Graier Thomas, Bordag Natalie, Hofer Angelika, Gruber-Wackernagel Alexandra, Legat Franz, Widnig Alice, Falkensteiner Katharina, Weger Wolfgang, Salmhofer Wolfgang, Wolf Peter
Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.
Skin Health Dis. 2025 May 16;5(3):214-222. doi: 10.1093/skinhd/vzaf021. eCollection 2025 Jun.
Little is known about treatment survival in patients with plaque psoriasis who have received phototherapy.
to analyse treatment survival in patients with plaque psoriasis who had received photother-apy, irrespective of the number of sessions and type of phototherapy, and to identify factors that influence the risk of treatment discontinuation.
Data from the Psoriasis Registry Austria and the phototherapy registry of the Centre of Phototherapy at the Department of Dermatology and Venereology, Medical University of Graz, were retrospectively analysed using Kaplan-Meier curves (logrank test) and a Cox (proportional hazards) regression analysis, irrespective of the number of phototherapy sessions or type of phototherapy.
The analysis revealed an overall treatment survival rate of 70% and 66% after 1 and 3 years, respectively, with a median treatment survival of 5.5 years. However, treatment survival rates have significantly decreased compared with the rates reported in the prebiologic era [hazard ratio (HR) 1.98, < 0.001]. While female sex did not influence overall treatment survival (HR 0.87, = 0.28), the risk of treatment discontinuation was significantly lower in women aged ≥ 60 years (HR 0.49, = 0.009). Moreover, patients with arthritis had an increased risk of treatment discontinuation (HR 1.69, = 0.003). The involvement of high-impact body areas (including scalp, nail, or inverse and/or genital body areas) did not alter treatment survival; however, palmar and/or plantar involvement increased the risk of treatment discontinuation (HR 1.48, = 0.006), especially in men (HR 2.19, < 0.001). No significant differences in the treatment survival of phototherapy in patients were observed regarding the duration of the psoriasis.
Male patients with psoriasis with palmar and/or plantar involvement have the highest risk of treatment discontinuation, whereas women aged ≥ 60 years at treatment start have the lowest risk. Therefore, early treatment escalation should be considered in men with palmar and/or plantar involvement and treatment-resistance disease forms. However, the current treatment survival rates reported for patients with psoriasis treated with phototherapy (median survival 30 months) are similar to the treatment survival rates reported for patients receiving tumour necrosis factor inhibitors.
对于接受光疗的斑块状银屑病患者的治疗持续时间了解甚少。
分析接受光疗的斑块状银屑病患者的治疗持续时间，无论光疗疗程数和光疗类型如何，并确定影响治疗中断风险的因素。
回顾性分析奥地利银屑病登记处以及格拉茨医科大学皮肤病与性病学系光疗中心的光疗登记处的数据，使用Kaplan-Meier曲线（对数秩检验）和Cox（比例风险）回归分析，无论光疗疗程数或光疗类型如何。
分析显示，1年和3年后的总体治疗持续率分别为70%和66%，中位治疗持续时间为5.5年。然而，与生物制剂时代之前报告的比率相比，治疗持续率显著下降[风险比（HR）1.98，P<0.001]。虽然女性性别不影响总体治疗持续时间（HR 0.87，P = 0.28），但≥60岁女性的治疗中断风险显著较低（HR 0.49，P = 0.009）。此外，有关节炎的患者治疗中断风险增加（HR 1.69，P = 0.003）。高影响身体部位（包括头皮、指甲或反向和/或生殖器身体部位）的受累情况并未改变治疗持续时间；然而，手掌和/或足底受累会增加治疗中断风险（HR 1.48，P = 0.006），尤其是男性（HR 2.19，P<0.001）。在银屑病病程方面，患者光疗的治疗持续时间未观察到显著差异。
手掌和/或足底受累的男性银屑病患者治疗中断风险最高，而治疗开始时年龄≥60岁的女性风险最低。因此，对于手掌和/或足底受累且患有难治性疾病形式的男性患者，应考虑早期强化治疗。然而，目前报告的接受光疗的银屑病患者的治疗持续率（中位生存期30个月）与接受肿瘤坏死因子抑制剂治疗的患者的治疗持续率相似。
