑块状银屑病患者,以随机数字表法分为对照组与研究组,各47例。对照组采用阿达木单抗进行治疗,研究组采用司库奇尤单抗进行治疗。对比两组患者的银屑病面积与严重性指数及其改善率,不良反应发生率。结果 治疗后第4、8、12周,研究组患者的银屑病面积与严重性指数分别为(7.55±6.51)、(4.60±5.85)、(2.90±5.55)分,对照组分别为(10.37±6.67)、(6.77±6.41)、(3.80±5.75)分。治疗后第4周,研究组患者的银屑病面积与严重性指数低于对照组,存在统计学意义(P<0.05)。治疗后第8、12周,两组患者的银屑病面积与严重性指数相差无统计意义(P>0.05)。对照组患者治疗后第4周的银屑病面积与严重性指数改善率为(51.13±8.69)%,第8周的银屑病面积与严重性指数改善率为(68.10±9.48)%,第12周的银屑病面积与严重性指数改善率为(82.09±9.62)%。研究组患者治疗后第4周的银屑病面积与严重性指数改善率为(66.62±9.04)%,第8周的银屑病面积与严重性指数改善率为(79.66±9.88)%,第12周的银屑病面积与严重性指数改善率为(87.17±10.30)%。研究组治疗后第4、8、12周的银屑病面积与严重性指数改善率明显高于对照组,存在统计学意义(P<0.05)。两组患者的不良反应发生率相差无统计意义(P>0.05)。结论 司库奇尤单抗和阿达木单抗对中重度斑块状银屑病均有显著疗效,不良反应的发生几率相差不大,均具有较高的安全性,可优先选择司库奇尤单抗。

可善挺治疗中重度斑块型银屑病的疗效分析

目的探究对中重度斑块型银屑病患者使用可善挺的治疗效果。方法便利选取2020年1月—2023年1月南平市疾病预防控制中心收治的64例中重度斑块型银屑病患者为研究对象,按随机数表法分为两组。对照组32例患者口服阿维A,外用卡泊三醇治疗,研究组32例患者使用可善挺治疗。比较两组用药后第2周、第6周以及第12周的严重度指数(Psoriasis Area and Severity Index,PASI)应答率、特殊部位受累应答率,停药后复发时间。结果研究组第2周PASI应答率(21.88%)、第6周PASI应答率(68.75%)、第12周PASI应答率(96.88%)高于对照组,差异有统计学意义(χ^(2)=5.143、18.515、13.166,P均<0.05)。研究组第6、12周特殊部位受累应答率高于对照组,差异有统计学意义(P均<0.05)。研究组停药后复发时间长于对照组,差异有统计学意义(P<0.05)。结论中重度斑块型银屑病患者使用可善挺治疗效果显著,在相同的治疗周期内,可善挺可明显减轻皮损面积与严重程度,停药后复发的时间较传统治疗明显延后。

PD-1抑制剂治疗后银屑病复发一例

免疫检查点抑制剂是一类新型的抗肿瘤免疫药物,但因其激活免疫系统,可引发免疫相关不良反应(immune-related adverse events,irAEs),皮肤科irAEs发生率约为40%,包括银屑病、湿疹、白癜风、大疱性疾病、重症药疹及脱发等。本例患者银屑病病史22年,因输尿管癌接受替雷利珠单抗治疗,6周后银屑病复发,遂停用替雷利珠单抗,予口服甲氨蝶呤、外用糖皮质激素软膏和UVB光疗治疗,1个月后皮损大部分消退。随访1年,患者仍有少量银屑病皮损,但外用药物控制良好,且肿瘤未见进展。

依奇珠单抗治疗中重度斑块型银屑病疗效观察

目的探讨依奇珠单抗对中重度斑块型银屑病的治疗效果。方法选取厦门大学附属第一医院2022年1月—2023年8月收治的75例中重度斑块型银屑病患者,应用抽签法进行分组,分为试验组(n=35)与对照组(n=40)。对照组采取常规外用药物治疗,试验组采取依奇珠单抗治疗。对比两组临床疗效,治疗前后外周血调节性T细胞(Treg)和辅助性T细胞17(Th17/Treg)细胞水平变化,并对所有患者进行6个月门诊复查随访,对比复发率及不良反应。结果试验组总有效率88.57%,高于对照组的67.50%(χ^(2)=4.730,P=0.028);治疗后两组患者Treg细胞升高,试验组(5.59±1.24)%高于对照组(4.12±1.13)%,对比差异有统计学意义(t=5.371,P<0.001),Th17细胞、Th17/Treg细胞降低,试验组[(1.06±0.14)%、0.19±0.05]低于对照组[(1.71±0.28)%、0.42±0.14],对比差异有统计学意义(t=12.434、9.212,P<0.001);试验组停药后6个月复发率低于对照组(5.71%vs 27.50%,χ^(2)=6.180,P=0.013);试验组不良反应发生率略高于对照组,组间对比差异无统计学意义(14.29%vs 5.00%,χ^(2)=1.900,P=0.168)。结论依奇珠单抗治疗中重度斑块型银屑病疗效显著,可调节Th17/Treg平衡,降低停药后复发率,且安全性较高。

