Ara M, Pérez A, Ferrando J
Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Actas Dermosifiliogr. 2011 Nov;102(9):706-16. doi: 10.1016/j.ad.2011.03.014. Epub 2011 May 19.
Biologic therapy has represented a major advance in the treatment of moderate to severe psoriasis but its use depends upon the characteristics of the patient and the criteria applied by the dermatologist. The aim of this survey was to determine the criteria employed by dermatologists in the decision to use these drugs.
A cross-sectional survey was undertaken among Spanish dermatologists with experience in the treatment of moderate to severe psoriasis. The survey comprised 31 items distributed in 5 sections: investigator profile, disease management, treatment of moderate to severe psoriasis, use of biologic drugs, and evaluation of the use of biologic drugs for the treatment of moderate to severe psoriasis.
One hundred-ninety dermatologists were included in the study. The study participants reported that 31% of patients receiving treatment for moderate to severe psoriasis are treated with biologic drugs. Of those, 28% require a change in treatment at some point due either to lack of activity or the appearance of side effects. Biologic drugs would be administered as monotherapy in 73% of cases. In between 53% and 59% of cases, biologic drugs would be prescribed as continuous treatments. On a scale of 1 to 5, the most valued pharmacological properties by dermatologists were safety (4.8 points; 95% confidence interval [CI], 4.7-4.9), long-term efficacy (4.6 points [4.5-4.7]), and tolerance (4.5 [4.4-4.6]).
Dermatologists with experience in the use of biologic drugs employ this treatment option in slightly more than a quarter of cases of moderate to severe psoriasis. In their opinion, the choice of biologic drug should be based on, in order of importance, safety, long-term efficacy, and tolerance.
生物疗法是中重度银屑病治疗的一项重大进展，但其使用取决于患者的特征以及皮肤科医生所采用的标准。本调查的目的是确定皮肤科医生在决定使用这些药物时所采用的标准。
对有中重度银屑病治疗经验的西班牙皮肤科医生进行了一项横断面调查。该调查包括31个项目，分为5个部分：研究者概况、疾病管理、中重度银屑病的治疗、生物药物的使用以及生物药物用于中重度银屑病治疗的使用评估。
190名皮肤科医生纳入了该研究。研究参与者报告称，接受中重度银屑病治疗的患者中有31%接受生物药物治疗。其中，28%的患者因缺乏疗效或出现副作用而在某个时间点需要更换治疗方案。73%的病例中生物药物将作为单一疗法使用。在53%至59%的病例中，生物药物将被规定为连续治疗。在1至5的评分中，皮肤科医生最看重的药理特性是安全性（4.8分；95%置信区间[CI]，4.7 - 4.9）、长期疗效（4.6分[4.5 - 4.7]）和耐受性（4.5[4.4 - 4.6]）。
有生物药物使用经验的皮肤科医生在略多于四分之一的中重度银屑病病例中采用这种治疗选择。在他们看来，生物药物的选择应基于重要性依次为安全性、长期疗效和耐受性。
