Department of Dermatology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
Dermatol Ther. 2022 Feb;35(2):e15228. doi: 10.1111/dth.15228. Epub 2021 Nov 30.
Scalp is a frequent localization of psoriasis that has a massive impact on patient's quality of life. Managing this psoriasis' manifestation is often challenging, thus biologic drugs are widely used as a treatment option in refractory scalp psoriasis. The aim of our study is to retrospectively compare the efficacy of anti-interleukin (IL) 23 drugs (guselkumab, tildrakizumab, risankizumab) and anti-IL17 or anti-IL17RA biologics (secukinumab, ixekizumab, and brodalumab) in real-life patients affected by scalp psoriasis. One hundred twenty-seven patients with a clinical diagnosis of scalp psoriasis and a baseline scalp Physician Global Assessment ≥3 were enrolled; 65 patients were treated with anti-IL23 and anti-IL62 with anti-IL17 or anti-IL17RA. Statistical analysis trough χ test was performed in order to evaluate the percentage of response among the two groups of patients. Responders' percentage of patients under anti-IL23 was 41.5%, 75.4%, 88.1%, 87.5%, 93.7%, and 100% at Week 4, 16, 48, 96, and 144, respectively. In the group on anti-IL17 was 62.9%, 90.3%, 91.2%, 97.3%, 96.9%, and 95.2% at Week 4, 16, 48, 96, and 144, respectively. Both anti-IL17 and anti-IL23 appeared to be effective on scalp psoriasis; in particular patients treated with anti-IL17 drugs reached a faster significant reduction of the lesions; on the other hand, anti-IL23 monoclonal antibodies were slightly superior in maintaining the clinical improvement through the follow-up.
头皮是银屑病的常见部位，对患者的生活质量有重大影响。管理这种银屑病的表现通常具有挑战性，因此生物药物广泛用作难治性头皮银屑病的治疗选择。我们的研究目的是回顾性比较抗白细胞介素 (IL) 23 药物（古塞单抗、替西单抗、瑞莎珠单抗）和抗 IL17 或抗 IL17RA 生物制剂（司库奇尤单抗、依奇珠单抗和布罗达单抗）在真实世界中受头皮银屑病影响的患者中的疗效。我们招募了 127 名临床诊断为头皮银屑病且基线头皮医师整体评估≥3 的患者；65 名患者接受了抗 IL23 和抗 IL62 与抗 IL17 或抗 IL17RA 的治疗。为了评估两组患者的反应率，进行了 χ2 检验的统计分析。在第 4、16、48、96 和 144 周时，接受抗 IL23 治疗的患者中，反应者的比例分别为 41.5%、75.4%、88.1%、87.5%、93.7%和 100%。在抗 IL17 组中，分别为 62.9%、90.3%、91.2%、97.3%、96.9%和 95.2%。抗 IL17 和抗 IL23 似乎对头皮银屑病均有效；特别是接受抗 IL17 药物治疗的患者，皮损的显著减轻更快；另一方面，抗 IL23 单克隆抗体在随访过程中稍微更能维持临床改善。
