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意大利真实临床环境中中重度斑块型银屑病患者应用环孢素 A 的疗效:TRANSITION 研究。

Effectiveness of cyclosporine A in patients with moderate to severe plaque psoriasis in a real-life clinical setting in Italy: the TRANSITION study.

机构信息

Unit of Dermatology, Versilia Hospital, Lido di Camaiore, Lucca, Italy.

Centro per la cura della Psoriasi, Hospital "Di Summa-Perrino", Brindisi, Italy.

出版信息

J Dermatolog Treat. 2022 Feb;33(1):401-407. doi: 10.1080/09546634.2020.1757017. Epub 2020 Apr 30.

DOI:10.1080/09546634.2020.1757017
PMID:32349568
Abstract

BACKGROUND

Cyclosporine A (CsA) is one of the systemic therapeutic options for moderate-to-severe psoriasis, based on its efficacy and rapidity of action. The current study investigated the response to CsA in patients with moderate-to-severe plaque psoriasis.

MATERIALS AND METHODS

TRANSITION was an observational, cross-sectional, multicentre study which evaluated the proportion of partial- and suboptimal-responders among patients with moderate-to-severe plaque psoriasis treated with continuous CsA for ≥12 weeks. Patients demonstrating a Psoriasis Area and Severity Index (PASI) response of ≥90, ≥75 and <90, ≥50 and <75 and <50 were defined as responders, suboptimal-responders, partial-responders, and non-responders, respectively.

RESULTS

A total of 196 patients (mean age, 46.6 years; 62.8% males) from 14 sites in Italy were evaluated. At the study visit, the mean (SD) PASI score was 4.2(5.5) compared with 15.3(7.1) prior to the last CsA cycle. For response categories, 39.8%, 22.4%, 16.8%, and 20.9% of patients were responders, suboptimal-responders, partial-responders, and non-responders to CsA treatment. Overall, 28.6% of patients permanently discontinued treatment with CsA (lack of efficacy [10.2%], poor tolerability and voluntary discontinuation [3.6% each], and other [11.7%]).

CONCLUSION

Patients were only partially satisfied with CsA treatment, reporting measurable impact on quality of life. Only 40% patients showed a satisfactory response to CsA.

摘要

背景

环孢素 A(CsA)是中度至重度银屑病的全身性治疗选择之一,基于其疗效和起效速度。本研究调查了 CsA 治疗中度至重度斑块型银屑病患者的反应。

材料和方法

TRANSITION 是一项观察性、横断面、多中心研究,评估了接受持续 CsA 治疗≥12 周的中度至重度斑块型银屑病患者中部分和不理想应答者的比例。对 PASI 应答≥90%、≥75%且<90%、≥50%且<75%和<50%的患者分别定义为应答者、不理想应答者、部分应答者和无应答者。

结果

共评估了来自意大利 14 个地点的 196 名患者(平均年龄 46.6 岁;62.8%为男性)。在研究访视时,平均(SD)PASI 评分为 4.2(5.5),而在前一个 CsA 周期前为 15.3(7.1)。在应答类别中,39.8%、22.4%、16.8%和 20.9%的患者分别对 CsA 治疗为应答者、不理想应答者、部分应答者和无应答者。总体而言,28.6%的患者永久停止 CsA 治疗(疗效不佳[10.2%]、耐受性差和自愿停药[各 3.6%]和其他[11.7%])。

结论

患者对 CsA 治疗仅部分满意,报告对生活质量有可衡量的影响。只有 40%的患者对 CsA 有满意的反应。

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