Megna Matteo, Battista Teresa, Noto Matteo, Picone Vincenzo, Fabbrocini Gabriella, Ruggiero Angelo, Genco Lucia
Department of Clinical Medicine and Surgery - Section of Dermatology, University of Naples Federico II, Naples, Italy.
Clin Cosmet Investig Dermatol. 2023 Mar 2;16:553-564. doi: 10.2147/CCID.S400679. eCollection 2023.
Biologic selection for psoriasis treatment should take into account numerous factors including injection site reactions (ISRs) such as swelling at the injection site, pain, burning, erythema, all possibly reducing patient adherence.
A 6-months observational real life study was performed involving psoriasis patients. Inclusion criteria were age ≥ 18 years, moderate-to-severe psoriasis diagnosis since at least 1 year, patients being on biologic treatment for psoriasis ≥ 6 months. A 14-item questionnaire was administered to all patients enrolled to assess whether the patient ever experienced ISRs after the injection of the biologic drug.
234 patients were included: 32.5% received an anti-TNF-alpha drug, 9.4% received anti-IL12/23, 32.5% received an anti-IL17, 25.6% received an anti-IL23. 51.2% of study population reported at least one symptom related to ISR. 35.9% of patients experienced pain, 31.6% swelling, 28.2% burning sensation and 17.9% erythema. 3.4% of the surveyed population experienced anxiety or fear of the biologic injection due to ISRs symptoms. The greater incidence of pain was registered in anti-TNF-alpha and anti-IL17 groups (47.4% and 42.1%, p<0.01). Ixekizumab proved to be the drug with the highest rate of patients experiencing pain (72.2%), burning (77.7%) and swelling (83.3%). No patients reported biologics discontinuation or delay for ISRs symptoms.
Our study highlighted that each different class of biologics for psoriasis was linked to ISRs. These events are more frequently reported with anti-TNF-alpha and anti-IL17.
银屑病治疗的生物制剂选择应考虑诸多因素，包括注射部位反应（ISR），如注射部位肿胀、疼痛、烧灼感、红斑，所有这些都可能降低患者的依从性。
对银屑病患者进行了一项为期6个月的观察性现实生活研究。纳入标准为年龄≥18岁、中度至重度银屑病诊断至少1年、接受生物制剂治疗银屑病≥6个月。对所有纳入的患者进行了一项14项问卷调查，以评估患者在注射生物制剂药物后是否曾经历过ISR。
纳入234例患者：32.5%接受抗TNF-α药物治疗，9.4%接受抗IL12/23治疗，32.5%接受抗IL17治疗，25.6%接受抗IL23治疗。51.2%的研究人群报告至少有一种与ISR相关的症状。35.9%的患者经历疼痛，31.6%肿胀，28.2%有烧灼感，17.9%有红斑。3.4%的被调查人群因ISR症状而对生物制剂注射感到焦虑或恐惧。抗TNF-α和抗IL17组疼痛发生率更高（47.4%和42.1%，p<0.01）。司库奇尤单抗被证明是患者经历疼痛（72.2%）、烧灼感（77.7%）和肿胀（83.3%）发生率最高的药物。没有患者因ISR症状报告停用或延迟使用生物制剂。
我们的研究强调，银屑病的每一类不同生物制剂都与ISR有关。这些事件在抗TNF-α和抗IL17药物中报告得更为频繁。
