Langley Richard G, Gordon Kenneth B
Division of Dermatology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
J Drugs Dermatol. 2007 Dec;6(12):1205-12.
The efficacy of biologic agents to treat psoriasis has been established in well-designed clinical trials. The primary endpoint is usually a 75% reduction from the baseline Psoriasis Area and Severity Index, stressing acute control of symptoms. Another important endpoint is remission, or duration of response off therapy, which reduces exposure to immunosuppressive agents and potentially lowers costs.
We searched the literature for randomized controlled clinical trials of remission with biologic agents.
Among approved biologic agents, alefacept produced the longest posttreatment clinical benefits in responders (7 to 8.6 months after a 12-week course), followed by infliximab (4.7 months after a 6-week, 3-dose induction period), etanercept (2.8 to 3.5 months after 12 weeks of therapy), and efalizumab (2.8 months after 24 weeks of therapy). Long-term response to infliximab in some patients may be limited by neutralizing antibodies. Additional data on adalimumab are needed.
生物制剂治疗银屑病的疗效已在精心设计的临床试验中得到证实。主要终点通常是银屑病面积和严重程度指数较基线降低75%，强调症状的急性控制。另一个重要终点是缓解，即停止治疗后的反应持续时间，这可减少免疫抑制剂的暴露并可能降低成本。
我们检索了有关生物制剂缓解的随机对照临床试验的文献。
在已获批的生物制剂中，阿法赛特在有反应者中产生的治疗后临床获益时间最长（12周疗程后7至8.6个月），其次是英夫利昔单抗（6周3剂诱导期后4.7个月）、依那西普（治疗12周后2.8至3.5个月）和依法利珠单抗（治疗24周后2.8个月）。部分患者对英夫利昔单抗的长期反应可能受中和抗体限制。需要更多关于阿达木单抗的数据。
