Pan Ke-Ting, Li I-Hsun, Kao Hui-Han, Chen Yi-Hsien, Zhong Pei-Xun, Kao Li-Ting
Institute of Environmental Design and Engineering, Bartlett School, UCL, London, United Kingdom.
Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Centre, Taipei, Taiwan.
Front Pharmacol. 2021 Jul 5;12:596375. doi: 10.3389/fphar.2021.596375. eCollection 2021.
To date, it remains uncertain whether benzodiazepine receptor agonists (BZRAs) are aggravating factors even though these drugs can elevate the levels of biomarkers associated with the development of psoriasis. Therefore, this study aimed to investigate the association of BZRA use with changes in psoriasis severity. All data were sourced from the National Health Insurance system in Taiwan. We conducted a population-based retrospective cross-sectional study of 15,727 psoriasis patients who received BZRAs (BZRA users), and 18,856 psoriasis patients who did not receive BZRAs (nonusers). At least a 1-year washout period without any BZRA prescriptions was required. The main outcome was the change in psoriasis severity between before and after BZRA exposure. This study detected the exacerbation of psoriasis severity in mild psoriasis population by using a logistic model. Then, this study carried another logistic model among those patients who had severe psoriasis to calculate the odds ratios (ORs) for the improvement of the psoriasis severity. Among patients with mild psoriasis, BZRA users had a significantly higher probability of psoriasis severity exacerbation (IPTW-adjusted OR = 1.46). Mild psoriasis patients who received high and low doses of BZRAs had 1.70- and 1.39-fold higher probabilities of psoriasis severity exacerbation, respectively, than the non-users. Furthermore, in the severe psoriasis population, more low-dose BZRA users improved psoriasis severity than non-users. In conclusion, this study provided clinical evidence of the effects of BZRA use on patients with psoriasis severity. Among patients with mild psoriasis, high-dose BZRA users may be associated with the changes in psoriasis severity. However, low-dose BZRA exposure only slightly exacerbated disease severity among patients with mild psoriasis. Accordingly, clinicians should evaluate the risks and benefits of the BZRA usage.
迄今为止，尽管苯二氮䓬受体激动剂（BZRAs）可提高与银屑病发生相关的生物标志物水平，但它们是否为加重因素仍不确定。因此，本研究旨在调查使用BZRA与银屑病严重程度变化之间的关联。所有数据均来自台湾国民健康保险系统。我们对15727名接受BZRAs治疗的银屑病患者（BZRA使用者）和18856名未接受BZRAs治疗的银屑病患者（非使用者）进行了一项基于人群的回顾性横断面研究。要求至少有1年的洗脱期，在此期间无任何BZRA处方。主要结局是BZRA暴露前后银屑病严重程度的变化。本研究通过使用逻辑模型检测了轻度银屑病人群中银屑病严重程度的加重情况。然后，本研究在重度银屑病患者中进行了另一个逻辑模型，以计算银屑病严重程度改善的比值比（OR）。在轻度银屑病患者中，BZRA使用者银屑病严重程度加重的概率显著更高（IPTW调整后的OR = 1.46）。接受高剂量和低剂量BZRAs治疗的轻度银屑病患者银屑病严重程度加重的概率分别比非使用者高1.70倍和1.39倍。此外，在重度银屑病人群中，与非使用者相比，更多低剂量BZRA使用者的银屑病严重程度得到改善。总之，本研究提供了使用BZRA对银屑病严重程度患者影响的临床证据。在轻度银屑病患者中，高剂量BZRA使用者可能与银屑病严重程度的变化有关。然而，低剂量BZRA暴露仅使轻度银屑病患者的疾病严重程度略有加重。因此，临床医生应评估使用BZRA的风险和益处。
