Department of Dermatology, Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Department of Dermatology, Laishan Branch of Yantai Yuhuangding Hospital, Yantai, China.
Dermatology. 2019;235(1):55-64. doi: 10.1159/000492784. Epub 2018 Nov 8.
BACKGROUND/AIMS: This study aimed to investigate the predicting values of depression and anxiety symptoms for clinical response to etanercept treatment in psoriasis patients.
A total of 85 psoriasis patients who received 6 months of etanercept treatment were consecutively enrolled in this prospective cohort study. The Psoriasis Area and Severity Index (PASI) score was evaluated at month 0 (M0), M1, M3, and M6, and the corresponding PASI 75/90 response at each visit was assessed. Also, anxiety and depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS) at M0, M1, M3, and M6.
Depression symptoms were observed to correlate with female gender (p = 0.004), longer disease duration (p = 0.018), and higher PASI score (p < 0.001), and anxiety symptoms were seen to be associated with female gender (p = 0.017), larger psoriasis-affected body surface area (p = 0.049), and higher PASI score (p = 0.017) in psoriasis patients. After etanercept treatment, HADS-Depression (HADS-D) and HADS-Anxiety (HADS-A) scores were both decreased at M1, M3, and M6 (all p < 0.001) compared with M0. Most importantly, baseline depressed patients presented with a lower PASI 75 response rate at M3 (p = 0.014) and M6 (p = 0.005), and a reduced PASI 90 response rate at M6 (p = 0.045) compared with baseline non-depressed patients. Furthermore, multivariate logistic regression analyses revealed that depression symptoms at baseline were an independent predictive factor for the lower possibility of both PASI 75 response (p = 0.048) and PASI 90 response (p = 0.048) achievements at M6 in psoriasis patients. However, no correlation of baseline anxiety symptoms with PASI 75/90 responses was observed.
Depression symptoms at baseline independently predict a worse clinical response to etanercept treatment in psoriasis patients.
背景/目的：本研究旨在探讨抑郁和焦虑症状对银屑病患者接受依那西普治疗临床反应的预测价值。
本前瞻性队列研究连续纳入了 85 例接受 6 个月依那西普治疗的银屑病患者。在基线（M0）、第 1 个月（M1）、第 3 个月（M3）和第 6 个月（M6）评估银屑病面积和严重程度指数（PASI）评分，并在每次就诊时评估相应的 PASI75/90 反应。同时，在 M0、M1、M3 和 M6 时采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁症状。
抑郁症状与女性（p=0.004）、疾病病程较长（p=0.018）和 PASI 评分较高（p<0.001）有关，焦虑症状与女性（p=0.017）、银屑病受累体表面积较大（p=0.049）和 PASI 评分较高（p=0.017）有关。接受依那西普治疗后，与 M0 相比，M1、M3 和 M6 时 HADS 抑郁量表（HADS-D）和 HADS 焦虑量表（HADS-A）评分均降低（均 p<0.001）。最重要的是，基线时抑郁患者在 M3（p=0.014）和 M6（p=0.005）时 PASI75 反应率较低，在 M6 时 PASI90 反应率较低（p=0.045），与基线时非抑郁患者相比。此外，多变量逻辑回归分析显示，基线时的抑郁症状是银屑病患者 PASI75 反应（p=0.048）和 PASI90 反应（p=0.048）可能性降低的独立预测因素。然而，基线时的焦虑症状与 PASI75/90 反应无相关性。
基线时的抑郁症状独立预测银屑病患者接受依那西普治疗的临床反应较差。
