抗 TNFα 抗体诱导炎症性肠病患者出现银屑病样皮肤损伤：一项爱尔兰队列研究。
Anti-TNFα antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease: an Irish Cohort Study.
机构信息
From the Trinity Academic Gastroenterology Group, Trinity College Dublin, Dublin, Ireland.
Department of Gastrenterology, Tallaght Hospital, Dublin, Ireland.
出版信息
QJM. 2017 Jun 1;110(6):379-382. doi: 10.1093/qjmed/hcx003.
AIM
To determine the prevalence of psoriasis in an IBD cohort with reference to clinical characteristics and anti-TNFα use.
METHODS
Patients with psoriasis and IBD were retrospectively identified from the IBD database at Tallaght Hospital from 2000 to 2015. Pertinent clinical data were obtained from patients notes including anti-TNFα exposure. Prevalence rates of genuine and reactive psoriasis were calculated and compared using Student's T -test. A P values of <0.05 was considered significant.
RESULTS
In total, 1384 IBD patients were identified. The overall prevalence rate of IBD and psoriasis was 2.4% ( n = 33), with 1.8% ( n = 25) in the Crohn's disease group and 0.6% ( n = 8) in the ulcerative colitis group. Within the psoriasis group, 24% ( n = 8 of 33) had reactive psoriasis. The prevalence rates of psoriasis in the non-biological and biological cohorts were similar 2.5% (25 of 981) and 2% (8 of 403), respectively. There was no significant association with reactive psoriasis and disease type. There was a trend towards higher rates of reactive psoriasis Adalimumab users, 3.6% (6 of 166) vs. 0.8% (2 of 237), OR = 4.283, P = 0.077, 95% CI 0.854-21.483 in infliximab users. In addition, in our cohort, smoking was not associated with any form of psoriasis in IBD, OR = 1.377, 95% CI 0.061-3.087, P = 0.437.
CONCLUSION
In our large study, the prevalence rate of reactive psoriasis was similar to the background rate of psoriasis in the overall IBD cohort (2.0 vs. 2.4%). A 2% prevalence rate represents a common adverse event that clinicians should be aware of.
目的
参照临床特征和抗 TNFα 治疗情况，确定炎症性肠病（IBD）患者中银屑病的患病率。
方法
从 2000 年至 2015 年，我们通过都柏林塔拉特医院的 IBD 数据库回顾性地确定了银屑病合并 IBD 的患者。我们从患者病历中获得了包括抗 TNFα 暴露情况在内的相关临床数据。使用 Student's T 检验计算并比较真、假银屑病的患病率。P 值<0.05 被认为具有统计学意义。
结果
共确定了 1384 例 IBD 患者。IBD 合并银屑病的总患病率为 2.4%（n=33），其中克罗恩病组为 1.8%（n=25），溃疡性结肠炎组为 0.6%（n=8）。在银屑病组中，24%（n=33 中的 8 例）为假银屑病。非生物制剂和生物制剂组中银屑病的患病率分别为 2.5%（981 例中的 25 例）和 2%（403 例中的 8 例），两者之间无显著差异。假银屑病与疾病类型之间也无显著关联。阿达木单抗使用者中假银屑病的发生率较高，为 3.6%（166 例中的 6 例），而英夫利昔单抗使用者中为 0.8%（237 例中的 2 例），比值比（OR）=4.283，P=0.077，95%可信区间（CI）为 0.854-21.483。此外，在我们的队列中，吸烟与 IBD 患者的任何类型银屑病均无关，OR=1.377，95%CI 为 0.061-3.087，P=0.437。
结论
在我们的大型研究中，假银屑病的患病率与总体 IBD 队列中银屑病的背景患病率（2.0%比 2.4%）相似。2%的患病率是一种常见的不良反应，临床医生应予以注意。
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