Department of Clinical Medicine and Surgery - Section of Dermatology, University of Naples Federico II, Italy.
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Expert Opin Drug Saf. 2020 Apr;19(4):523-531. doi: 10.1080/14740338.2020.1728253. Epub 2020 Feb 14.
: The approach to manage psoriasis in the elderly (ages ≥65 years) patients can be challenging. They often suffer from multiple comorbidities and polypharmacy with possible adverse effects and undergo a progressive functional impairment of the immune system that increases susceptibility to infections as well as to auto-reactivity. Despite the increasing aging of the general population and although several therapies are currently available for psoriasis treatment, data regarding their use and tolerability in the elderly are quite limited.: This review focuses on topical and systemic therapies that have been investigated in elderly patients in order to provide their safety profile in this population.: Conventional systemic therapies in elderly patients should be carefully dispensed and the correct dosage individually determined, taking into account the metabolism changes, organ impairment, comorbidities, concomitant medications, and contraindications. Apremilast, due to its satisfactory safety profile and low risk of drug interactions, results as an appropriate treatment option for elderly patients. Biologics (TNF-α, IL-12/23, IL-17, and IL-23 inhibitors) come out as safe and long-term options for the management of these patients resulting not associated with a higher risk of adverse events.
老年人(年龄≥65 岁)的银屑病治疗方法可能具有挑战性。他们常患有多种合并症和多药治疗,可能会产生不良反应,并经历免疫系统的进行性功能障碍,从而增加感染和自身反应的易感性。尽管普通人群老龄化日益加剧,而且目前有几种治疗银屑病的方法,但关于这些方法在老年人中的使用和耐受性的数据非常有限。
本综述重点关注已在老年患者中进行研究的局部和系统疗法,以提供这些疗法在该人群中的安全性概况。
对于老年患者,应谨慎使用传统的系统疗法,并根据代谢变化、器官损害、合并症、同时使用的药物和禁忌证,单独确定正确的剂量。阿普米司特由于其令人满意的安全性和低药物相互作用风险,结果成为老年患者的一种合适的治疗选择。生物制剂(TNF-α、IL-12/23、IL-17 和 IL-23 抑制剂)是安全且长期的选择,可用于这些患者的治疗,不会增加不良事件的风险。