Unit of Dermatology, Villa Scassi Hospital, ASL3, Genoa, Italy.
Section of Dermatology, Department of Health Sciences (DiSSal), University of Genoa, Genoa, Italy.
Skin Res Technol. 2024 Aug;30(8):e13902. doi: 10.1111/srt.13902.
Trypanophobia or "needle phobia" represents a potential hindrance to the effective management of chronic diseases whenever an injectable therapy might be required, especially in case of frequent administrations. Psoriasis, a chronic dermatologic disease, can be effectively treated with biologic drugs administered subcutaneously. Thankfully, anti-IL-23 drugs require few administrations per year and are available in prefilled pens that hide the needle, thus representing a convenient option in patients with trypanophobia.
An observational multicentric study was conducted on patients with moderate-to-severe psoriasis who were treated with 75 mg × 2 risankizumab prefilled syringe therapy for more than 6 months and reported a loss of efficacy measured by the Psoriasis Area and Severity Index (PASI) from PASI 90 to PASI 75 attributed to a reduction of adherence due to trypanophobia. The patients were switched to 1 prefilled pen of risankizumab 150 mg and asked to fill out the Self-Injection Assessment Questionnaire (SIAQ) before and after the injection at week 0 and at the following administration after 12 weeks. Subjects scored each item of the SIAQ on a 5-point scale, scores were later transformed from 0 (worst experience) to 10 (best experience).
Twenty-two patients were enrolled. The mean SIAQ predose domain scores were 5.5 for feelings about injection, 6.2 for self-confidence, and 6.4 for satisfaction with self-injection. After dose scores were higher (> 8.5) for each of the six domains at Week 0 and even higher after 12 weeks (> 9.0).
User-friendly devices, such as prefilled pens, and a lower number of injections improved patient satisfaction in a group of patients with psoriasis on treatment with biologic drugs. We believe that treatment adherence could be positively influenced by such changes in the way of administration of a biologic treatment.
恐针症(又名“针恐惧症”)是一种潜在障碍,可能会影响慢性疾病的有效管理,尤其是在需要注射治疗且需要频繁注射的情况下。银屑病是一种慢性皮肤病,可以通过皮下注射生物药物进行有效治疗。值得庆幸的是,抗白细胞介素-23 药物每年只需注射几次,并且有预充式注射器可供使用,这种注射器隐藏了针头,对于有恐针症的患者来说是一种方便的选择。
对接受 75mg×2 利纳西单抗预装注射器治疗超过 6 个月且因恐针症导致依从性降低而导致疗效丧失(根据银屑病面积和严重程度指数[PASI]从 PASI90 降至 PASI75 评估)的中重度银屑病患者进行了一项观察性多中心研究。这些患者改用 1 支利纳西单抗 150mg 预装笔,并在第 0 周和第 12 周后的下一次给药前和给药后填写自我注射评估问卷(SIAQ)。受试者对 SIAQ 的每个条目进行 5 分制评分,评分随后从 0(最差体验)转换为 10(最佳体验)。
共纳入 22 例患者。SIAQ 预注射剂量域评分的平均分数分别为注射感受 5.5 分、自我信心 6.2 分和自我注射满意度 6.4 分。第 0 周时,每个剂量域的 SIAQ 评分均高于 8.5(>8.5),第 12 周后甚至更高(>9.0)。
在接受生物药物治疗的银屑病患者中,使用预充式笔等易于使用的装置和减少注射次数可提高患者满意度。我们认为,通过改变生物治疗的给药方式,可以积极影响治疗依从性。