Bizzarri Francesco, Ruiz-Villaverde Ricardo, Morales-Garrido Pilar, Ruiz-Carrascosa Jose Carlos, Cebolla-Verdugo Marta, Prados-Carmona Alvaro, Rodriguez-Troncoso Mar, Raya-Alvarez Enrique
Servicio de Reumatologia, Instituto Biosanitario de Granada, Ibs, Hospital Universitario San Cecilio, 18012 Granada, Spain.
Servicio de Dermatología, Instituto Biosanitario de Granada, Ibs, Hospital Universitario San Cecilio, 18012 Granada, Spain.
Diagnostics (Basel). 2024 May 8;14(10):988. doi: 10.3390/diagnostics14100988.
Psoriatic disease (PsD) affects multiple clinical domains and causes a significant inflammatory burden in patients, requiring comprehensive evaluation and treatment. In recent years, new molecules such as JAK inhibitors (JAKinhibs) have been developed. These have very clear advantages: they act quickly, have a beneficial effect on pain, are well tolerated and the administration route is oral. Despite all this, there is still little scientific evidence in daily clinical practice. This observational, retrospective, single-center study was carried out in patients diagnosed with PsA in the last two years, who started treatment with Tofacitinib or Upadacitinib due to failure of a DMARD. The data of 32 patients were analyzed, and the majority of them (75%) started treatment with Tofacitinib. Most had moderate arthritis activity and mild psoriasis involvement according to activity indices. Both Tofacitinib and Upadacitinib demonstrated significant efficacy, with rapid and statistically significant improvement in joint and skin activity indices, C-reactive protein reduction, and objective measures of disease activity such as the number of painful and inflamed joints. Although there was some difference in the baseline characteristics of the cohort, treatment responses were comparable or even superior to those in the pivotal clinical trials. In addition, there was a low frequency of mild adverse events leading to treatment discontinuation and no serious adverse events. These findings emphasize the strong efficacy and tolerability of JAKinhibs in daily clinical practice, supporting their role as effective therapeutic options for patients with PsD.
银屑病(PsD)影响多个临床领域,给患者带来显著的炎症负担,需要进行全面评估和治疗。近年来,开发了诸如JAK抑制剂(JAKinhibs)等新分子。这些分子具有非常明显的优势:起效迅速,对疼痛有有益作用,耐受性良好且给药途径为口服。尽管如此,在日常临床实践中仍缺乏科学证据。这项观察性、回顾性、单中心研究针对过去两年内被诊断为银屑病关节炎(PsA)且因传统改善病情抗风湿药(DMARD)治疗失败而开始使用托法替布或乌帕替尼治疗的患者开展。分析了32例患者的数据,其中大多数(75%)开始使用托法替布治疗。根据活动指数,大多数患者关节炎活动度为中度,银屑病累及程度为轻度。托法替布和乌帕替尼均显示出显著疗效,关节和皮肤活动指数迅速且有统计学意义地改善,C反应蛋白降低,以及疾病活动的客观指标如疼痛和发炎关节数量减少。尽管该队列的基线特征存在一些差异,但治疗反应相当,甚至优于关键临床试验中的反应。此外,导致治疗中断的轻度不良事件发生率较低,且无严重不良事件。这些发现强调了JAKinhibs在日常临床实践中的强效疗效和耐受性,支持它们作为PsD患者有效治疗选择的作用。