度普利尤单抗治疗特应性皮炎患者的性功能和睡眠质量改善：一项单中心前瞻性观察研究。

Improvement of Sexual Function and Sleep Quality in Patients with Atopic Dermatitis Treated with Dupilumab: A Single-Centre Prospective Observational Study.

机构信息

Department of Dermatology, Virgen de las Nieves University Hospital, 18012 Granada, Spain.

Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain.

出版信息

Int J Environ Res Public Health. 2023 Jan 20;20(3):1918. doi: 10.3390/ijerph20031918.

DOI:10.3390/ijerph20031918

PMID:36767285

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9914896/

Abstract

Atopic dermatitis (AD) is a chronic inflammatory skin disease presenting as xerosis, eczema and intense pruritus. These symptoms negatively impact patients' quality of life. However, the effect of AD on sexual function and sleep quality and how treatment with dupilumab could modify them have not been explored in depth. The aim of this study is to assess the effects of dupilumab on sexual and sleep quality in patients with AD. For that purpose, an observational prospective study was designed. Patients were evaluated at baseline and after 16 weeks of dupilumab treatment. Disease severity was assessed by Eczema Area and Severity (EASI) and SCORing Atopic Dermatitis index (SCORAD). Sexual function was evaluated using validated questionnaires, for men via the International Index of Erectile Dysfunction 5 (IIEF-5) and for women via the Female Sexual Function Index (FSFI). Sleep impairment was recorded through Pittsburgh Sleep Quality Index (PSQI). Thirty-two patients, with a mean age of 30.53 ± 14.48 years old, were included. Regarding sex, 59.8% (20) were female. Most patients had a severe disease reflected in a mean basal EASI of 23.24 ± 6.74 and a SCORAD of 54.07 ± 13.89. Clinical scores improved after dupilumab treatment. At baseline, 47.37% women presented sexual dysfunction and 66.67% men had erectile dysfunction. FSFI improved from 23.51 to 27.93 points ( = 0.008) after dupilumab. Desire, arousal, satisfaction and pain were the components with great improvement. Women with a great improvement in FSFI showed greater clinical results and increased quality of life. At first, 96.9% (31/32) of participants presented with poor sleep quality. After treatment with dupilumab, sleep quality was enhanced and PSQI scores decreased from 12.8 points at baseline to 7.73 points ( < 0.001). In conclusion, dupilumab is associated with reduced sexual dysfunction, mainly in women, and sleep quality.

摘要

特应性皮炎（AD）是一种慢性炎症性皮肤病，表现为干燥、湿疹和剧烈瘙痒。这些症状会严重影响患者的生活质量。然而，AD 对性功能和睡眠质量的影响，以及度普利尤单抗治疗如何改变这些影响，尚未得到深入探讨。本研究旨在评估度普利尤单抗对 AD 患者性功能和睡眠质量的影响。为此，设计了一项观察性前瞻性研究。患者在基线时和度普利尤单抗治疗 16 周后进行评估。疾病严重程度通过湿疹面积和严重程度指数（EASI）和特应性皮炎评分指数（SCORAD）进行评估。性功能通过经过验证的问卷进行评估，男性使用国际勃起功能指数 5 （IIEF-5），女性使用女性性功能指数（FSFI）。通过匹兹堡睡眠质量指数（PSQI）记录睡眠障碍。共纳入 32 名患者，平均年龄为 30.53±14.48 岁。按性别划分，59.8%（20 名）为女性。大多数患者病情严重，基底 EASI 平均为 23.24±6.74，SCORAD 为 54.07±13.89。度普利尤单抗治疗后临床评分有所改善。基线时，47.37%的女性存在性功能障碍，66.67%的男性存在勃起功能障碍。FSFI 从基线时的 23.51 分提高到 27.93 分（ = 0.008）。性欲、唤起、满意度和疼痛是改善较大的组成部分。FSFI 改善较大的女性表现出更好的临床结果和更高的生活质量。最初，32 名参与者中有 96.9%（31 名）睡眠质量较差。用度普利尤单抗治疗后，睡眠质量得到改善，PSQI 评分从基线时的 12.8 分降至 7.73 分（ < 0.001）。综上所述，度普利尤单抗可降低性功能障碍，主要是女性的性功能障碍，以及睡眠质量。