Leyla S. Namazova-Baranova, Eduard T. Ambarchyan, Vladislav V. Ivanchikov, Anastasia D. Kuzminova, Anna G. Shandra, Elena A. Vishneva, Grigorii V. Revunenkov, Kirill A. Valyalov
{"title":"彼得罗夫斯基国家外科研究中心儿科和儿童健康研究所","authors":"Leyla S. Namazova-Baranova, Eduard T. Ambarchyan, Vladislav V. Ivanchikov, Anastasia D. Kuzminova, Anna G. Shandra, Elena A. Vishneva, Grigorii V. Revunenkov, Kirill A. Valyalov","doi":"10.15690/vsp.v22i5.2641","DOIUrl":null,"url":null,"abstract":"Background. Psoriasis is an independent risk factor for cardiovascular diseases (CVD). One of the markers associated with the CVD course is epicardial fatty tissue (EFT) that is thicker in psoriasis patients. EFT assessment can be used as a useful indicator of CVD in psoriasis patients. The data about the effect of genetically engineered biological therapy (GEBT), used for psoriasis management, on the EFT thickness is limited. Examination of GEBT effects on EFT may improve our understanding of CVD prevention in psoriasis patients. Objective. The aim of the study is to study the changes in EFT thickness on GEBT. Methods. A prospective cohort study included 56 children with severe and moderate psoriasis. Patients underwent transthoracic two-dimensional echocardiography (M-mode) with EFT thickness assessment and PASI (Psoriasis Area and Severity Index) scoring before the GEBT initiation. All the parameters were re-evaluated after 16 weeks. All patients were divided into three groups according to the initiated therapy: adalimumab, secukinumab and ustekinumab. When dividing the therapy received into groups, the age of the patients was taken into account: inclusion in the adalimumab group was carried out from 4 years, in the secukinumab and ustekinumab groups — from 6 years. Otherwise, the process of group assignment was random. The study results were processed using descriptive statistics methods: the changes in EFT thickness in individual groups were compared via the Wilcoxon test, and results were considered statistically significant at p 0.05. Results. Before the start of therapy, in 56 patients the mean of EFT thickness was 2.11 mm, the mean PASI — 18.32. The adalimumab group had the following indicators: the mean EFT thickness before the therapy was 2.1 mm, and it has decreased to 1.77 mm after 16 weeks of therapy. The mean change in EFT thickness was 0.33 mm, and the median — 0.17 mm [CI 0.33 ± 0.25]. The ustekinumab group: the mean EFT thickness before the therapy was 2.13 mm, 16 weeks after — 1.69 mm. The mean change in EFT thickness was 0.44 mm, and the median — 0.38 [CI 0.44 ± 0.13]. The secukinumab group: the mean EFT thickness before the therapy was 2.08 mm, 16 weeks after — 1.82 mm. The mean change in EFT thickness was 0.27 mm, and the median — 0.27 [CI 0.27 ± 0.07]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the EFT after therapy in all groups (p 0.05). 73% of patients achieved PASI 50, and 6% — PASI 75 in the adalimumab group. 21% of patients did not achieve PASI 50. The mean PASI score before therapy was 16.73 points, and after 16 ± 4 weeks — 6.4 points, the mean dynamics was 10.33 points, the median dynamics was 7 points [CI 10.33 ± 4]. All patients achieved PASI 50, 75.3% — PASI 75, 8% — PASI 90, and 16.7% — PASI 100 in the ustekinumab group. The mean PASI score before therapy was 22.17 points, and after 16 weeks — 3.67 points, the mean dynamics was 19.28 points, the median dynamics was 17 points [CI 18.5 ± 3.03]. All patients achieved PASI 50, 47% — PASI 75, and 11% — PASI 90 in the secukinumab group. The median PASI before therapy was 14.29 points, and after 16 ± 4 weeks — 3.71 points, the mean PASI score before therapy was 14.29 points, and after 16 weeks — 3.7 points, the mean dynamics was 10.59 points, the median dynamics was 10 points [CI 10.59 ± 2.27]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the PASI