Department of Medicine, Section of Dermatology and Venereology, University of Verona, Italy GISED Study Centre, Ospedali Riuniti, Bergamo, Italy.
J Eur Acad Dermatol Venereol. 2013 Jan;27(1):e30-41. doi: 10.1111/j.1468-3083.2012.04450.x. Epub 2012 Feb 7.
To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees.
Prospective cohort study.
Italian public referral centres for psoriasis treatment.
First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks.
Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension.
Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88).
Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed.
评估 Psocare 登记处新接受至少 16 周全身性银屑病治疗的患者，在开始新的全身性银屑病治疗后 16 周内实验室参数和选定临床情况的诊断变化。
前瞻性队列研究。
意大利公立银屑病治疗转诊中心。
至少接受 16 周连续全身性银屑病治疗的首次接受者（n = 10539）。
（第 8 周和第 16 周）总胆固醇和低密度脂蛋白胆固醇、甘油三酯、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶和肌酐水平的患者平均变化以及第 16 周达到血清水平临床显著升高（第 16 周）的患者比例，以及新诊断糖尿病和动脉高血压的第 16 周累积发生率。
阿维 A 酯或环孢素治疗患者的胆固醇和甘油三酯水平显著升高。依那西普和依那西普治疗患者的平均甘油三酯水平也升高。甲氨蝶呤治疗患者的平均转氨酶值升高，英夫利昔单抗治疗患者的平均天门冬氨酸氨基转移酶水平升高。环孢素治疗患者的血清肌酐值平均升高。阿维 A 酯和环孢素与高胆固醇血症的风险相关（比值比 1.51 和 1.34），阿维 A 酯与高甘油三酯血症的风险相关（比值比 1.43）。甲氨蝶呤和英夫利昔单抗与天门冬氨酸氨基转移酶（比值比 2.06 和 1.87）和丙氨酸氨基转移酶（比值比 2.38 和 1.74）值超过正常值两倍的风险增加相关。接受环孢素治疗的患者发生动脉高血压和糖尿病的相对风险增加（比值比 3.31 和 2.88）。
银屑病的全身性治疗对分析的参数产生了不同的影响。
