Koyama Asumi, Li Lixin, Yamamoto Toyoki, Taira Haruka, Sugimoto Eiki, Ito Yukiko, Mizuno Yuka, Awaji Kentaro, Tateishi Shoko, Kanda Hiroko, Sato Shinichi, Shibata Sayaka
Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Dermatol. 2024 Dec;51(12):1572-1578. doi: 10.1111/1346-8138.17465. Epub 2024 Sep 13.
The advent of biologics has greatly improved patient outcomes, yet some patients are compelled to switch therapies. Predicting these therapeutic failures is important; however, the factors associated with switching biologics have not been fully explored. This study examined patterns and determinants of biologics switching in psoriasis treatment retrospectively over 13 years. We focused on the association between clinical characteristics, basal laboratory data, and frequency of biologics switching. The findings revealed that elevated Psoriasis Area Severity Index scores and the presence of arthritis were observed in patients who experienced two or more treatment switches compared with those without treatment switches. Moreover, neutrophil to lymphocyte ratio was associated with higher biologics switching rates, indicating that systemic inflammation significantly impacts treatment adherence. A treatment approach, taking into account both the clinical presentation and inflammatory biomarkers, may be important for optimizing patient management in psoriasis.
生物制剂的出现极大地改善了患者的治疗效果,但仍有一些患者不得不更换治疗方案。预测这些治疗失败情况很重要;然而,与生物制剂更换相关的因素尚未得到充分探索。本研究回顾性分析了13年来银屑病治疗中生物制剂更换的模式和决定因素。我们重点关注临床特征、基础实验室数据与生物制剂更换频率之间的关联。研究结果显示,与未更换治疗方案的患者相比,经历两次或更多次治疗更换的患者银屑病面积和严重程度指数评分升高,且有关节炎。此外,中性粒细胞与淋巴细胞比率与更高的生物制剂更换率相关,这表明全身炎症显著影响治疗依从性。一种兼顾临床表现和炎症生物标志物的治疗方法,可能对优化银屑病患者管理很重要。