after therapy in all groups (p 0.05). There were no adverse events leading to cessation of therapy during the follow-up period. Conclusion. All groups have shown decrease in the in EFT thickness and in the PASI score. The most significant dynamics was observed in the ustekinumab group. Research limitations were the small patients sample and the absence of a control group (participants without psoriasis).","PeriodicalId":37561,"journal":{"name":"Voprosy Sovremennoi Pediatrii - Current Pediatrics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery\",\"authors\":\"Leyla S. Namazova-Baranova, Eduard T. Ambarchyan, Vladislav V. Ivanchikov, Anastasia D. Kuzminova, Anna G. Shandra, Elena A. Vishneva, Grigorii V. Revunenkov, Kirill A. Valyalov\",\"doi\":\"10.15690/vsp.v22i5.2641\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Psoriasis is an independent risk factor for cardiovascular diseases (CVD). One of the markers associated with the CVD course is epicardial fatty tissue (EFT) that is thicker in psoriasis patients. EFT assessment can be used as a useful indicator of CVD in psoriasis patients. The data about the effect of genetically engineered biological therapy (GEBT), used for psoriasis management, on the EFT thickness is limited. Examination of GEBT effects on EFT may improve our understanding of CVD prevention in psoriasis patients. Objective. The aim of the study is to study the changes in EFT thickness on GEBT. Methods. A prospective cohort study included 56 children with severe and moderate psoriasis. Patients underwent transthoracic two-dimensional echocardiography (M-mode) with EFT thickness assessment and PASI (Psoriasis Area and Severity Index) scoring before the GEBT initiation. All the parameters were re-evaluated after 16 weeks. All patients were divided into three groups according to the initiated therapy: adalimumab, secukinumab and ustekinumab. When dividing the therapy received into groups, the age of the patients was taken into account: inclusion in the adalimumab group was carried out from 4 years, in the secukinumab and ustekinumab groups — from 6 years. Otherwise, the process of group assignment was random. The study results were processed using descriptive statistics methods: the changes in EFT thickness in individual groups were compared via the Wilcoxon test, and results were considered statistically significant at p 0.05. Results. Before the start of therapy, in 56 patients the mean of EFT thickness was 2.11 mm, the mean PASI — 18.32. The adalimumab group had the following indicators: the mean EFT thickness before the therapy was 2.1 mm, and it has decreased to 1.77 mm after 16 weeks of therapy. The mean change in EFT thickness was 0.33 mm, and the median — 0.17 mm [CI 0.33 ± 0.25]. The ustekinumab group: the mean EFT thickness before the therapy was 2.13 mm, 16 weeks after — 1.69 mm. The mean change in EFT thickness was 0.44 mm, and the median — 0.38 [CI 0.44 ± 0.13]. The secukinumab group: the mean EFT thickness before the therapy was 2.08 mm, 16 weeks after — 1.82 mm. The mean change in EFT thickness was 0.27 mm, and the median — 0.27 [CI 0.27 ± 0.07]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the EFT after therapy in all groups (p 0.05). 73% of patients achieved PASI 50, and 6% — PASI 75 in the adalimumab group. 