Hayashi Mitsuha, Umezawa Yoshinori, Fukuchi Osamu, Ito Toshihiro, Saeki Hidehisa, Nakagawa Hidemi
Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan.
J Dermatol. 2014 Nov;41(11):974-80. doi: 10.1111/1346-8138.12653.
The ratio of the elderly among psoriasis patients has been increasing. However, satisfactory long-term management of psoriasis for the elderly is challenging because of the more frequent presence of comorbidities, and the higher risk of adverse events from systemic therapeutic agents than younger patients. The use of ustekinumab (UST) appears to be an appropriate systemic treatment because it is considered less likely to cause adverse events than other systemic treatments, as well as necessitating fewer hospital visits. Our retrospective study aimed to evaluate the efficacy and safety profile of UST in elderly patients with psoriasis. The study included 24 patients aged over 65 years (range, 65-88 years; mean, 73.1 years) with moderate to severe plaque psoriasis with impaired quality of life. Efficacy and safety were assessed over a 1-year period using the Psoriasis Area and Severity Index (PASI) and the Dermatology Live Quality Index (DLQI). The efficacy was evaluated by the proportion of subjects who achieved ≥75% reduction in PASI score (PASI 75). PASI 75 responses were 56.5% at week 16, 59.1% at week 28, and 60.0% at week 52. None of the patients developed any serious infection during the 1-year treatment. The mean DLQI score at weeks 0, 16, 28, and 52 was 7.8 ± 6.0, 2.5 ± 3.4, 1.4 ± 1.7, and 1.2 ± 1.7, respectively. UST showed sufficient efficacy for elderly patients with psoriasis without any serious infection over the 1-year treatment. Our results suggest that UST is the preferable agent for the treatment of elderly patients with psoriasis.
银屑病患者中老年患者的比例一直在上升。然而，由于老年患者合并症更为常见，且与年轻患者相比，全身治疗药物发生不良事件的风险更高，因此对老年银屑病患者进行令人满意的长期管理具有挑战性。乌司奴单抗（UST）的使用似乎是一种合适的全身治疗方法，因为它被认为比其他全身治疗方法引起不良事件的可能性更小，且所需的门诊就诊次数更少。我们的回顾性研究旨在评估UST在老年银屑病患者中的疗效和安全性。该研究纳入了24例65岁以上（年龄范围65 - 88岁；平均73.1岁）、患有中度至重度斑块状银屑病且生活质量受损的患者。在1年的时间里，使用银屑病面积和严重程度指数（PASI）和皮肤病生活质量指数（DLQI）评估疗效和安全性。疗效通过PASI评分降低≥75%（PASI 75）的受试者比例进行评估。在第16周时PASI 75反应率为56.5%，第28周时为59.1%，第52周时为60.0%。在1年的治疗期间，没有患者发生任何严重感染。在第0、16、28和52周时，平均DLQI评分分别为7.8±6.0、2.5±3.4、1.4±1.7和1.2±1.7。在1年的治疗中，UST对老年银屑病患者显示出足够的疗效，且没有任何严重感染。我们的结果表明，UST是治疗老年银屑病患者的首选药物。
