Silva Laura Maria Andrade, Rocha Bruno de Oliveira, Nobre Ana Cláudia Pinto, Rêgo Vitória Regina Pedreira de Almeida, Follador Ivonise, Oliveira Maria de Fátima Santos Paim de
Universidade Federal da Bahia, Salvador, BA, Brazil.
An Bras Dermatol. 2014 May-Jun;89(3):436-40. doi: 10.1590/abd1806-4841.20142613.
Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis.
We report the experience of a state referral center that uses anti-TNFα agents for psoriasis.
We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05.
Forty-one subjects (55.40%) were male, with a mean age of 47.69 ± 14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively.
Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites.
银屑病是一种慢性免疫介导性疾病，其特征为肿瘤坏死因子α（TNFα）水平升高。抗TNFα药物通过靶向参与其发病机制的重要分子，彻底改变了重度银屑病的治疗方式。
我们报告一家国家转诊中心使用抗TNFα药物治疗银屑病的经验。
我们进行了一项回顾性病例系列研究。120例患者中有74例符合纳入标准。使用卡方检验、 Wilcoxon检验和McNemar检验对临床和实验室数据进行分析。当p值<0.05时，关联被认为具有统计学意义。
41名受试者（55.40%）为男性，平均年龄为47.69±14.99岁。疾病持续时间中位数和治疗前银屑病面积和严重程度指数（PASI）分别为14.0个月（四分位间距9.0 - 20.0）和13.55分（四分位间距8.5 - 20.32）。60例患者（81.10%）患有关节病型银屑病。46名受试者（62.20%）有合并症；最常见的是血脂异常（25.70%）。在55.40%的患者中，对传统疗法反应不足是使用抗TNFα药物的主要指征。93.20%的病例出现临床改善，治疗后PASI中位数为0.0分（四分位间距0.0 - 0.0）。6.80%的患者出现不良反应。感染和转氨酶升高分别发生在28.40%和8.10%的病例中。
治疗后PASI降低情况令人满意，不良反应发生率较低，主要为轻度输注反应和给药部位局部反应。
