银屑病患者开始使用不同类别的生物制剂治疗时发生银屑病关节炎的风险。
Risk of developing psoriatic arthritis in patients with psoriasis initiating treatment with different classes of biologics.
作者信息
Gisondi Paolo, Bellinato Francesco, Galeone Carlotta, Turati Federica, Idolazzi Luca, Zabotti Alen, McGonagle Dennis, Girolomoni Giampiero
机构信息
Section of Dermatology and Venereology, University of Verona, Verona, Italy.
Section of Dermatology and Venereology, University of Verona, Verona, Italy.
出版信息
Ann Rheum Dis. 2025 Mar;84(3):435-441. doi: 10.1016/j.ard.2025.01.006. Epub 2025 Feb 6.
OBJECTIVES
To investigate the risk of psoriatic arthritis (PsA) in plaque psoriasis (PsO) patients receiving different classes of biologics.
METHODS
A retrospective observational study involving consecutive bionaïve PsO patients starting biologic treatment was performed. We compared the occurrence of PsA by the class of the biologic (tumour necrosis factor [TNF], interleukin [IL]-17, or IL-23 inhibitors) using inverse probability of treatment weighting (IPTW) in the setting of multiple treatments to balance pretreatment covariates across cohorts and thus adjust for potential confounders. An IPTW Cox regression model was used to estimate hazard ratios (HRs) of PsA for IL-17 and IL-23 inhibitors versus TNF inhibitors.
RESULTS
In total, 622 patients, 430 (62.4%) males, mean ± SD age 46.9 ± 12.9 years, were included. They have been treated with TNF (n = 317, 50.9%), IL-17 (n = 164, 26.4%) or IL-23 inhibitors (n = 141, 22.7%) and followed for 2510 person-years (a mean of 4.1 ± 2.1 years per person). TNF, IL-17, and IL-23 inhibitor cohorts had a total of 1569, 486, and 455 person-years of follow-up. A total of 60 (10%) out of 622 patients on biologic therapy developed incident PsA during the observation period: 45 (14.2%) in the TNF, 9 (5.5%) in the IL-17, and 6 (4.3%) in the IL-23 inhibitor cohorts. After IPTW, the 3 treatment cohorts were well-balanced, and the HRs of PsA were 0.63 (95% CI, 0.38-1.05) for IL-17 and 0.57 (95% CI, 0.34-0.96) for IL-23 compared with the TNF treatment group.
CONCLUSIONS
The risk of developing PsA appeared slightly different in patients receiving diverse classes of biologics.
目的
研究接受不同种类生物制剂治疗的斑块状银屑病（PsO）患者发生银屑病关节炎（PsA）的风险。
方法
开展一项回顾性观察研究，纳入连续的初治PsO患者并开始生物治疗。我们在多种治疗的背景下，使用治疗权重逆概率（IPTW）比较不同生物制剂类别（肿瘤坏死因子 [TNF]、白细胞介素 [IL]-17或IL-23抑制剂）的PsA发生率，以平衡各队列的预处理协变量，从而调整潜在混杂因素。使用IPTW Cox回归模型估计IL-17和IL-23抑制剂与TNF抑制剂相比的PsA风险比（HRs）。
结果
共纳入622例患者，其中男性430例（62.4%），平均年龄±标准差为46.9±12.9岁。他们接受了TNF（n = 317，50.9%）、IL-17（n = 164，26.4%）或IL-23抑制剂（n = 141，22.7%）治疗，并随访了2510人年（平均每人4.1±2.1年）。TNF、IL-17和IL-23抑制剂队列的随访总人年数分别为1569、486和455人年。在观察期内，622例接受生物治疗的患者中共有60例（10%）发生新发PsA：TNF队列中45例（14.2%），IL-17队列中9例（5.5%），IL-23抑制剂队列中6例（4.3%）。IPTW后，3个治疗队列平衡良好，与TNF治疗组相比，IL-17的PsA HRs为0.63（95% CI，0.38 - 1.05），IL-23为0.57（95% CI，0.34 - 0.96）。
结论
接受不同种类生物制剂治疗的患者发生PsA的风险似乎略有不同。
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