银屑病患者的性别与全身治疗结局相关性：一项两国多中心前瞻性非干预性登记研究。

Association of sex and systemic therapy treatment outcomes in psoriasis: a two-country, multicentre, prospective, noninterventional registry study.

机构信息

Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

出版信息

Br J Dermatol. 2021 Dec;185(6):1160-1168. doi: 10.1111/bjd.20387. Epub 2021 Jun 22.

DOI:10.1111/bjd.20387

PMID:33837519

Abstract

BACKGROUND

Few systematic data on sex-related treatment responses exist for psoriasis.

OBJECTIVES

To evaluate sex differences with respect to systemic antipsoriatic treatment.

METHODS

Data from patients with moderate-to-severe psoriasis in the PsoBest or Swiss Dermatology Network of Targeted Therapies (SDNTT) registries were analysed. Treatment response was defined as achieving a ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75) or PASI ≤ 3 at treatment months 3, 6 and 12, supplemented by patient-reported outcomes [i.e. Dermatology Life Quality Index (DLQI) ≤ 1 and delta DLQI ≥ 4].

RESULTS

In total, 5346 patients registered between 2007 and 2016 were included (PsoBest, n = 4896; SDNTT, n = 450). The majority received nonbiological treatment (67·3% male, 69·8% female). Women showed slightly higher PASI response rates after 3 (54·8% vs. 47·2%; P ≤ 0·001), 6 (70·8% vs. 63·8%; P ≤ 0·001) and 12 months (72·3% vs. 66·1%; P ≤ 0·004). A significantly higher proportion of women achieved a reduction in DLQI ≥ 4 [month 3: 61·4% vs 54·8% (P ≤ 0·001); month 6: 69·6% vs. 62·4% (P ≤ 0·001); month 12: 70·7% vs. 64·4% (P ≤ 0·002)]. Regarding PASI ≤ 3, women on biologics showed a significantly superior treatment response compared with men at 3 (57·8% vs. 48·5%; P ≤ 0·004) and 6 months (69·2% vs. 60·9%; P ≤ 0·018). Women in the nonbiological treatment group had a significantly better treatment response (PASI response, PASI 75 and PASI ≤ 3) over 12 months compared with men.

CONCLUSIONS

We provide evidence that women experience better treatment outcomes with systemic antipsoriatic therapy than men.

摘要

背景

银屑病的治疗反应与性别相关的系统数据很少。

目的

评估系统抗银屑病治疗的性别差异。

方法

对来自 PsoBest 或瑞士皮肤科靶向治疗网络（SDNTT）登记处的中重度银屑病患者的数据进行分析。治疗反应定义为治疗第 3、6 和 12 个月时达到银屑病面积和严重程度指数（PASI）75%以上改善（PASI 75）或 PASI≤3，辅以患者报告的结果[即皮肤病生活质量指数（DLQI）≤1 和 delta DLQI≥4]。

结果

总共纳入了 2007 年至 2016 年间登记的 5346 名患者（PsoBest，n=4896；SDNTT，n=450）。大多数患者接受非生物治疗（男性占 67.3%，女性占 69.8%）。女性在治疗 3 个月（54.8% vs. 47.2%；P≤0.001）、6 个月（70.8% vs. 63.8%；P≤0.001）和 12 个月（72.3% vs. 66.1%；P≤0.004）时的 PASI 反应率略高。有更高比例的女性实现了 DLQI 改善≥4[第 3 个月：61.4% vs 54.8%（P≤0.001）；第 6 个月：69.6% vs. 62.4%（P≤0.001）；第 12 个月：70.7% vs. 64.4%（P≤0.002）]。关于 PASI≤3，生物制剂治疗的女性与男性相比，在第 3 个月（57.8% vs. 48.5%；P≤0.004）和第 6 个月（69.2% vs. 60.9%；P≤0.018）时具有显著更好的治疗反应。在接受非生物治疗的女性中，在 12 个月时，她们的治疗反应（PASI 反应、PASI 75 和 PASI≤3）明显优于男性。