21% of patients did not achieve PASI 50. The mean PASI score before therapy was 16.73 points, and after 16 ± 4 weeks — 6.4 points, the mean dynamics was 10.33 points, the median dynamics was 7 points [CI 10.33 ± 4]. All patients achieved PASI 50, 75.3% — PASI 75, 8% — PASI 90, and 16.7% — PASI 100 in the ustekinumab group. The mean PASI score before therapy was 22.17 points, and after 16 weeks — 3.67 points, the mean dynamics was 19.28 points, the median dynamics was 17 points [CI 18.5 ± 3.03]. All patients achieved PASI 50, 47% — PASI 75, and 11% — PASI 90 in the secukinumab group. The median PASI before therapy was 14.29 points, and after 16 ± 4 weeks — 3.71 points, the mean PASI score before therapy was 14.29 points, and after 16 weeks — 3.7 points, the mean dynamics was 10.59 points, the median dynamics was 10 points [CI 10.59 ± 2.27]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the PASI after therapy in all groups (p 0.05). There were no adverse events leading to cessation of therapy during the follow-up period. Conclusion. All groups have shown decrease in the in EFT thickness and in the PASI score. The most significant dynamics was observed in the ustekinumab group. Research limitations were the small patients sample and the absence of a control group (participants without psoriasis).\",\"PeriodicalId\":37561,\"journal\":{\"name\":\"Voprosy Sovremennoi Pediatrii - Current Pediatrics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Voprosy Sovremennoi Pediatrii - Current Pediatrics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15690/vsp.v22i5.2641\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Voprosy Sovremennoi Pediatrii - Current Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15690/vsp.v22i5.2641","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
背景。牛皮癣是心血管疾病(CVD)的独立危险因素。与CVD病程相关的标志物之一是牛皮癣患者较厚的心外膜脂肪组织(EFT)。EFT评价可作为银屑病患者CVD的有效指标。用于牛皮癣治疗的基因工程生物疗法(GEBT)对EFT厚度的影响数据有限。检查GEBT对EFT的影响可能会提高我们对银屑病患者CVD预防的认识。目标。本研究的目的是研究GEBT上EFT厚度的变化。方法。一项前瞻性队列研究包括56名患有重度和中度牛皮癣的儿童。患者在GEBT开始前接受经胸二维超声心动图(m模式),EFT厚度评估和PASI(银屑病面积和严重程度指数)评分。16周后重新评估所有参数。所有患者根据起始治疗分为三组:阿达木单抗、secukinumab和ustekinumab。在将接受的治疗分组时,考虑了患者的年龄:阿达木单抗组从4岁开始纳入,secukinumab组和ustekinumab组从6岁开始纳入。否则,分组分配过程是随机的。研究结果采用描述性统计方法处理,各组EFT厚度变化比较采用Wilcoxon检验,p < 0.05认为结果有统计学意义。结果。治疗前56例患者EFT平均厚度2.11 mm,平均PASI - 18.32。阿达木单抗组EFT平均厚度治疗前为2.1 mm,治疗16周后降至1.77 mm。EFT厚度的平均变化为0.33 mm,中位变化为- 0.17 mm [CI 0.33±0.25]。ustekinumab组:治疗前平均EFT厚度为2.13 mm,治疗后16周- 1.69 mm。EFT厚度的平均变化为0.44 mm,中位变化为- 0.38 [CI 0.44±0.13]。secukinumab组:治疗前平均EFT厚度为2.08 mm,治疗后16周- 1.82 mm。EFT厚度的平均变化为0.27 mm,中位数变化为- 0.27 [CI 0.27±0.07]。经Wilcoxon检验评价指标显示,治疗后各组EFT下降有统计学意义(p < 0.05)。在阿达木单抗组中,73%的患者达到PASI 50, 6%达到PASI 75。21%的患者未达到PASI 50。治疗前PASI平均为16.73分,治疗后16±4周- 6.4分,平均动力学为10.33分,中位动力学为7分[CI 10.33±4]。在ustekinumab组中,所有患者均达到PASI 50、75.3% - PASI 75、8% - PASI 90和16.7% - PASI 100。治疗前PASI平均评分为22.17分,治疗16周后为3.67分,平均动力学为19.28分,中位动力学为17分[CI 18.5±3.03]。在secukinumab组中,所有患者均达到PASI 50, 47% - PASI 75和11% - PASI 90。治疗前PASI中位数为14.29分,治疗后16±4周- 3.71分,治疗前PASI平均为14.29分,治疗后16周- 3.7分,平均动力学为10.59分,动力学中位数为10分[CI 10.59±2.27]。经Wilcoxon检验评价指标显示,各组治疗后PASI下降有统计学意义(p < 0.05)。随访期间无不良事件导致停止治疗。结论。各组EFT厚度和PASI评分均有所下降。在ustekinumab组观察到最显著的动态。研究的局限性是患者样本小,缺乏对照组(无牛皮癣的参与者)。
Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery
Background. Psoriasis is an independent risk factor for cardiovascular diseases (CVD). One of the markers associated with the CVD course is epicardial fatty tissue (EFT) that is thicker in psoriasis patients. EFT assessment can be used as a useful indicator of CVD in psoriasis patients. The data about the effect of genetically engineered biological therapy (GEBT), used for psoriasis management, on the EFT thickness is limited. Examination of GEBT effects on EFT may improve our understanding of CVD prevention in psoriasis patients. Objective. The aim of the study is to study the changes in EFT thickness on GEBT. Methods. A prospective cohort study included 56 children with severe and moderate psoriasis. Patients underwent transthoracic two-dimensional echocardiography (M-mode) with EFT thickness assessment and PASI (Psoriasis Area and Severity Index) scoring before the GEBT initiation. All the parameters were re-evaluated after 16 weeks. All patients were divided into three groups according to the initiated therapy: adalimumab, secukinumab and ustekinumab. When dividing the therapy received into groups, the age of the patients was taken into