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甲氨蝶呤和生物制剂对银屑病患者抑郁和焦虑症状的影响。

The Effects of Methotrexate and Biologics on the Symptoms of Depression and Anxiety in Patients with Psoriasis.

作者信息

Uğurer Ece, Altunay İlknur K, Özkur Ezgi, Baltan Ecem

机构信息

From the Department of Dermatology, Lüleburgaz State Hospital, Kırklareli, Turkey.

Department of Dermatology, Şişli Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey.

出版信息

Indian J Dermatol. 2023 May-Jun;68(3):237-244. doi: 10.4103/ijd.ijd_241_22.

Abstract

BACKGROUND

In patients with psoriasis, psychiatric co-morbidities accompany quite frequently.

AIMS AND OBJECTIVES

We aimed to compare the effects of methotrexate and biologics on psychiatric comorbidities, and also examine the relationship of these symptoms with systemic inflammation parameters.

MATERIALS AND METHODS

Sixty patients with psoriasis treated with biologics or methotrexate were enrolled. At the baseline and the 24 week of the treatment, the patients filled Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Dermatology Life Quality Index (DLQI), inflammation was assessed with serum C-reactive protein (CRP) and tumour necrosis factor-alpha (TNF-α) levels.

RESULTS

The decrease in BAI and BDI scores at the 24 week was significant in both the groups. When the decrease in BAI and BDI scores of the two groups were compared, no significant differences were found between the groups. The decrease in DLQI scores of the patients who received biologics was significantly superior compared to the patients who received methotrexate ( = 0.007). There was no significant correlation between the change in serum inflammation parameters and the decrease in the BDI/BAI scores.

CONCLUSIONS

In patients with psoriasis, biologics and methotrexate reduce the symptoms of depression and anxiety. The difference between the two groups was insignificant. Biologics improve the quality of life better than methotrexate. Systemic inflammation parameters do not reflect the changes in these symptoms in such patients.

摘要

背景

银屑病患者常伴有精神共病。

目的

我们旨在比较甲氨蝶呤和生物制剂对精神共病的影响,并研究这些症状与全身炎症参数之间的关系。

材料与方法

纳入60例接受生物制剂或甲氨蝶呤治疗的银屑病患者。在治疗基线和第24周时,患者填写贝克焦虑量表(BAI)、贝克抑郁量表(BDI)和皮肤病生活质量指数(DLQI),通过血清C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平评估炎症情况。

结果

两组在第24周时BAI和BDI评分均显著降低。比较两组BAI和BDI评分的降低情况,组间无显著差异。接受生物制剂治疗的患者DLQI评分的降低显著优于接受甲氨蝶呤治疗的患者(P = 0.007)。血清炎症参数的变化与BDI/BAI评分的降低之间无显著相关性。

结论

在银屑病患者中,生物制剂和甲氨蝶呤均可减轻抑郁和焦虑症状。两组之间的差异不显著。生物制剂比甲氨蝶呤能更好地改善生活质量。全身炎症参数不能反映此类患者这些症状的变化。

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