Norris Diana, Photiou Louise, Tacey Mark, Dolianitis Con, Varigos George, Foley Peter, Baker Chris
a Skin and Cancer Foundation Inc , Carlton , Australia.
b Peter MacCallum Cancer Centre , Parkville , Australia.
J Dermatolog Treat. 2017 Dec;28(8):731-736. doi: 10.1080/09546634.2017.1329501. Epub 2017 Jun 23.
BACKGROUND/OBJECTIVES: Psoriasis is a chronic condition that may require long-term treatment for disease control. This analysis utilizes data from the Australasian Psoriasis Registry with particular attention to the impact of biologic therapy on DLQI, and the differences between the biologics in terms of DLQI score change.
A retrospective review of patients enrolled in the Australasian Psoriasis Registry from April 2008 to August 2016 was conducted. All subjects from the registry that had DLQI and Psoriasis Assessment Severity Index (PASI) scores recorded at a baseline time point of treatment commencement, in addition to week 12 and 24 post commencement were included in the study. A window of ±3 weeks was permitted at these time points. Multivariate linear regression analysis was undertaken to identify significant predictors associated with change in DLQI.
Significant predictors of reduction in DLQI and PASI score from baseline to week 24 include use of adalimumab, infliximab, secukinumab and ustekinumab. Other therapies, including etanercept and oral systemic agents did not show significant change. Each class of biologic showed significant reductions in DLQI score, with IL-12/23 blockade showing the greatest reduction. Significant predictors of lack of reduction in DLQI score include a baseline PASI score <16, and history of diabetes, alcoholism or uveitis.
Patients with moderate to severe chronic plaque psoriasis who are treated with biologics show the greatest reduction in DLQI score, compared with other treatments. Australian dermatologists are prescribing biologics when patients qualify for them in keeping with current guidelines.
背景/目的：银屑病是一种慢性疾病，可能需要长期治疗以控制病情。本分析利用来自澳大拉西亚银屑病登记处的数据，特别关注生物制剂对皮肤病生活质量指数（DLQI）的影响，以及不同生物制剂在DLQI评分变化方面的差异。
对2008年4月至2016年8月纳入澳大拉西亚银屑病登记处的患者进行回顾性研究。登记处中所有在治疗开始的基线时间点以及开始后第12周和第24周记录了DLQI和银屑病评估严重程度指数（PASI）评分的受试者均纳入本研究。这些时间点允许有±3周的时间窗口。进行多变量线性回归分析以确定与DLQI变化相关的显著预测因素。
从基线到第24周DLQI和PASI评分降低的显著预测因素包括使用阿达木单抗、英夫利昔单抗、司库奇尤单抗和乌司奴单抗。其他疗法，包括依那西普和口服全身用药，未显示出显著变化。每类生物制剂的DLQI评分均显著降低，其中白细胞介素12/23阻断剂的降低幅度最大。DLQI评分未降低的显著预测因素包括基线PASI评分<16，以及糖尿病、酗酒或葡萄膜炎病史。
与其他治疗方法相比，接受生物制剂治疗的中度至重度慢性斑块状银屑病患者DLQI评分降低幅度最大。澳大利亚皮肤科医生在患者符合当前指南的情况下会为其开具生物制剂处方。
