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预测中重度特应性皮炎患者初始使用 Janus 激酶抑制剂的有利条件。

Predicting Favorable Conditions for the Determination of Initial Use of Janus Kinase Inhibitors in Patients with Moderate to Severe Atopic Dermatitis.

作者信息

Park Ju Heon, Oh Sejin, Park Jihye, Choi YoungHwan, Lee Jong Hee

机构信息

Department of Dermatology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea.

Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea.

出版信息

J Clin Med. 2025 Jun 17;14(12):4312. doi: 10.3390/jcm14124312.

Abstract

Numerous novel medications are being developed to treat moderate to severe atopic dermatitis (AD), notably biologics and Janus kinase inhibitors (JAKis). However, the exact guideline for the first determination of which medication has not been established yet. This study was conducted to identify patients who would show favorable clinical results from using JAKis. : Based on the degree of improvement in EASI at 16 weeks, 43 patients were divided into three groups: Group 1 (EASI-90), Group 2 (EASI-75), and Group 3 (EASI-50). : Compared to Group 1 and Group 2, Group 3 exhibited a significantly higher rate of multiple positive results in MAST (-value = 0.005, -value = 0.004), a greater proportion of individuals with higher IgE levels exceeding 1000 (-value = 0.003, -value = 0.027), and the presence of allergic comorbidities (-value = 0.049, -value = 0.026). However, baseline laboratory test results, such as eosinophil counts, LDH, and so on, showed no significant differences among the three groups. JAKis might provide prompt clinical improvement, especially in patients with relatively low serum Ig E levels who do not have multiple allergen positivities and allergic comorbidities.

摘要

目前正在研发多种新型药物来治疗中度至重度特应性皮炎(AD),尤其是生物制剂和 Janus 激酶抑制剂(JAK 抑制剂)。然而,尚未确定首次使用哪种药物的确切指南。本研究旨在确定使用 JAK 抑制剂能取得良好临床效果的患者。根据 16 周时湿疹面积和严重程度指数(EASI)的改善程度,43 例患者被分为三组:第 1 组(EASI - 90)、第 2 组(EASI - 75)和第 3 组(EASI - 50)。与第 1 组和第 2 组相比,第 3 组在多点刺试验中出现多项阳性结果的比例显著更高(P 值 = 0.005,P 值 = 0.004),IgE 水平超过 1000 的个体比例更大(P 值 = 0.003,P 值 = 0.027),且存在过敏性合并症(P 值 = 0.049,P 值 = 0.026)。然而,三组之间的基线实验室检查结果,如嗜酸性粒细胞计数、乳酸脱氢酶等,并无显著差异。JAK 抑制剂可能会带来迅速的临床改善,尤其是对于血清 IgE 水平相对较低、没有多种过敏原阳性和过敏性合并症的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fd8/12194643/3a24789599bd/jcm-14-04312-g001.jpg

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