使用优特克单抗治疗中重度银屑病患者抑郁症状的改善：一项使用贝克抑郁量表、汉密尔顿抑郁评定量表及氟脱氧葡萄糖（FDG）正电子发射断层显像（PET）验证的开放标签试验
Improvement of depressive symptoms in patients with moderate-to-severe psoriasis treated with ustekinumab: an open label trial validated using beck depression inventory, Hamilton depression rating scale measures and fluorodeoxyglucose (FDG) positron emission tomography (PET).
作者信息
Kim Seong-Jang, Park Min-Young, Pak Kyoungjune, Han Junhee, Kim Gun-Wook, Kim Hoon-Soo, Ko Hyun-Chang, Kim Moon-Bum, Kim Byung-Soo
机构信息
a Department of Nuclear Medicine, School of Medicine , Pusan National University , Busan , Korea.
b Department of Dermatology, School of Medicine , Pusan National University , Busan , Korea.
出版信息
J Dermatolog Treat. 2018 Dec;29(8):761-768. doi: 10.1080/09546634.2018.1466021. Epub 2018 May 7.
BACKGROUND
Psoriasis is a chronic skin disease associated with psychiatric co-morbidities, especially depression. Early detection of psychological vulnerability in patients with psoriasis seems to be of great clinical importance and significantly impacts the quality of life of the patients.
OBJECTIVES
We sought to clarify the association between psoriasis and depressive symptoms in patients with moderate-to-severe psoriasis, and to determine the risk factors for depressive symptoms and analyze the effect of ustekinumab on the symptoms. We also aimed to evaluate the changes in glucose metabolism using fluorodeoxyglucose (FDG) positron emission tomography (FDG-PET).
METHODS
Fifteen patients with moderate-to-severe psoriasis scheduled to be treated with ustekinumab were enrolled. At baseline and after achieving a 75% reduction in the Psoriasis Area and Severity Index (PASI) score (PASI75), all patients underwent a psychiatric interview and FDG-PET. Fifteen healthy volunteers were enrolled for comparison.
RESULTS
Patients with moderate-to-severe psoriasis were more depressed than those in the control group were (p < .05). The severity of psoriasis at baseline did not correlate with the depression symptoms. Treatment with ustekinumab significantly reduced the depressive symptoms, as verified using Beck Depression Inventory and Hamilton Depression Rating Scale psychiatric interviews (p < .05). However, FDG-PET of the brain showed no significant difference before and after PASI75 achievement using ustekinumab injection.
CONCLUSIONS
Patients with moderate-to-severe psoriasis are at an increased risk for depressive symptoms, and treatment with ustekinumab may be beneficial. FDG-PET does not reflect the changes in depressive symptoms in such patients.
背景
银屑病是一种与精神共病相关的慢性皮肤病，尤其是抑郁症。早期发现银屑病患者的心理易感性似乎具有重要的临床意义，并对患者的生活质量产生重大影响。
目的
我们试图阐明中度至重度银屑病患者中银屑病与抑郁症状之间的关联，确定抑郁症状的危险因素并分析乌司奴单抗对症状的影响。我们还旨在使用氟脱氧葡萄糖（FDG）正电子发射断层扫描（FDG-PET）评估葡萄糖代谢的变化。
方法
招募了15名计划接受乌司奴单抗治疗的中度至重度银屑病患者。在基线时以及银屑病面积和严重程度指数（PASI）评分降低75%（PASI75）后；所有患者均接受了精神科访谈和FDG-PET检查。招募了15名健康志愿者进行比较。
结果
中度至重度银屑病患者比对照组患者更易抑郁（p < 0.05）。基线时银屑病的严重程度与抑郁症状无关。使用乌司奴单抗治疗可显著减轻抑郁症状，这通过贝克抑郁量表和汉密尔顿抑郁评定量表精神科访谈得到证实（p < 0.05）。然而，使用乌司奴单抗注射达到PASI75前后，大脑的FDG-PET检查未显示出显著差异。
结论
中度至重度银屑病患者出现抑郁症状的风险增加，使用乌司奴单抗治疗可能有益。FDG-PET不能反映此类患者抑郁症状的变化。
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