古塞奇尤单抗与英夫利西单抗治疗重度斑块状银屑病的效果对比

目的对比古塞奇尤单抗与英夫利西单抗治疗重度斑块状银屑病的效果。方法回顾性分析2022年2月—2023年7月在天津市天津医院接受靶向免疫治疗的126例重度斑块状银屑病患者的病历资料,根据治疗方法分为古塞奇尤组64例和英夫利西组62例,古塞奇尤组皮下注射古塞奇尤单抗,连续44周;英夫利西组静脉滴注英夫利西单抗,连续46周。评价两组的疗效及不良反应,比较两组银屑病面积严重指数(PASI)评分、皮肤病生活质量指数(DLQI)、白细胞介素-23(IL-23)、白细胞介素-17(IL-17)、抗肿瘤坏死因子-α(TNF-α)水平。结果古塞奇尤组与英夫利西组治疗前、治疗后4和12周、治疗结束时PASI、DLQI评分比较,结果:①不同时间点PASI、DLQI评分比较,差异有统计学意义(P<0.05);②古塞奇尤组与英夫利西组PASI、DLQI评分比较,差异有统计学意义(P<0.05);③两组PASI、DLQI评分变化趋势比较,差异有统计学意义(P<0.05)。古塞奇尤组治疗前后IL-23、IL-17的差值均高于英夫利西组(P<0.05),TNF-α的差值低于英夫利西组(P<0.05)。古塞奇尤组治疗有效率高于英夫利西组(P<0.05)。两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论相比英夫利西单抗,古塞奇尤单抗治疗重度斑块状银屑病能够获得更好的临床疗效,且安全性较好。

司库奇尤单抗联合卡泊三醇治疗中重度斑块型银屑病患者的临床研究

目的观察司库奇尤单抗联合卡泊三醇治疗中重度斑块型银屑病患者的临床疗效。方法将中重度斑块型银屑病患者按队列法分为试验组和对照组。对照组给予卡泊三醇软膏,于患处均匀涂抹适量软膏,每天2次;试验组在对照组治疗的基础上给予司库奇尤单抗注射液,每次300 mg,每周1次,注射4周后调整为每4周注射1次,皮下注射。2组患者均治疗12周。比较2组患者治疗后的临床疗效、银屑病面积及严重程度指数(PASI)评分、生活质量[皮肤生命质量指数(DLQI)评分]、皮肤屏障功能指标[角质层油脂含量、角质层含水量]、血清血管内皮生长因子(VEGF)、白细胞介素-22(IL-22)、IL-17,并进行安全性评价。结果对照组入组42例,试验组入组48例。治疗后,试验组和对照组总有效率分别为93.75%(45例/48例)和78.57%(33例/42例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组和对照组的PASI评分分别为(6.57±1.52)和(10.68±2.13)分,DLQI评分分别为(5.36±1.29)和(9.85±1.67)分,角质层油脂含量分别为(49.73±6.16)和(42.81±5.97)μg·cm^(-2),角质层含水量分别为(36.84±4.59)%和(29.53±4.06)%,血清VEGF含量分别为(136.43±25.05)和(183.52±29.56)pg·mL^(-1),血清IL-22含量分别为(5.27±1.15)和(7.93±1.43)pg·mL^(-1),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有腹泻、呼吸道感染、鼻炎,对照组的药物不良反应主要有皮肤刺激、皮肤干燥。试验组和对照组的总药物不良反应发生率分别为8.33%(4例/48例)和7.14%(3例/42例),在统计学上差异无统计学意义(P>0.05)。结论司库奇尤单抗联合卡泊三醇能降低中重度斑块型银屑病患者PASI评分,提高生活质量,改善皮肤屏障功能,减少血清VEGF及IL-22含量。

司库奇尤单抗联合窄谱UVB照射治疗对中重度斑块型银屑病PASI评分及血 清IgE、IgA、IgG的影响

目的:观察司库奇尤单抗联合窄谱中波紫外线(UVB)照射治疗中重度斑块型银屑病疗效及对患者银屑病面积和严重程度指数(Psoriasis area and severity index,PASI)评分及血清免疫球蛋白、炎症因子的影响。方法:选取2021年1月-2023年7月笔者医院皮肤科就诊的80例中重度斑块型银屑病患者,按随机数字表法分为观察组和对照组各40例。对照组予以窄谱UVB照射治疗,观察组予以司库奇尤单抗联合窄谱UVB照射治疗。两组患者均治疗观察12周,评价临床疗效、治疗前后PASI及皮肤病生活质量指数(Dermatology life quality index,DLQI)评分;检测患者血清免疫球蛋白(IgE、IgA、IgG)及白介素-17(IL-17)、白介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)水平,记录不良反应情况。结果:治疗后,观察组总有效率95.00%,高于对照组的80.00%(P<0.05)。治疗后,两组患者PASI、DLQI评分均较治疗前下降,且观察组PASI、DLQI评分均较对照组低(P<0.05)。治疗后,两组患者血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较治疗前下降,且观察组血清IgE、IgA、IgG及IL-17、IL-23、TNF-α水平均较对照组低(P<0.05)。观察组不良反应总发生率15.00%,与对照组的7.50%比较差异无统计学意义(P>0.05)。结论:司库奇尤单抗联合窄谱UVB照射治疗中重度斑块型银屑病,相较单独窄谱UVB治疗效果更佳,有助于减轻症状、调节免疫功能、抑制炎症水平,对提高患者生活质量有积极意义,且未明显增加不良反应。