司库奇尤单抗治疗七例银屑病疗效评价

目的：评价司库奇尤单抗治疗银屑病的疗效和安全性。方法：选取中重度斑块状银屑病患者及泛发性脓疱型银屑病患者,给予司库奇尤单抗,300 mg/次,0～4周每周一次,后每4周一次,并分别于治疗前、1周后、4周后、8周后记录斑块状银屑病患者的银屑病皮损面积和严重度指数(PASI)、泛发性银屑病患者银屑病症状量表(PSS)评分。结果：共治疗6例斑块状银屑病和1例脓疱型银屑病患者,所选的患者均接受至少8周的司库奇尤单抗治疗,起效时间为（1.6±0.73)天;治疗4周时,6例斑块状银屑病患者中全部达到PASI 75,3例达到PASI 90;脓疱型患者PSS评分为2。治疗8周时6例斑块状银屑病患者均达到PASI 100;脓疱型患者PSS评分为0。所有患者治疗期间均未出现严重的药物不良反应。结论：司库奇尤单抗治疗中重度银屑病起效迅速,疗效显著,不良反应少。     

司库奇尤单抗治疗中重度斑块型银屑病患者中NLR与PASI值相关性分析

目的：分析司库奇尤单抗治疗中重度斑块型银屑病时中性粒细胞和淋巴细胞比值(NLR)与PASI值的相关性。方法：2017年4月1日至7月31日中重度斑块型银屑病患者每周皮下注射司库奇尤单抗,治疗4次,随后每4周1次,治疗11次。结果：司库奇尤单抗共治疗中重度斑块型患者22例,PASI评分由治疗前的22.28分下降至2.31分,NLR下降值同PASI下降值具有相关性（r12周=0.504,r24周=0.604,r36周=0.470,r48周=0.454;均P<0.05）。结论：司库奇尤单抗治疗银屑病有效,NLR下降值与PASI下降值呈正相关。     

司库奇尤单抗治疗中重度斑块状银屑病20例临床观察

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)...     

司库奇尤单抗治疗中重度斑块状银屑病的近期疗效及安全性观察

【摘要】 目的 观察司库奇尤单抗治疗中重度斑块状银屑病的近期疗效及安全性。方法 2019年6 - 11月收集就诊于河南省人民医院皮肤科的中重度斑块状银屑病患者36例,给予司库奇尤单抗单药皮下注射治疗,300 mg/次,分别于基线、第1、2、3、4周注射1次,随后每4周1次,分别于第4、8、12周时记录患者银屑病皮损面积和严重度指数（PASI）,观察药物不良反应。结果 36例患者均接受至少12周的治疗。4周时,8例达PASI75,其中3例达PASI90,1例达PASI100;8周时,26例达PASI75,其中16例达PASI90,4例达PASI100;12周时,32例达PASI75,其中26例达PASI90,8例达PASI100。所有患者均未发生严重感染或恶性肿瘤等严重药物不良反应,1例腹部皮下注射后出现腹痛、腹胀,持续3 d后症状消失;1例患者出现扁桃体炎,之后原有皮损处出现湿疹样改变;1例颈部出现化脓性淋巴结炎。结论 司库奇尤单抗治疗中重度斑块状银屑病疗效显著,不良反应较少,是中重度斑块状银屑病患者新的治疗选择之一。     

司库奇尤单抗治疗红皮病型银屑病7例的临床疗效及安全性观察

【摘要】 目的 观察司库奇尤单抗治疗红皮病型银屑病的临床疗效及安全性。方法 2019年7月至2021年8月就诊于武汉市中西医结合医院的红皮病型银屑病并接受司库奇尤单抗（300 mg/次皮下注射,分别于第0、1、2、3、4周注射1次,随后每4周1次）治疗的7例患者,在第0、 4、 8、12周时记录患者银屑病皮损面积和严重度指数（PASI）,同时观察药物不良反应。结果 7例患者均接受至少12周的治疗,治疗4周时,4例达到PASI50;治疗12周,4例达到PASI75,2例达到PASI90。均未发生严重药物不良反应,1例治疗过程中出现发热,用药后体温恢复正常;1例出现咳嗽咳痰,予以口服咽炎合剂后症状缓解。结论 司库奇尤单抗治疗红皮病型银屑病疗效显著,不良反应较少,为红皮病型银屑病的治疗提供了新的选择。     

司库奇尤单抗治疗红皮病型银屑病一例并文献复习

报道一例司库奇尤单抗治疗红皮病型银屑病治疗效果并复习相关文献.41岁红皮病型银屑病男性患者,在排除肝炎、结核的基础上,经知情同意后,给予司库奇尤单抗标准方案:0～4周每周皮下注射300 mg,随后每4周注射300 mg.在第4周达到PASI 75,第8周达到PASI 100.随访32周未见明显复发及不良反应.     

