Langley Richard G, Ho Vincent, Lynde Charles, Papp Kim A, Poulin Yves, Shear Neil, Toole Jack, Zip Catherine
Queen Elizabeth II Health Science Centre, Dalhousie University, 4195 Dickson Building, B3H 2Y9, Halifax, NS.
J Cutan Med Surg. 2006;9 Suppl 1:18-25. doi: 10.1007/s10227-006-0103-1.
Psoriasis is a T-cell mediated skin disease that affects approximately 2% of the population worldwide. Despite the prevalence of the disease and long-standing efforts to develop strategies to treat it, there is a need for safe and effective therapies to treat psoriasis, particularly the more severe forms. Biological agents such as alefacept, efalizumab, etanercept, and infliximab have been recognized as a class of treatment distinct from other forms of therapy in the treatment algorithm of psoriasis. Recent national and international consensus meetings have developed statements that position biological agents as an important addition to the treatment armamentarium for moderate to severe psoriasis, along with phototherapy and traditional systemic agents. There has been consensus that treatment should be individualized to each patient's needs and circumstances. Biological agents offer the hope of safe, effective, long-term management of moderate to severe psoriasis. As new agents receive approval from Health Canada, the available range of therapeutic options for treating this chronic disease will broaden. A Canadian Psoriasis Expert Panel recently convened in February 2005 to analyze, based on a series of clinical case scenarios, the indications, contraindications, and considerations for and against each of the four biological agents, derived from product labelling, where available, and from the efficacy and safety data from phase 3 and earlier clinical trials, as well as post-marketing reports. The Panel has formulated a set of recommendations for incorporating these biological agents into the current treatment paradigm of moderate to severe plaque psoriasis and has identified the preferred biological agents for each patient based on individual needs and circumstances.
银屑病是一种由T细胞介导的皮肤病，全球约2%的人口受其影响。尽管该疾病普遍存在，且长期以来人们一直在努力制定治疗策略，但仍需要安全有效的疗法来治疗银屑病，尤其是更严重的类型。诸如阿法赛特、依法利珠单抗、依那西普和英夫利昔单抗等生物制剂在银屑病治疗方案中已被视为一类有别于其他治疗形式的疗法。最近的国内和国际共识会议发表声明，将生物制剂定位为中重度银屑病治疗手段的重要补充，与光疗和传统全身用药并列。人们已达成共识，治疗应根据每位患者的需求和情况进行个体化。生物制剂为中重度银屑病的安全、有效、长期管理带来了希望。随着新制剂获得加拿大卫生部批准，治疗这种慢性病的可用治疗选择范围将会扩大。一个加拿大银屑病专家小组最近于2005年2月召开会议，基于一系列临床病例情况，分析了四种生物制剂各自的适应证、禁忌证以及支持和反对使用的因素，这些因素来源于现有产品标签以及3期和更早临床试验的疗效和安全性数据，还有上市后报告。该小组已制定了一套建议，以便将这些生物制剂纳入当前中重度斑块状银屑病的治疗模式，并根据个体需求和情况为每位患者确定了首选生物制剂。
