Federico Diotallevi, Maria Esposito, Maria Concetta Fargnoli, Pietro Quaglino, Luca Mastorino, Luca Stingeni, Katharina Hansel, Claudio Feliciani, Matteo Megna, Lucia Gallo, Agostina Legori, Giuseppe Argenziano, Anna Balato, Federico Bardazzi, Martina Burlando, Emanuele Cozzani, Luca Bianchi, Marco Galluzzo, Paolo Gisondi, Francesco Bellinato, Tommaso Bianchelli, Giovanni Marco D'Agostino, Giulia Matacchione, Anna Campanati
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引用次数: 0
Abstract
Introduction: Palmoplantar psoriasis (PPp) has a profound negative impact on patients' quality of life, and it represents a therapeutic challenge, as palms and soles are difficult to treat area. Although the efficacy profile of tildrakizumab has been well evaluated in the literature, data on its use for PPp are still limited. The objective of the study was to evaluate the efficacy and safety of tildrakizumab on moderate-to-severe plaque psoriasis with involvement of the palmoplantar area.
Methods: A multicenter, retrospective, real-life study was performed enrolling patients with moderate-to-severe plaque psoriasis involving the palmoplantar area undergoing treatment with tildrakizumab with a follow-up of at least 52 weeks. At baseline, demographic and clinical data were assessed. Psoriasis severity was evaluated by using Psoriasis Activity Severity Index (PASI), body surface area (BSA), Psoriasis Global Assessment (PGA), Pruritus-Numerical Rating Scale (P-NRS) and Dermatology Life Quality Index (DLQI). Palmoplantar PASI (ppPASI) was used to evaluate psoriasis severity in the palmoplantar region. Clinical improvement was evaluated at each follow-up visit [week (W) 4, 16, 52].
Results: A total of 99 patients were enrolled. A reduction in PASI, BSA, PGA, P-NRS and DLQI was observed at each time point. Mean ppPASI at baseline was 16.9 ± 13.2, which started to improve at W4 (8.9 ± 9.1) and continued to decrease at W16 (2.1 ± 3.1) and W52 (0.5 ± 1.0). Moreover, a sub-analysis showed that the probability of achieving ppPASI50 at W4 increased in case of nail psoriasis (p < 0.05) and decreased in bio-experienced patients (p < 0.001). Similarly, the probability of achieving ppPASI75 at W4 decreased in the case of prior biologic exposure (p < 0.05). Finally, patients with nail psoriasis showed a higher probability of reaching ppPASI75 at W16 (p < 0.05), whereas patients previously treated with systemic therapies for psoriasis reported a reduced probability of ppPASI75 achievement at this time point (p < 0.05).
Conclusion: Tildrakizumab was shown to be a fast and effective treatment for patients with PPp, being able to achieve significant results already after only 4 weeks of treatment. Moreover, the identification of potential clinical factors predictive of response may improve the selection of the best treatment in patients with PPp.
掌跖牛皮癣（PPp）对患者的生活质量有着深远的负面影响，并且由于手掌和脚底是难以治疗的区域，它代表了一个治疗挑战。尽管tildrakizumab的疗效在文献中得到了很好的评价，但其用于PPp的数据仍然有限。该研究的目的是评估tildrakizumab治疗掌足底区中重度斑块型银屑病的疗效和安全性。方法：一项多中心、回顾性、现实研究纳入了接受tildrakizumab治疗的中重度斑块性银屑病患者，这些患者累及掌跖区，随访至少52周。基线时，评估人口统计学和临床数据。采用银屑病活动严重程度指数（PASI）、体表面积（BSA）、银屑病整体评估（PGA）、瘙痒数值评定量表（P-NRS）和皮肤病生活质量指数（DLQI）评价银屑病严重程度。Palmoplantar PASI （ppPASI）用于评估掌跖区银屑病的严重程度。在每次随访时评估临床改善[周(W) 4,16,52]。结果：共纳入99例患者。PASI、BSA、PGA、P-NRS和DLQI在各时间点均有所降低。基线时平均ppPASI为16.9±13.2，在W4（8.9±9.1）时开始改善，在W16（2.1±3.1）和W52（0.5±1.0）时继续下降。此外，一项亚分析显示，甲牛皮癣患者在W4时达到ppPASI50的概率增加(p)。结论：Tildrakizumab被证明是一种快速有效的治疗PPp患者的方法，仅在治疗4周后就能取得显著的效果。此外，识别预测疗效的潜在临床因素可能有助于PPp患者选择最佳治疗方案。
期刊介绍：
Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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