Carrasquillo Osward Y, Pabón-Cartagena Gabriela, Falto-Aizpurua Leyre A, Santiago-Vázquez Marely, Cancel-Artau Karina J, Arias-Berrios Gabriel, Martín-García Rafael F
Department of Dermatology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
Transitional Year Program, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
J Am Acad Dermatol. 2020 Jul;83(1):151-158. doi: 10.1016/j.jaad.2020.03.073. Epub 2020 Apr 2.
Biologic medications for plaque psoriasis have been used to treat erythrodermic psoriasis (EP). Since the guidelines for management of EP were published, new biologic medications have been approved for the treatment of plaque psoriasis.
To analyze the evidence of biologic medications in the treatment of EP based on response and tolerability.
A comprehensive search was conducted with the PubMed, Cochrane Library, Embase, and Scopus databases through December 31, 2018. Studies reporting 1 or more cases of EP, defined as >75% body surface area involvement, in patients aged ≥18 years treated with biologics were included. Baseline Psoriasis Area and Severity Index score, score improvement, and adverse events were documented. Adequate response to treatment was defined as Psoriasis Area and Severity Index ≥50.
Included were 43 articles, yielding a total of 179 patients. Most patients responded at some point during treatment, with a higher level of evidence for infliximab, ustekinumab, ixekizumab, and guselkumab. Infection was the most common adverse event (n = 35).
Data are limited to case reports, case series, and uncontrolled studies.
Patients with EP treated with biologics demonstrated positive responses and treatment was well-tolerated, with a weak recommendation and limited quality of evidence in favor of infliximab, ustekinumab, ixekizumab, and guselkumab.
用于斑块状银屑病的生物制剂已被用于治疗红皮病型银屑病（EP）。自从EP的管理指南发布以来，新的生物制剂已被批准用于治疗斑块状银屑病。
基于疗效和耐受性分析生物制剂治疗EP的证据。
通过检索PubMed、Cochrane图书馆、Embase和Scopus数据库，全面检索截至2018年12月31日的文献。纳入报告了1例或更多例EP（定义为体表面积受累>75%）且年龄≥18岁接受生物制剂治疗患者的研究。记录基线银屑病面积和严重程度指数评分、评分改善情况及不良事件。治疗的充分反应定义为银屑病面积和严重程度指数≥50。
纳入43篇文章，共179例患者。大多数患者在治疗的某个阶段有反应，英夫利昔单抗、乌司奴单抗、司库奇尤单抗和古塞奇尤单抗的证据水平更高。感染是最常见的不良事件（n = 35）。
数据限于病例报告、病例系列和非对照研究。
接受生物制剂治疗的EP患者显示出阳性反应，且治疗耐受性良好，对英夫利昔单抗、乌司奴单抗、司库奇尤单抗和古塞奇尤单抗的推荐较弱且证据质量有限。