司库奇尤单抗治疗中重度斑块状银屑病疗效及安全性的真实世界研究

目的 观察真实世界司库奇尤单抗治疗中重度斑块状银屑病的临床疗效及安全性。方法 本研究共纳入45例中重度斑块状银屑病患者,接受司库奇尤单抗150 mg或300 mg治疗,持续至少24周。通过银屑病皮损面积及严重程度指数(PASI)、体表受累面积(BSA)、皮肤病生活质量指数(DLQI)的变化来评估疗效,并对其安全性进行分析。结果 所有患者经过24周治疗,PASI、BSA及DLQI评分均显著下降(P<0.001)。其中16例接受150 mg治疗的患者第12周PASI75、PASI90、PASI100的应答率分别为93.75%、62.50%和12.50%,在第24周时达到100.00%、93.75%和43.75%。而29例接受300 mg治疗的患者第12周时PASI75、PASI90、PASI100应答率分别为100.00%、79.31%和34.48%,第24周时则为100%、93.10%和62.07%。而在改善患者生活质量上,150 mg组患者第12周和第24周DLQI 0/1的应答率分别为50.00%和75.00%;300 mg组患者第12、24周DLQI 0/1的应答率分别为51...     

斑块状银屑病司库奇尤单抗应答不良转换为依奇珠单抗的疗效及安全性观察

目的 探讨司库奇尤单抗治疗中重度斑块状银屑病出现应答不良的患者，转换为依奇珠单抗治疗的疗效和安全性。方法 纳入司库奇尤单抗治疗的中重度斑块状银屑病患者，达到PASI50但从未达到PASI90,以及曾达到PASI90后失去PASI75的患者，转换为依奇珠单抗治疗，观察其12周及长期疗效及安全性。结果 共纳入7例患者，男5例，女2例，年龄中位数39.7(34.0,57.3)岁，平均病程(26.7±9.1)年，平均BMI 30.6±4.8。PASI评分从基线时(9.8±4.3)分下降至12周时(1.4±1.2)分，平均治疗时间(46.9±11.2)周，末次随访PASI评分(2.5±2.3)分。3例(42.86%)患者出现局限性湿疹，1例(14.29%)出现注射部位反应，1例(14.29%)出现口腔念珠菌病。结论 司库奇尤单抗应答不良的中重度斑块状银屑病患者转换为依奇珠单抗，仍然能获得较好的治疗效果，且其安全性可。     

司库奇尤单抗治疗妊娠期重度斑块状银屑病1例

患者女,26岁,头皮、躯干及四肢鳞屑性丘疹、斑块反复8年,诊断为重度斑块状银屑病。使用司库奇尤单抗治疗,治疗期间患者意外妊娠,随即停用司库奇尤单抗。患者孕24周时,银屑病复发,严重影响母体妊娠。给予司库奇尤单抗治疗后,患者PASI评分明显下降,孕40周,顺利产下一名健康女婴。     

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

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。     

生物制剂与甲氨蝶呤治疗儿童重度斑块状银屑病疗效及安全性比较

目的比较生物制剂与甲氨蝶呤治疗儿童重度斑块状银屑病的疗效及安全性。方法采用回顾性匹配病例对照研究设计, 按银屑病皮损面积和严重程度指数(PASI)评分及年龄、以1∶1比例纳入首都医科大学附属北京儿童医院2016年6月至2021年11月接受生物制剂(阿达木单抗或司库奇尤单抗)或甲氨蝶呤治疗的重度斑块状银屑病患儿各10例。治疗第4、8、12周时分别评估PASI、医师对病情整体评分(PGA)及体表受累面积(BSA)评分, 并记录药物的不良反应。统计分析主要采用Mann-WhitneyU检验、Fisher确切概率法及广义估计方程。结果治疗第4、8周时, 生物制剂组PASI75应答率(7/10、10/10)及PASI90应答率(5/10、9/10)显著高于甲氨蝶呤组(PASI75:1/10、5/10, PASI90:0/10、1/10;均P<0.05), 而第12周时生物制剂组与甲氨蝶呤组PASI75(10/10比8/10)及PASI90应答率(9/10比4/10)差异均无统计学意义(均P > 0.05)。基线时两组PASI、BSA、PGA评分差异均无统计学意义(P > 0.0...     

