Carvalho André Vicente Esteves de, Romiti Ricardo, Souza Cacilda da Silva, Paschoal Renato Soriani, Milman Laura de Mattos, Meneghello Luana Pizarro
Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brazil.
Universidade de São Paulo (USP) - São Paulo (SP), Brazil.
An Bras Dermatol. 2016 Nov-Dec;91(6):781-789. doi: 10.1590/abd1806-4841.20165080.
During the last decade, different studies have converged to evidence the high prevalence of comorbidities in subjects with psoriasis. Although a causal relation has not been fully elucidated, genetic relation, inflammatory pathways and/or common environmental factors appear to be underlying the development of psoriasis and the metabolic comorbidities. The concept of psoriasis as a systemic disease directed the attention of the scientific community in order to investigate the extent to which therapeutic interventions influence the onset and evolution of the most prevalent comorbidities in patients with psoriasis. This study presents scientific evidence of the influence of immunobiological treatments for psoriasis available in Brazil (infliximab, adalimumab, etanercept and ustekinumab) on the main comorbidities related to psoriasis. It highlights the importance of the inflammatory burden on the clinical outcome of patients, not only on disease activity, but also on the comorbidities. In this sense, systemic treatments, whether immunobiologicals or classic, can play a critical role to effectively control the inflammatory burden in psoriatic patients.
在过去十年中，不同的研究都证实了银屑病患者中合并症的高患病率。尽管因果关系尚未完全阐明，但遗传关系、炎症途径和/或共同的环境因素似乎是银屑病和代谢合并症发展的潜在原因。银屑病作为一种全身性疾病的概念引起了科学界的关注，以便研究治疗干预在多大程度上影响银屑病患者中最常见合并症的发生和发展。本研究提供了巴西可用的银屑病免疫生物治疗（英夫利昔单抗、阿达木单抗、依那西普和乌司奴单抗）对与银屑病相关的主要合并症影响的科学证据。它强调了炎症负担对患者临床结局的重要性，不仅对疾病活动，而且对合并症。从这个意义上说，全身治疗，无论是免疫生物治疗还是传统治疗，都可以在有效控制银屑病患者的炎症负担方面发挥关键作用。
