Puig L, Carrascosa J M, Carretero G, de la Cueva P, Lafuente-Urrez R F, Belinchón I, Sánchez-Regaña M, García-Bustínduy M, Ribera M, Alsina M, Ferrándiz C, Fonseca E, García-Patos V, Herrera E, López-Estebaranz J L, Marrón S E, Moreno J C, Notario J, Rivera R, Rodriguez-Cerdeira C, Romero A, Ruiz-Villaverde R, Taberner R, Vidal D
Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Actas Dermosifiliogr. 2013 Oct;104(8):694-709. doi: 10.1016/j.adengl.2013.04.013. Epub 2013 Sep 7.
Biologic therapy is a well-established strategy for managing moderate and severe psoriasis. Nevertheless, the high cost of such therapy, the relatively short span of clinical experience with biologics, and the abundance of literature now available on these agents have made evidence-based and consensus-based clinical guidelines necessary. The ideal goal of psoriasis treatment is to achieve complete or nearly complete clearing of lesions and to maintain it over time. Failing that ideal, the goal would be to reduce involvement to localized lesions that can be controlled with topical therapy. Although current evidence allows us to directly or indirectly compare the efficacy or risk of primary or secondary failure of available biologics based on objective outcomes, clinical trial findings cannot be directly translated to routine practice. As a result, the prescribing physician must tailor the treatment regimen to the individual patient. This update of the clinical practice guidelines issued by the Spanish Academy of Dermatology and Venereology (AEDV) on biologic therapy for psoriasis incorporates information from the most recent publications on this topic.
生物疗法是治疗中度和重度银屑病的一种成熟策略。然而,此类疗法成本高昂,生物制剂的临床经验相对较短,且目前关于这些药物的文献众多,因此有必要制定基于证据和共识的临床指南。银屑病治疗的理想目标是实现皮损完全或几乎完全清除,并长期维持。若无法实现这一理想目标,则目标是将受累范围缩小至可通过局部治疗控制的局限性皮损。尽管目前的证据使我们能够基于客观结果直接或间接比较现有生物制剂原发性或继发性失败的疗效或风险,但临床试验结果不能直接应用于常规实践。因此,开处方的医生必须根据个体患者情况调整治疗方案。西班牙皮肤病与性病学会(AEDV)发布的关于银屑病生物疗法的临床实践指南的此次更新纳入了该主题最新出版物中的信息。