英夫利西单抗长疗程治疗关节病型银屑病的临床疗效分析

目的：评价长疗程应用英夫利西单抗治疗关节病型银屑病的临床疗效。方法：随访分析2016年11月至2018年11月就诊于中国人民解放军总医院皮肤科接受英夫利西单抗治疗的关节病型银屑病患者。观察第2周、6周以及此后每间隔8周用药后的关节症状及皮损改善情况以及肿瘤坏死因子-α(TNF-α)等指标的变化。结果：8例患者用药疗程满30周，纳入数据分析, 其中5例满46周。LSD法显示，治疗后患者肿胀关节数（0周VS 30周：t=6.939，P<0.001；0周VS 46周：t=3.822，P=0.019)、压痛关节数（0周VS 30周：t=5.353，P=0.001；0周VS 46周：t=3.132，P=0.035)明显减少，PASI值在第30周时下降最明显（0周VS 30周：t=3.742，P=0.007）, TNF-α水平在第22周最高（0周VS 22周：t=3.569，P=0.009），超过22周后逐渐降低（30周VS 46周：t=4.104，P=0.009）。 结论：英夫利西单抗能够显著改善关节病型银屑病患者的关节症状和皮损，但长疗程应用时疗效呈降低趋势。

Efficacy of infliximab in the long-term treatment of psoriasis arthropathica

Objective: To assess the efficacy of long-term treatment with infliximab in the patients with psoriasis arthropathica. Methods: Patients diagnosed as psoriasis arthropathica who treated with infliximab in our hospital from November 2016 to November 2018 were followed up and analyzed. The improvement of joint symptoms, PASI and the changes of TNF-α level were evaluated before treatment and after treatment at  week 2 , week 6, and then once every 8 weeks. Results: The data of eight patients received the treatment of infliximab for at least 30 weeks was analyzed, of those five treated for more than 46 weeks. LSD method showed that the number of swollen joints (before treatment VS week 30: t=6.939, P<0.001; before treatment VS week 46: t=3.822, P=0.019) and tenderness joints (before treatment VS week 30: t=5.353, P=0.001; before treatment VS week 46: t=3.132, P=0.035) significantly decreased after treatment, and the PASI score reached the lowest level at week 30 (before treatment VS week 30: t=3.742, P=0.007), while plasma TNF-α increased within first 22 weeks (before treatment VS week 22: t=3.569, P=0.009) and then decreased afterwards (week 30 VS week 46: t=4.104, P=0.009). Conclusion: Infliximab can significantly improve articular symptoms and skin lesions in patients with psoriasis arthropathica. However, the drug efficacy showed a declining trend in a long-term treatment.