Boehncke Wolf-Henning, Prinz Jörg, Gottlieb Alice B
Department of Dermatology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
J Rheumatol. 2006 Jul;33(7):1447-51. Epub 2006 May 15.
Alefacept, efalizumab, etanercept, and infliximab are currently approved for the treatment of adults with moderate to severe plaque psoriasis, and phase 3 trials for adalimumab are ongoing. The high level of evidence from large randomized, double-blind, placebo-controlled clinical studies for each of these biologics allows high-grade recommendations and helps define uncertainties, one of which is longterm safety. For tumor necrosis factor-a blocking agents, safety profiles are available from clinical experience in other indications. In general, biologics are safe and effective in the treatment of psoriasis, with potential to address unmet medical needs. Their distinct profiles allow dermatologists to match the biologic agent to individual characteristics of patients who are candidates for systemic therapy or phototherapy. In this evidence-based review of the literature, we assess the effects on psoriasis of induction therapy with 5 biologics and provide preliminary treatment guidelines.
阿法西普、依法利珠单抗、依那西普和英夫利昔单抗目前已被批准用于治疗中度至重度斑块状银屑病的成人患者，阿达木单抗的3期试验正在进行。这些生物制剂中的每一种都有来自大型随机、双盲、安慰剂对照临床研究的高水平证据，这使得能够给出高级别推荐并有助于明确不确定性，其中之一就是长期安全性。对于肿瘤坏死因子-α阻断剂，可从其他适应症的临床经验中获得安全性资料。总体而言，生物制剂在治疗银屑病方面安全有效，有潜力满足未被满足的医疗需求。它们独特的特性使皮肤科医生能够根据全身治疗或光疗候选患者的个体特征来匹配生物制剂。在本次基于证据的文献综述中，我们评估了5种生物制剂诱导治疗对银屑病的影响并提供初步治疗指南。
