Darabian Saman, Badii Maziar, Dutz Jan P, Chan Jonathan
Faculty of Arts, University of British Columbia, Vancouver, BC, Canada.
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
J Psoriasis Psoriatic Arthritis. 2022 Jan;7(1):13-16. doi: 10.1177/24755303211063841. Epub 2021 Dec 20.
This study aims to evaluate clinical responses in patients with active psoriatic arthritis who, despite secukinumab 300 mg subcutaneous monthly, are switched to ixekizumab 80 mg subcutaneous every four weeks. We conducted a chart review of adult patients with psoriatic arthritis treated at one clinical center. We identified all patients with active inflammatory arthritis who were switched from secukinumab to ixekizumab. Baseline demographics such as disease duration, age, gender, number of previous DMARDs, and previous time on secukinumab were collected. We collected clinical outcome data such as tender and swollen joint count, enthesitis based on SPARCC score, dactylitis, psoriasis severity, CRP, and BASDAI if axial involvement was present. Eight of 10 patients were included in the analysis. Most patients were female, average age 62 years old, and had been on secukinumab for an average of 79 weeks. Twelve weeks following switch to ixekizumab, 6/8 had improvement in tender joint count, 6/8 improved in swollen joint count, 2/2 had resolution of enthesitis, 4/4 had resolution of dactylitis, 5/6 had improvement in psoriasis severity, 1 patient had absolute improvement of 2.3 in BASDAI, and 7/8 had improvement in the CRP level. Patients with active psoriatic arthritis despite treatment with secukinumab may still have a clinical response following treatment with another anti-IL17 agent. Larger studies will be required to confirm this finding, and studies which emphasize dactylitis and enthesitis outcomes will be needed as most patients did not have activity in these domains.
本研究旨在评估尽管每月皮下注射300mg司库奇尤单抗但仍转为每四周皮下注射80mg依奇珠单抗的活动性银屑病关节炎患者的临床反应。我们对在一个临床中心接受治疗的成年银屑病关节炎患者进行了病历回顾。我们确定了所有从司库奇尤单抗转为依奇珠单抗的活动性炎性关节炎患者。收集了疾病持续时间、年龄、性别、既往DMARDs数量以及既往使用司库奇尤单抗的时间等基线人口统计学数据。如果存在轴向受累，我们收集了临床结局数据，如压痛和肿胀关节计数、基于SPARCC评分的附着点炎（肌腱端炎）、指（趾）炎、银屑病严重程度、CRP以及BASDAI。10名患者中的8名纳入分析。大多数患者为女性，平均年龄62岁，平均使用司库奇尤单抗79周。转为依奇珠单抗12周后，8例中有6例压痛关节计数改善，8例中有6例肿胀关节计数改善，2例附着点炎消退，4例指（趾）炎消退，6例中有5例银屑病严重程度改善，1例患者BASDAI绝对改善2.3，8例中有7例CRP水平改善。尽管使用司库奇尤单抗治疗但仍患有活动性银屑病关节炎的患者在使用另一种抗IL - 17药物治疗后可能仍有临床反应。需要更大规模的研究来证实这一发现，并且由于大多数患者在这些领域没有活动，因此需要强调指（趾）炎和附着点炎结局的研究。
