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接受生物制剂治疗的银屑病患者发生真菌感染的风险:一项回顾性单中心队列研究。

Risk of fungal infection in patients with psoriasis receiving biologics: A retrospective single-center cohort study.

作者信息

Minami Yoshihito, Hiruma Junichiro, Harada Kazuharu, Fujimori Kazuki, Suzuki Risa, Mori Miho, Okura Masahiro, Abe Namiko, Harada Kazutoshi, Okubo Yukari

机构信息

Department of Dermatology, Tokyo Medical University, Tokyo, Japan.

Department of Health Data Science, Tokyo Medical University, Tokyo, Japan.

出版信息

J Am Acad Dermatol. 2025 Jan;92(1):108-115. doi: 10.1016/j.jaad.2024.09.037. Epub 2024 Sep 30.

Abstract

BACKGROUND

The risk of fungal infection in patients with psoriasis receiving biologics is not fully understood in clinical practice.

OBJECTIVE

To assess the incidence and the risk of fungal infection onset in patients with psoriasis receiving biologics.

METHODS

A retrospective cohort study of 592 psoriasis cases treated with biologics at a single center.

RESULTS

Seventy-three (12.3%) of the 592 cases involved a fungal infection. Fungal infection occurrence was more frequently associated with the use of interleukin (IL) 17 inhibitors than of other biologics. The risk factors of fungal infection were the type of biologic agent (P = .004), age at the start of biologic therapy (odds ratio, 1.04; 95% CI, 1.02-1.06), and diabetes mellitus (odds ratio, 2.40; 95% CI, 1.20-4.79).

LIMITATIONS

The present, retrospective study did not include patients who did not receive biologic therapy. Moreover, the type of biologic agent used was changed in many cases.

CONCLUSIONS

Patients with psoriasis treated with IL-17 inhibitors were more likely to cause fungal infections, especially candidiasis, than other biologics. Moreover, the age at the start of biologic therapy and diabetes mellitus onset were also independent risk factors of fungal infection.

摘要

背景

在临床实践中,接受生物制剂治疗的银屑病患者发生真菌感染的风险尚未完全明确。

目的

评估接受生物制剂治疗的银屑病患者真菌感染的发生率及发病风险。

方法

对单中心592例接受生物制剂治疗的银屑病病例进行回顾性队列研究。

结果

592例病例中有73例(12.3%)发生真菌感染。与使用其他生物制剂相比,真菌感染的发生更常与使用白细胞介素(IL)-17抑制剂有关。真菌感染的危险因素包括生物制剂类型(P = 0.004)、生物治疗开始时的年龄(比值比,1.04;95%可信区间,1.02 - 1.06)和糖尿病(比值比,2.40;95%可信区间,1.20 - 4.79)。

局限性

本回顾性研究未纳入未接受生物治疗的患者。此外,在许多病例中生物制剂的使用类型发生了变化。

结论

与其他生物制剂相比,接受IL - 17抑制剂治疗的银屑病患者更易发生真菌感染,尤其是念珠菌感染。此外,生物治疗开始时的年龄和糖尿病发病也是真菌感染的独立危险因素。

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