Loft Nikolai, Egeberg Alexander, Rasmussen Mads Kirchheiner, Bryld Lars Erik, Nissen Christoffer V, Dam Tomas Norman, Ajgeiy Kawa Khaled, Iversen Lars, Skov Lone
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, DK-2900 Hellerup, Denmark. E-mail:
Acta Derm Venereol. 2021 Jan 4;101(1):adv00357. doi: 10.2340/00015555-3722.
Early response to treatment with biologics might be important for the stability of psoriasis and long-term outcome. The aim of this study was therefore to assess whether risk of flares and drug survival are associated with disease activity in the first 6 months of treatment of psoriasis with biologics. Biologic-naïve patients from the Danish nationwide registry, DERMBIO, were grouped based on absolute Psoriasis Area and Severity Index (PASI) during the first 6 months of treatment, as: PASI = 0, PASI > 0-≤2, PASI > 2-≤ 4, and PASI > 4. Among 1,684 patients, 746 achieved PASI= 0, 485 PASI > 0-≤2, 246 PASI > 2-≤4, and 207 PASI > 4. Longer flare-free period and drug survival were observed for patients with lower PASI in the first 6 months of treatment (adjusted hazard ratios for flares (95% confidence interval) with PASI= 0 as reference: PASI > 0-≤2 (1.35 (1.11-1.72]), PASI > 2-≤ 4 (2.32 [1.80-2.99]), and PASI > 4 (2.38 [1.80-3.15])). In conclusion, a low PASI in the first 6 months of treatment with biologics in biologic-naïve patients with psoriasis was associated with a more stable disease course, lower risk of flares, and longer drug survival.
生物制剂治疗的早期反应对于银屑病的病情稳定和长期预后可能很重要。因此，本研究的目的是评估在使用生物制剂治疗银屑病的前6个月中，病情复发风险和药物留存率是否与疾病活动度相关。来自丹麦全国性登记处DERMBIO的初治生物制剂患者，根据治疗前6个月的绝对银屑病面积和严重程度指数（PASI）进行分组，分为：PASI = 0、PASI > 0至≤2、PASI > 2至≤4以及PASI > 4。在1684例患者中，746例达到PASI = 0，485例PASI > 0至≤2，246例PASI > 2至≤4，207例PASI > 4。在治疗的前6个月中，PASI较低的患者观察到更长的无复发期和药物留存时间（以PASI = 0为参照，复发的调整风险比（95%置信区间）：PASI > 0至≤2（1.35 [1.11 - 1.72]），PASI > 2至≤4（2.32 [1.80 - 2.99]），以及PASI > 4（2.38 [1.80 - 3.15]））。总之，在初治银屑病患者中，使用生物制剂治疗的前6个月PASI较低与更稳定的病程、更低的复发风险和更长的药物留存时间相关。
