Chandy Rithi J, Chokshi Aditi, Tan Isabella, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
J Cutan Med Surg. 2024 May-Jun;28(3):269-275. doi: 10.1177/12034754241238735. Epub 2024 Mar 28.
To describe the published efficacy and adverse event rates associated with existing biologics for the treatment of pityriasis rubra pilaris (PRP).
A literature review using the PubMed database (January 1990-July 2023) was conducted. Multiple search combinations were conducted using "pityriasis rubra pilaris" and various biologics as keywords to identify relevant articles.
Inclusion criteria included all study types that were published within the past 30 years in English and mentioned at least one biologic and PRP. A preliminary search yielded a total of 499 results. After screening using inclusion and exclusion criteria, 77 relevant articles (69 case reports, 5 case series, 2 clinical trials, and 1 retrospective analysis) were analyzed.
TNF-α inhibitors have been evaluated and are effective in treating PRP. However, recent treatment with anti-interleukin (IL)-17 and anti-IL-23 therapies such as ustekinumab, secukinumab, and ixekizumab are emerging as new treatment options with a mean improvement in PRP Area and Severity Index scores, change in severity of erythema, scaling, and thickness of PRP lesions. From initial clinical trials, secukinumab and ixekizumab are promising treatment options for achieving remission.
This review compares the efficacy for numerous biologics and a discussion to guide clinicians on benefits and risks in choosing a biologic for PRP patients.
Biologics may be a favourable treatment option leading to greater patient adherence due to reduced dosing frequencies, improvement in quality of life, and reduction in frequency and severity of flares.
描述已发表的与现有生物制剂治疗毛发红糠疹（PRP）相关的疗效和不良事件发生率。
使用PubMed数据库（1990年1月至2023年7月）进行文献综述。使用“毛发红糠疹”和各种生物制剂作为关键词进行了多种搜索组合，以识别相关文章。
纳入标准包括过去30年内以英文发表且提及至少一种生物制剂和PRP的所有研究类型。初步搜索共产生499条结果。在使用纳入和排除标准进行筛选后，对77篇相关文章（69篇病例报告、5篇病例系列、2篇临床试验和1篇回顾性分析）进行了分析。
肿瘤坏死因子-α抑制剂已得到评估，对治疗PRP有效。然而，最近使用抗白细胞介素（IL）-17和抗IL-23疗法（如乌司奴单抗、司库奇尤单抗和依奇珠单抗）作为新的治疗选择，PRP面积和严重程度指数评分有平均改善，PRP皮损的红斑、鳞屑和厚度严重程度也有变化。从初步临床试验来看，司库奇尤单抗和依奇珠单抗是有望实现缓解的治疗选择。
本综述比较了多种生物制剂的疗效，并进行了讨论，以指导临床医生在为PRP患者选择生物制剂时考虑其益处和风险。
生物制剂可能是一种有利的治疗选择，由于给药频率降低、生活质量改善以及发作频率和严重程度降低，患者依从性更高。
