[1]曹瑞祥,孟静,于建斌,等.司库奇尤单抗对MTX治疗无效的中重度斑块型银屑病13例临床观察[J].中国皮肤性病学杂志,2020,(12):1468-1471.[doi:10.13735/j.cjdv.1001-7089.202005062]
 CAO Ruixiang,MENG Jing,YU Jianbin,et al.Clinical Observation on Secukinumab in the Treatment of 13 Cases of Moderate-to-Severe Plaque Psoriasis Responding Inadequately to MTX[J].The Chinese Journal of Dermatovenereology,2020,(12):1468-1471.[doi:10.13735/j.cjdv.1001-7089.202005062]
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司库奇尤单抗对MTX治疗无效的中重度斑块型银屑病13例临床观察()
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《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2020年12期
页码:
1468-1471
栏目:
药物与临床
出版日期:
2020-12-01

文章信息/Info

Title:
Clinical Observation on Secukinumab in the Treatment of 13 Cases of Moderate-to-Severe Plaque Psoriasis Responding Inadequately to MTX
文章编号:
1001-7089(2020)12-1468-04
作者:
曹瑞祥1孟静2于建斌1张江安1李小红1
1.郑州大学第一附属医院皮肤科,河南 郑州450000; 2.商丘市第一人民医院皮肤科,河南 商丘476000
Author(s):
CAO Ruixiang1MENG Jing2YU Jianbin1ZHANG Jiang'an1LI Xiaohong1
1.Department of Dermatology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China; 2.Department of Dermatology,the First People's Hospital of Shangqiu,Shangqiu 476000,China
关键词:
银屑病中重度斑块型 司库奇尤单抗 甲氨蝶呤 临床疗效 不良反应
Keywords:
Psoriasismoderate-to-severeplaque Secukinumab Methotrexate Clinical efficacy Adverse reactions
分类号:
R 758.63
DOI:
10.13735/j.cjdv.1001-7089.202005062
文献标志码:
B
摘要:
目的 观察司库奇尤单抗对甲氨蝶呤(MTX)治疗无效的中重度斑块型银屑病的临床疗效及安全性。方法 2019年8月-10月纳入对MTX治疗无效的13例中重度斑块型银屑病,给予司库奇尤单抗皮下注射治疗,于第0、1、2、3、4、8和12周皮下注射300 mg,于第0、4、8、12、16周观察13例患者PSAI 90、PASI 75应答率,在第16周复查血常规、肝功能、肾功能、HBV、HCV、PPD和T-SPOT,同时观察0~16周期间出现的药物不良反应。结果 13例患者均完成12周疗程的药物治疗。第4、8、12和16周PASI 75应答率分别为46.15%、84.62%、92.31%和100%,而PASI 90应答率分别为23.07%、46.15%、61.54%和84.61%。所有患者在第16周复查血常规、肝功能、肾功能、HBV、HCV、PPD和T-SPOT结果均正常,且均未出现严重感染及恶性肿瘤等严重不良反应,其中2例患者治疗期间出现急性荨麻疹,1例患者出现注射部位红斑,1例患者出现轻度腹泻症状,给予对症处理后均可缓解。结论 司库奇尤单抗治疗中重度斑块型银屑病临床疗效显著,同时需要注意治疗期间药物不良反应的发生。
Abstract:
Objective To explore the clinical efficacy and safety of Secukinumab in the treatment of 13 cases of moderate-to-severe plaque psoriasis after responding inadequately to MTX.Methods A total of 13 moderate-to-severe plaque psoriasis patients who have responded inadequately to MTX between August 2019 and October 2019 were enrolled.All patients were received subcutaneous injection of Secukinumab with a dose of 300 mg at week 0,1,2,3,4,8 and 12.The PSAI 90,PASI 75 and PASI 50 of 13 patients were calculated at week 0,4,8,12 and 16.At week 16,the blood routine,liver function,renal function,HBV,HCV,PPD and T-SPOT in all patients were reexamined,and drug related adverse reactions were also observed.Results All the 13 patients completed 12-week subcutaneous injection of Secukinumab.The response rates of PASI 75 at week 4,8,12,16 were 46.15%,84.62%,92.31% and 100%,respectively.The response rates of PASI 90 at week 4,8,12,16 were 23.07%,46.15%,61.54% and 84.61%,respectively.The results of blood routine test,liver function,renal function,HBV,HCV,PPD and T-SPOT were normal in all patients at the week 16.There were no serious adverse reactions such as serious infection and malignant tumor that occurred during the period of Secukinumab treatment.Furthermore,acute urticaria occurred in 2 patients,erythema at the injection site occurred in 1 patient,and mild diarrhea in 1 patient,and all patients were relieved after symptomatic treatment.Conclusion The clinical efficacy of Secukinumab in the treatment of moderate-to-severe plaque psoriasis is significant.Meanwhile,the drug related adverse reactions during the treatment should be also concerned.

