Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin, Herlev and Gentofte Hospital, Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2022 Aug;36(8):1284-1291. doi: 10.1111/jdv.18126. Epub 2022 Apr 12.
Treatment with biologics often leads to clearance of psoriasis. However, some patients do repeatedly fail to respond and/or lose an achieved response (treatment refractory) to the biologic, whereas other patients achieve excellent response to one biologic and remain clear of psoriasis for several years (super-responders).
To identify and characterize patients with treatment refractory psoriasis and patients who are super-responders to biologic treatment.
Patients registered in DERMBIO between January 2007 and November 2019 were included. Patients were categorized as being treatment refractory if they had had treatment failure to ≥3 biologics targeting ≥2 different pathways. Super-responders were patients treated with their first biologic for minimum 5 years without an absolute psoriasis area and severity index (PASI) > 3 between 6 months and 5 years of treatment. All remaining patients from DERMBIO served as comparators.
In total, 3280 patients were included with a mean age of 45.0 years. 1221 (37%) of the patients were females. Of the included patients, 214 (6.5%) were categorized as treatment refractory and 207 (6.3%) were categorized as super-responders. Treatment refractory patients had higher mean body weight (100.6 kg vs. 90.6 kg, P < 0.0001) and higher mean BMI (32.2 vs. 29.4, P < 0.0001) compared with the rest of patients in DERMBIO. Super-responders had higher socioeconomic status and fewer comorbidities compared with the comparator group (P < 0.0001).
A small proportion of patients with psoriasis treated with biologics are either super-responders or treatment refractory. Treatment refractory patients have higher body weight, whereas super-responders have fewer comorbidities and higher socioeconomic status.
生物制剂治疗常可清除银屑病。然而，有些患者反复不能应答和/或失去生物制剂的应答（治疗抵抗），而另一些患者对一种生物制剂有极好的应答，且数年无银屑病（超级应答者）。
识别和描述生物制剂治疗抵抗的银屑病患者和对生物制剂治疗有超级应答的患者。
纳入 2007 年 1 月至 2019 年 11 月期间在 DERMBIO 登记的患者。如果患者有≥3 种针对≥2 种不同途径的生物制剂治疗失败，则归类为治疗抵抗。超级应答者为用其第一种生物制剂治疗至少 5 年，在治疗 6 个月至 5 年内无绝对银屑病面积和严重程度指数（PASI）>3 的患者。DERMBIO 中的所有其余患者作为对照。
共纳入 3280 例患者，平均年龄为 45.0 岁。1221 例（37%）为女性。在纳入的患者中，214 例（6.5%）归类为治疗抵抗，207 例（6.3%）归类为超级应答者。治疗抵抗患者的平均体重（100.6kg 比 90.6kg，P<0.0001）和平均 BMI（32.2 比 29.4，P<0.0001）均高于 DERMBIO 中的其余患者。超级应答者的社会经济地位较高，合并症较少，与对照组相比（P<0.0001）。
用生物制剂治疗的银屑病患者中，一小部分是超级应答者或治疗抵抗者。治疗抵抗患者的体重较高，而超级应答者的合并症较少，社会经济地位较高。
