Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy.
Dermatol Ther. 2022 Oct;35(10):e15759. doi: 10.1111/dth.15759. Epub 2022 Aug 26.
Biological therapies revolutionized the treatment of many chronic inflammatory skin diseases, first of all psoriasis, thanks to their high efficacy and the reduced number of side effects. However, the use of a single biologic drug does not always provide complete control of the disease or associated comorbidities over time. The first biological drugs used for the treatment of psoriasis, tumor necrosis factor alpha inhibitors, have long been used in combination with traditional topical and systemic therapies to induce a complete remission of the disease that could not be achieved with innovative drug alone. Even with the advent of new biological therapies with more precise molecular targets, the challenge of using combination therapies remained. Psoriatic patients often have major comorbidities, such as arthritis, inflammatory bowel disease, uveitis or have other concomitant conditions such as chronic spontaneous urticaria and atopic dermatitis, which may require different biologic treatments than those indicated in psoriasis. The objective of this article is, through a comprehensive revision of the literature, to analyze in which cases the use of the combination of the latest therapies for psoriasis may be useful.
生物疗法极大地改变了许多慢性炎症性皮肤病的治疗方法,尤其是银屑病,这要归功于它们的高效性和较少的副作用。然而,单一的生物药物的使用并不总是能在疾病的控制或随时间推移相关的合并症方面提供完全的控制。首先用于治疗银屑病的生物药物,肿瘤坏死因子-α抑制剂,长期以来一直与传统的局部和全身治疗联合使用,以诱导疾病的完全缓解,而创新药物单独使用无法实现这一点。即使出现了具有更精确分子靶点的新型生物疗法,联合治疗的挑战仍然存在。银屑病患者经常有主要的合并症,如关节炎、炎症性肠病、葡萄膜炎,或有其他伴随病症,如慢性自发性荨麻疹和特应性皮炎,这可能需要不同于银屑病治疗的不同生物治疗。本文的目的是,通过对文献的全面回顾,分析在哪些情况下使用最新的银屑病联合治疗可能是有用的。