参考文献/References:

[1] 苏华振,魏明.IL-17A对体外培养角质形成细胞角蛋白17的影响及作用机制[J].中国皮肤性病学杂志,2018,32(9):996-1000.
[2] Langley RG,Elewski BE,Lebwohl M,et al.Secukinumab in plaque psoriasis-results of two phase 3 trials[J].N Engl J Med,2014,371(4):326-338.
[3] McInnes IB,Mease PJ,Kirkham B,et al.Secukinumab,a human anti-interleukin-17A monoclonal antibody,in patients with psoriatic arthritis(FUTURE 2):a randomised,double-blind,placebo-controlled,phase 3 trial[J].Lancet,2015,386(9999):1137-1146.
[4] 孟静,李丹,陈燕辉,等.NLR联合hs-CRP在预测甲氨蝶呤治疗中-重度斑块型银屑病患者临床疗效中的价值[J].中国皮肤性病学杂志,2019,33(7):26-31.
[5] Yan K,Zhang Y,Han L,et al.Safety and efficacy of methotrexate for Chinese adults with psoriasis with and without psoriatic arthritis[J].JAMA Dermatol,2019,155(3):327-334.
[6] Barker J,Hoffmann M,Wozel G,et al.Efficacy and safety of infliximab vs.methotrexate in patients with moderate-to-severe plaque psoriasis:results of an open-label,active-controlled,randomized trial(RESTORE1)[J].Br J Dermatol,2011,165(5):1109-1117.
[7] Heydendael VM,Spuls PI,Opmeer BC,et al.Methotrexate versus cyclosporine in moderate-to-severe chronic plaque psoriasis[J].N Engl J Med,2003,349(7):658-665.
[8] Warren RB,Barker JNWB,Finlay AY,et al.Secukinumab for patients failing previous tumour necrosis factor-α inhibitor therapy:results of a randomized open-label study(SIGNATURE)[J].Br J Dermatol,2020,183(1):60-70.
[9] 王刚.皮肤科生物制剂的主要不良反应及对策[J].中华皮肤科杂志,2019,52(2):77-80.
[10] Ribero S,Licciardello M,Quaglino P,et al.Efficacy and safety of secukinumab in patients with plaque psoriasis and latent tuberculosis[J].Case Rep Dermatol,2019,11(Suppl 1):23-28.
[11] Kammüller M,Tsai TF,Griffiths CE,et al.Inhibition of IL-17A by secukinumab shows no evidence of increased Mycobacterium tuberculosis infections[J].Clin Transl Immunology,2017,6(8):e152.
[12] Peccerillo F,Odorici G,Pellacani G,et al.Secukinumab:a positive outcome in a patient with severe psoriasis and HBV-HCV co-infection[J].Dermatol Ther,2018,31(4):e12601.

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备注/Memo

备注/Memo:
[基金项目] 国家自然科学基金-河南联合基金(U1804180); 河南省科技厅项目(182300410305)
[通信作者] 于建斌,E-mail:yjbdoctor@sina.com
更新日期/Last Update: 2020-12-05