account: inclusion in the adalimumab group was carried out from 4 years, in the secukinumab and ustekinumab groups — from 6 years. Otherwise, the process of group assignment was random. The study results were processed using descriptive statistics methods: the changes in EFT thickness in individual groups were compared via the Wilcoxon test, and results were considered statistically significant at p 0.05. Results. Before the start of therapy, in 56 patients the mean of EFT thickness was 2.11 mm, the mean PASI — 18.32. The adalimumab group had the following indicators: the mean EFT thickness before the therapy was 2.1 mm, and it has decreased to 1.77 mm after 16 weeks of therapy. The mean change in EFT thickness was 0.33 mm, and the median — 0.17 mm [CI 0.33 ± 0.25]. The ustekinumab group: the mean EFT thickness before the therapy was 2.13 mm, 16 weeks after — 1.69 mm. The mean change in EFT thickness was 0.44 mm, and the median — 0.38 [CI 0.44 ± 0.13]. The secukinumab group: the mean EFT thickness before the therapy was 2.08 mm, 16 weeks after — 1.82 mm. The mean change in EFT thickness was 0.27 mm, and the median — 0.27 [CI 0.27 ± 0.07]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the EFT after therapy in all groups (p 0.05). 73% of patients achieved PASI 50, and 6% — PASI 75 in the adalimumab group. 21% of patients did not achieve PASI 50. The mean PASI score before therapy was 16.73 points, and after 16 ± 4 weeks — 6.4 points, the mean dynamics was 10.33 points, the median dynamics was 7 points [CI 10.33 ± 4]. All patients achieved PASI 50, 75.3% — PASI 75, 8% — PASI 90, and 16.7% — PASI 100 in the ustekinumab group. The mean PASI score before therapy was 22.17 points, and after 16 weeks — 3.67 points, the mean dynamics was 19.28 points, the median dynamics was 17 points [CI 18.5 ± 3.03]. All patients achieved PASI 50, 47% — PASI 75, and 11% — PASI 90 in the secukinumab group. The median PASI before therapy was 14.29 points, and after 16 ± 4 weeks — 3.71 points, the mean PASI score before therapy was 14.29 points, and after 16 weeks — 3.7 points, the mean dynamics was 10.59 points, the median dynamics was 10 points [CI 10.59 ± 2.27]. Evaluation of indicators via Wilcoxon test has shown statistically significant decrease in the PASI after therapy in all groups (p 0.05). There were no adverse events leading to cessation of therapy during the follow-up period. Conclusion. All groups have shown decrease in the in EFT thickness and in the PASI score. The most significant dynamics was observed in the ustekinumab group. Research limitations were the small patients sample and the absence of a control group (participants without psoriasis).
期刊介绍:
The main purpose of the academic journal "Current Pediatrics" is to cover the issues related to health, emotional state, and social adaptation of children. In the journal we publish the most pressing issues of research and applied problems (such as social paediatrics; clinical findings, anamnesis, and diagnosis of paediatric diseases; prevention and rehabilitation; supply of healthy and sick child), reviews on the current state of medical science and management of health care in Russia. Along with the concern for providing a high level of basic research publications, the journal, being a mass media tool, tends to meet the interests and requirements of practitioners from different regions and bring up vital and urgent questions. To accomplish this purpose the journal includes the materials of practical interest presented in the following sections: "Exchange of experience", "Doctor''s aid", "Continuous professional education", "Expert Opinion". The journal presents actual official information from the Union of Paediatricians of Russia and publishes materials on the history of medical science, congresses, seminars, conferences, both in our country and abroad.