司库奇尤单抗治疗银屑病导致严重湿疹一例

Secukinumab是第一个完全人源化的抗白介素17A单克隆抗体,已成功治疗中重度斑块状银屑病。这些新的靶向药物越来越普遍,但长期副作用尚不完全清楚.目前国际上已有患者应用司库奇尤单抗后出现类似汗疱疹和痤疮样皮损皮疹的报道。本文报道司库奇尤单抗治疗银屑病患者后发生严重红皮病,并出现手足汗疱疹样改变1例。     

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。     

司库奇尤单抗治疗儿童银屑病六例疗效评价

目的：评价司库奇尤单抗注射液治疗儿童银屑病的临床疗效及安全性。方法：收集2020年1月1日至2020年5月1日传统治疗方法不佳的儿童银屑病患者,在第0、1、2、3、4周进行皮下注射司库奇尤单抗150 mg,每周一次,共5次。记录患者PASI及BSA评分。结果：司库奇尤单抗共治疗6例儿童银屑病,治疗第4周时,6例患者均达到PASI 90,BSA显著降低,未出现不良反应。结论：司库奇尤单抗注射液治疗儿童银屑病安全有效。     

司库奇尤单抗治疗甲银屑病一例

报道一例司库奇尤单抗成功治疗甲银屑病治疗效果。患者,女,65岁,指甲增厚碎裂7年,诊断为甲银屑病,常规治疗效果不佳,予司库奇尤单抗300 mg,病情好转,目前随访中。     

司库奇尤单抗治疗脓疱型银屑病合并心衰及呼衰1例

患者男,66岁,全身鳞屑性红斑、丘疹、脓疱3年,加重伴发热3个月。皮肤科情况：全身弥漫红斑,其上散在小脓疱,部分融合成脓湖。辅助检查：PCO₂ 28 mmHg, PO₂ 43 mmHg, BNP 1 366.0 pg/mL。诊断为脓疱型银屑病、急性心力衰竭、Ⅰ型呼衰。在抗心衰及呼衰治疗后,给予司库奇尤单抗150 mg皮下注射,4周后皮损改善达到PASI95,心功能及呼吸功能也得到了改善。     

乌司奴单抗成功治疗司库奇尤单抗诱发斑块状银屑病患者的湿疹样皮炎2例

报告乌司奴单抗治疗2例使用司库奇尤单抗治疗后出现湿疹样皮损的斑块状银屑病患者。2例女性患者均因司库奇尤单抗治疗后反复出现不同部位的红斑、丘疹、渗液,伴剧烈瘙痒,主要累及头面、四肢,严重影响患者生活质量。更换生物制剂予乌司奴单抗治疗,26～28周银屑病皮损得到控制,随访48周湿疹样皮炎未见复发加重。     

司库奇尤单抗治疗伴甲损害的寻常型银屑病一例

患者,男,38岁。头皮、腋下红斑脱屑,手足甲增厚变色1年余。皮肤科查体：头皮、双侧腋下可见红斑,部分红斑上可见细小鳞屑;双手足部分甲板远端甲分离、甲下角化过度,甲变色,甲板表面可见点状凹陷。诊断为寻常型银屑病、甲银屑病。给予司库奇尤单抗治疗,皮损迅速消退,指/趾甲损害显著改善。随访1年未见皮损反复及明显不良反应。     

司库奇尤单抗及依奇珠单抗治疗中重度斑块型银屑病小样本短期疗效评价

目的 探讨比较司库奇尤单抗和依奇珠单抗治疗中重度斑块型银屑病的疗效和安全性.方法 采用随机对照研究设计,纳入上海市皮肤病医院2019年6月-2020年12月门诊中重度斑块状银屑病患者20例,随机分配进入两个治疗组,司库奇尤单抗治疗组及依奇珠单抗治疗组.用药第4、8、12周后分别评价两组药物的疗效及安全性.计量资料两组间...     

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.     

