治疗银屑病的生物制剂--主要类别和剂量系统

Elsherbiny Bedeer Sabry
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摘要

这篇综述探讨了银屑病治疗不断发展的前景,重点关注生物制剂的变革性影响。银屑病是一种以红色鳞屑斑块为特征的流行性顽固皮肤病,以往主要依靠局部治疗、光疗和全身治疗,但每种治疗方法都有其局限性。生物制剂的出现代表了一项重大进步,它通过解决疾病背后的特定免疫机制,提供有针对性的干预措施。目前,生物制剂被认为是治疗慢性中重度斑块状银屑病的首选系统疗法,尤其是在传统疗法无效或存在缺点的情况下。本综述阐述了针对肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)和白细胞介素-23(IL-23)的生物制剂的作用机制。每个类别下的具体药物,包括依那西普(etanercept)、英夫利昔单抗(infliximab)、阿达木单抗(adalimumab)、secukinumab、乌斯替康单抗(ustekinumab)等,都有详细的推荐剂量。生物制剂已显示出巨大的疗效,临床试验和实际研究显示,这些药物可显著改善疾病的严重程度和患者的生活质量。值得注意的是,这些药物作用迅速,通常在数周内就能产生明显的变化。虽然生物制剂给银屑病治疗带来了革命性的变化,但综述强调,由于注射部位反应和呼吸道感染等潜在副作用,谨慎使用非常重要。由于存在感染和自身免疫反应等严重不良反应,因此有必要谨慎选择患者并对其进行安全性监测。总之,生物制剂为银屑病治疗提供了一种精确有效的方法,有望明显改善症状,提高生活质量。本综述强调了负责任地使用生物制剂的必要性,同时考虑了患者的具体因素,并期待生物制剂不断取得进步,以改善对这种慢性皮炎的控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Biologic Medications for the Treatment of Psoriasis - Main Groups and Dosing System
This review explores the evolving landscape of psoriasis treatment with a focus on the transformative impact of biologic drugs. Psoriasis, a prevalent and persistent skin condition characterized by red and scaly patches, historically relied on topical, phototherapeutic, and systemic treatments, each with limitations. The advent of biologics represents a significant advancement, offering targeted interventions by addressing specific immunologic mechanisms underlying the disease. Biologics are now considered the preferred systemic therapy for chronic moderate-to-severe plaque psoriasis, particularly when conventional treatments prove ineffective or present disadvantages. The review delineates the mechanisms of action for biologics targeting tumour necrosis factor-alpha (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23). Specific drugs under each category, including etanercept, infliximab, adalimumab, secukinumab, ustekinumab, and others, are detailed with recommended dosages. Biologics have demonstrated substantial effectiveness, with clinical trials and real-world studies showcasing significant improvements in disease severity and patient’s quality of life. Notably, these drugs exhibit rapid action, often yielding noticeable changes within weeks. While biologics have revolutionized psoriasis treatment, the review emphasizes the importance of judicious use due to potential side effects such as injection-site reactions and respiratory infections. Serious adverse events, including infections and autoimmune reactions, necessitate careful patient selection and monitoring for safety. In conclusion, biologics offer a precise and effective approach to psoriasis treatment, promising marked symptom improvement and enhanced quality of life. The review underscores the need for responsible utilization, considering patient-specific factors, and anticipates ongoing advancements in biologics for improved control over this chronic dermatitis.
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