A comparison between BSA, PASI, PLASI and SAPASI as measures of disease severity and improvement by therapy in patients with psoriasis

Background This study investigates four measures of disease severity in patients with psoriasis, both before and after therapy. Methods Data records were analyzed from 33 patients with moderate‐to‐severe chronic plaque psoriasis who were treated with efalizumab, 1 mg/kg/week subcutaneously, for 12 weeks. Four measures of disease severity were used: body surface area (BSA), psoriasis area and severity index (PASI), psoriasis log‐based area and severity index (PLASI) and self‐administered PASI (SAPASI). Results At the end of the 12‐week therapy, the mean percent improvement shown by each measure varied considerably, ranging from 48.6% (PASI) to 70.6% (SAPASI). PASI and PLASI were the most comparable (67.3% and 66.5%). These differences were smaller when a dermatologist's opinion about the improvement was taken into account, for example “very good improvement” ranged from mean percent improvement of 63.8% (BSA) to 83.8% (PASI). The correlation between all measures revealed a high level of significance (P≤ 10^?5). Conclusions Comparing the slopes and intercepts of the regression lines revealed PLASI as the most reliable measure for the severity and therapeutic improvement in patients with moderate‐to‐severe chronic plaque psoriasis. PLASI proved to be a marginally more accurate than PASI, and much more accurate than SAPASI and BSA. The superiority of PLASI may be a result of the logarithmic scale of the affected skin surface.     

Definition of treatment goals for moderate to severe psoriasis: a European consensus

Patients with moderate to severe psoriasis are undertreated. To solve this persistent problem, the consensus programme was performed to define goals for treatment of plaque psoriasis with systemic therapy and to improve patient care. An expert consensus meeting and a collaborative Delphi procedure were carried out. Nineteen dermatologists from different European countries met for a face-to-face discussion and defined items through a four-round Delphi process. Severity of plaque psoriasis was graded into mild and moderate to severe disease. Mild disease was defined as body surface area (BSA) ??10 and psoriasis area and severity index (PASI) ??10 and dermatology life quality index (DLQI) ??10 and moderate to severe psoriasis as (BSA?>?10 or PASI?>?10) and DLQI?>?10. Special clinical situations may change mild psoriasis to moderate to severe including involvement of visible areas or severe nail involvement. For systemic therapy of plaque psoriasis two treatment phases were defined: (1) induction phase as the treatment period until week 16; however, depending on the type of drug and dose regimen used, this phase may be extended until week 24 and (2) maintenance phase for all drugs was defined as the treatment period after the induction phase. For the definition of treatment goals in plaque psoriasis, the change of PASI from baseline until the time of evaluation (??PASI) and the absolute DLQI were used. After induction and during maintenance therapy, treatment can be continued if reduction in PASI is ??75%. The treatment regimen should be modified if improvement of PASI is <50%. In a situation where the therapeutic response improved ??50% but <75%, as assessed by PASI, therapy should be modified if the DLQI is >5 but can be continued if the DLQI is ??5. This programme defines the severity of plaque psoriasis for the first time using a formal consensus of 19 European experts. In addition, treatment goals for moderate to severe disease were established. Implementation of treatment goals in the daily management of psoriasis will improve patient care and mitigate the problem of undertreatment. It is planned to evaluate the implementation of these treatment goals in a subsequent programme involving patients and physicians.     

Etanercept: Efficacy and safety

Objective  To evaluate the efficacy and safety of etanercept in the treatment of patients with moderate to severe plaque psoriasis.
Methods  An observational, longitudinal, and retrospective study involving two groups of dose of treatment with etanercept (50 vs. 100 mg/week). The selected patients presented moderate to severe plaque psoriasis, and they had received treatment with the mentioned drug. A total of 58 patients were included in the study. The efficacy of the drug was evaluated by measuring the psoriasis area and severity index (PASI), body surface area (BSA) and physician's global assessment (PGA) in weeks 8, 16, 24, 32, 40 and 48.
Results  A statistically significant improvement was observed in the PASI, BSA and PGA indexes after 24 and 48 weeks of therapy. As for PASI, and after 48 weeks of treatment, PASI 50, 75 and 90 were 100.0%, 92.3% and 69.2%, respectively. In our series, etanercept 50 mg/week reached the same results after 48 weeks as etanercept 100 mg/week, though the initial response was faster in the last group. The PASI, BSA and PGA indexes diminished significantly with the treatment, though without statistically significant differences between both groups. As for the safety, etanercept was well tolerated, and no serious adverse events were recorded. There were no cases of tuberculosis or opportunistic infections.
Conclusions  Our study confirms the efficacy and safety outcomes of the clinical trials of etanercept in psoriasis with both doses of treatment. As for the safety, etanercept was well tolerated, and all the recorded adverse events coincided with the known potential side-effects of treatment.

Conflicts of interest

None declared     

PASI临床指标可靠性评价

目的：评价银屑病PASI记分系统中红斑、脱屑、浸润和受累面积指标的可靠性。方法：按PASI记分法，三位皮肤科医生分别对银屑病患者进行评估，将所得资料计算各指标的Kappa值。结果：临床症状指标的红斑、脱屑和浸润Kappa值分别为0．361、0．384、0．319，均＜0．4，一致性较差。受累面积指标Kappa值为0．592，一致性不满意。结论：应用PASI法评价寻常型银屑病病情严重性的可靠性较差，在应用PASI做为评价工具的临床药物试验中对结果解释应慎重。