Secukinumab治疗成人中重度银屑病疗效和安全性的Meta分析

目的:评价Secukinumab治疗成人中重度银屑病的疗效和安全性。方法:计算机检索PubMed、EMBASE、Cochrane图书馆、中国知网、维普期刊数据库、万方医学数据库、中国生物医学文献数据库有关Secukinumab治疗成人中重度银屑病的随机对照试验文献,时间为数据库建库时间至2017年2月,由两名独立的研究员对纳入的文献进行质量评价,用RevMan 5.3软件进行Meta分析。结果:分析共纳入7篇文献、3474例成人中重度银屑病患者。Meta分析结果显示,300 mg Secukinumab治疗组中PASI积分下降75%、90%和100%的患者例数和研究者全面评估(IGA)分数为0或1的患者例数高于150 mg Secukinumab治疗组及安慰剂组,差异均有统计学意义(P0.00001)。300 mg和150 mg Secukinumab治疗组中患者不良反应发生率明显高于安慰剂组,但300 mg Secukinumab治疗组和150mg Secukinumab治疗组间不良反应发生率差异无统计学意义。结论:300 mg Secukinumab治疗中重度银屑病疗效明显优于150 mg Secukinumab,不良反应发生率无明显差异。     

Assessment of serum biomarkers in patients with plaque psoriasis on secukinumab

The molecular basis of interleukin (IL)-17A in driving psoriasis pathogenesis is not fully elucidated yet. To investigate the underlying mechanisms and biomarkers associated with IL-17A and the role in psoriasis pathogenesis, over 30 serum proteins were evaluated in a study assessing the effectiveness and safety of secukinumab, where treatment was directly switched from cyclosporin A to secukinumab. Serum β-defensin 2 (BD-2) levels rapidly and robustly reduced following secukinumab treatment. BD-2 levels were well-correlated with Psoriasis Area and Severity Index (PASI) score; changes in BD-2 levels preceded change in PASI score. Serum BD-2, an easily measurable protein, can possibly be used as a suitable surrogate biomarker to monitor responses to IL-17A-targeted therapies for psoriasis in clinical practice.     

Effectiveness and safety of secukinumab in 69 patients with moderate to severe plaque psoriasis: A retrospective multicenter study

Secukinumab (anti‐IL17A) is effective as treatment for moderate to severe plaque psoriasis, but real‐life data on effectiveness and safety lack. We aimed to present real‐life data of all Danish patients treated with secukinumab (n = 69). At baseline, before initiation of treatment with secukinumab 300 mg (47.8%) or off‐label treatment with secukinumab 150 mg (52.2%), the median PASI score was 7.1. A total of 66.7% (34/51) and 52.9% (27/51) of patients still on secukinumab at week 12 achieved a PASI (Psoriasis Area and Severity Index)‐50 and PASI‐75 of 66.7% and 52.9%, respectively. A total of 83.0% (44/53) and 60.4% (32/53) of the patients had a PASI‐score < 5 and PASI‐score < 2, respectively, after 12 weeks on treatment with secukinumab. A third of the patients had secukinumab discontinued due to limited clinical improvement or adverse events (n = 23) within a median of 92 days (interquartile range 51–212 days). Notably, the majority of the patients may represent a particularly difficult‐to‐treat group of patients, as 92.8% had been refractory to other biologic treatment. A total of 26.1% (n = 18) experienced adverse events. Secukinumab appears to be an effective treatment option with a favorable side effect profile in patients with plaque psoriasis who are refractory to or have side effects of traditional biologic drugs.     

IL-17A拮抗剂治疗儿童重症银屑病一例

患儿,男,4岁。全身反复出现红斑、鳞屑1年,加重2个月。患儿既往体健,无系统疾病史,其母有“银屑病”病史。皮肤科检查可见头面部、躯干、四肢大面积鳞屑性斑块,Auspitz’s征(+)。实验室检查未见明显异常,诊断为斑块型银屑病。给予IL-17A拮抗剂治疗,4周后,皮损基本消退,仅留有色素沉着。本例患者是迄今使用司库奇尤单抗治疗的年龄最小的斑块型银屑病患者,值得进一步观察。     

