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生物疗法治疗斑块状银屑病后体重及临床参数变化的比较

Comparison of body weight and clinical-parameter changes following the treatment of plaque psoriasis with biological therapies.

作者信息

Prignano F, Ricceri F, Pescitelli L, Buggiani G, Troiano M, Zanieri F, Rossari S, Lotti T

机构信息

Department of Dermatological Sciences, Physiotherapy Unit, Firenze, Italy.

出版信息

Curr Med Res Opin. 2009 Sep;25(9):2311-6. doi: 10.1185/03007990903162465.

Abstract

OBJECTIVE

This study is a retrospective analysis evaluating the presence of comorbidities, as well as the changes in body weight and clinical parameters in psoriasis patients following treatment with anti-TNF-alpha agents and with the anti-CD11a agent efalizumab.

RESEARCH DESIGN AND METHODS

A total of 268 patients affected by chronic plaque psoriasis, and receiving systemic monotherapy with efalizumab, etanercept, or infliximab, were included. The follow-up period was 2, 4 and 6 months.

MAIN OUTCOME MEASURES

Clinical data including age, gender, weight, type and severity of psoriasis and age of onset were collected. Severity of psoriasis was assessed according to the Psoriasis Area and Severity Index (PASI) and body surface area (BSA).

RESULTS

Hypertension and hyperlipidaemia were the comorbidities present with the higher frequency in our group of patients. PASI score was reduced by between 43.8 and 52% in all treatment groups. No relevant blood chemistry changes were observed following therapy, with the exception of a decrease in neutrophils and an increase in leukocyte numbers reported in the efalizumab and etanercept groups. Interestingly, after 6 months of therapy, the weight of the patients remained unvaried in those taking efalizumab (-0.05%) but was moderately increased in the etanercept (+0.72%) and in infliximab groups (+0.3%).

CONCLUSIONS

The present study shows that there were clinically significant differences in weight gain effects between efalizumab and anti-TNF-alpha agents in psoriatic patients. The changes in body weight gain increase did not reach statistical significance, although there is a trend towards this, and this may be due to the relatively small number of patient studied.

摘要

目的

本研究为一项回顾性分析,旨在评估银屑病患者在接受抗TNF-α药物和抗CD11a药物依法利珠单抗治疗后合并症的存在情况,以及体重和临床参数的变化。

研究设计与方法

共纳入268例慢性斑块状银屑病患者,这些患者接受了依法利珠单抗、依那西普或英夫利昔单抗的全身单药治疗。随访期为2、4和6个月。

主要观察指标

收集临床数据,包括年龄、性别、体重、银屑病的类型和严重程度以及发病年龄。根据银屑病面积和严重程度指数(PASI)和体表面积(BSA)评估银屑病的严重程度。

结果

高血压和高脂血症是我们患者组中出现频率较高的合并症。所有治疗组的PASI评分降低了43.8%至52%。治疗后未观察到相关的血液化学变化,但依法利珠单抗组和依那西普组报告有中性粒细胞减少和白细胞数量增加。有趣的是,治疗6个月后,服用依法利珠单抗的患者体重保持不变(-0.05%),但依那西普组(+0.72%)和英夫利昔单抗组(+0.3%)的患者体重有适度增加。

结论

本研究表明,银屑病患者中依法利珠单抗和抗TNF-α药物在体重增加效应方面存在临床显著差异。体重增加的变化虽有此趋势但未达到统计学显著性,这可能是由于研究的患者数量相对较少。

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