Efficacy and safety of secukinumab in patients with generalized pustular psoriasis: A 52‐week analysis from phase III open‐label multicenter Japanese study

Generalized pustular psoriasis (GPP) is a severe inflammatory skin disease characterized by the presence of sterile pustules covering almost the entire body and systemic symptoms such as fever. Secukinumab, a fully human‐recombinant anti‐interleukin‐17A monoclonal antibody was indicated for psoriasis vulgaris and psoriatic arthritis in Japan but is not yet investigated for GPP. In this phase III, open‐label multicenter single arm study, the efficacy and safety of secukinumab as monotherapy or with co‐medication was evaluated in 12 Japanese patients with GPP. All the patients received secukinumab 150 mg s.c. at baseline, week 1, 2, 3 and 4, and then every 4 weeks. Two non‐responders were up‐titrated to 300 mg. Change in GPP severity from baseline was evaluated by clinical global impression (CGI) categorized as “worsened”, “no change”, “minimally improved”, “much improved” or “very much improved”. Treatment success was achieved by 83.3% (n = 10) of patients at week 16 (primary end‐point) with CGI evaluated as “very much improved” (n = 9) and “much improved” (n = 1). Moreover, the area of erythema with pustules improved as early as week 1 and resolved by week 16 in most of the patients. The improvements were sustained throughout 52 weeks. Over the 52‐week treatment period, secukinumab was well tolerated with no unexpected safety signals. Nasopharyngitis, urticaria, diabetes mellitus and arthralgia were the frequent adverse events reported. The data from this study shows that secukinumab can become one of the potent treatment options for GPP.     

IL-17A单抗治疗儿童泛发性脓疱型银屑病一例并文献复习

传统药物如甲氨蝶呤,阿维A和环孢菌素A等治疗儿童泛发性脓疱型银屑病(GPP)受到限制,目前没有针对青少年GPP的标准化诊疗指南,本文报道IL-17A单抗成功治疗儿童脓疱型银屑病一例并进行文献复习.     

Efficacy and safety of ixekizumab treatment for Japanese patients with moderate to severe plaque psoriasis,erythrodermic psoriasis and generalized pustular psoriasis: Results from a 52‐week,open‐label,phase 3 study (UNCOVER‐J)

Psoriasis, a chronic, immune‐mediated skin disease characterized by red, scaly plaques, affects approximately 0.3% of the population in Japan. The aim of this open‐label study was to evaluate the long‐term efficacy and safety of ixekizumab, a humanized, anti‐interleukin‐17A monoclonal antibody, in Japanese patients with plaque psoriasis (n = 78, including 11 psoriatic arthritis), erythrodermic psoriasis (n = 8) and generalized pustular psoriasis (n = 5). Ixekizumab was administrated s.c. at baseline (week 0, 160 mg), from weeks 2 to 12 (80 mg every 2 weeks), and from weeks 16 to 52 (80 mg every 4 weeks). At week 52, 92.3% of patients with plaque psoriasis achieved Psoriasis Area and Severity Index (PASI) 75, 80.8% achieved PASI 90, 48.7% achieved PASI 100, and 52.6% had remission of plaques (by static Physician Global Assessment, sPGA [0]). Difficult to treat areas of psoriasis (nail or scalp) also responded to ixekizumab. All patients with psoriatic arthritis who were assessed (5/5) achieved an American College of Rheumatology 20 response. Most patients with erythrodermic psoriasis or generalized pustular psoriasis responded to ixekizumab and the clinical outcome was maintained over 52 weeks (75% and 60% of patients achieved sPGA [0, 1] at week 52, respectively). Mostly mild or moderate treatment‐emergent adverse events were reported by 79 of 91 patients; the most common were nasopharyngitis, eczema, seborrheic dermatitis, urticaria and injection site reactions. In conclusion, 52‐week ixekizumab treatment was efficacious and well tolerated in Japanese patients with plaque psoriasis. Efficacy was also observed in patients with erythrodermic psoriasis, generalized pustular psoriasis and psoriatic arthritis.