银屑病靶向治疗的排序:这重要吗?

IF 8.6 1区 医学 Q1 DERMATOLOGY
Nicole D. Boswell, Shikha Singla, Kenneth B. Gordon
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引用次数: 0

摘要

随着治疗银屑病的生物制剂的不断发展,一些患者的病情得到了最佳控制,但如果一种生物制剂最初未能改善皮肤(称为原发性无应答),或在最初改善后失去疗效(称为继发性无应答),则仍缺乏推荐的生物制剂顺序。任何一类生物制剂都可能出现原发性和继发性无应答,而无应答的类型会促使患者选择是在一类生物制剂中更换还是更换到另一类生物制剂。在治疗银屑病合并银屑病关节炎时,生物制剂的选择也具有挑战性,因为两种疾病的严重程度以及轴向和外周关节受累的进一步分类会导致治疗方法的不同。在选择生物制剂时,还要考虑每位患者的合并症和偏好,以提供最佳治疗。由于生物制剂治疗失败后缺乏既定的生物制剂治疗顺序,我们的综述旨在确定肿瘤坏死因子(TNF)、白细胞介素-17(IL-17)和白细胞介素-23(IL-23)抑制剂类药物在治疗银屑病和银屑病关节炎时的治疗顺序。我们提出的生物制剂治疗顺序是通过分析每类生物制剂的疗效、临床试验中的主要和次要无应答率以及专家意见的临床经验得出的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sequencing of Targeted Therapy in Psoriasis: Does it Matter?

Sequencing of Targeted Therapy in Psoriasis: Does it Matter?

Sequencing of Targeted Therapy in Psoriasis: Does it Matter?

With the continued development of biologics for the treatment of psoriasis, some patients have achieved optimal control, but a recommended biologic sequence if a biologic fails to initially improve the skin, termed primary nonresponse, or loses efficacy after initial improvement, termed secondary nonresponse, is still lacking. Primary and secondary nonresponse can occur with any class of biologics, and the type of nonresponse can drive the choice of whether to switch within a biologic class or to a different biologic class. The choice of biologic can also be challenging when managing psoriasis and concomitant psoriatic arthritis, as treatment differs on the basis of the severity of both diseases and further classification of axial and peripheral joint involvement. When choosing a biologic, each patient’s comorbidities and preferences are also taken into account to provide the optimal therapy. With this lack of an established biologic sequence after biologic failure, the objective of our review is to define a therapy sequence for the tumor necrosis factor (TNF), interleukin-17 (IL-17), and interleukin-23 (IL-23) inhibitor classes in the treatment of psoriasis and psoriatic arthritis. Our proposed biologic sequence was derived through an analysis of the efficacy of each biologic class, primary and secondary nonresponse rates from clinical trials, and clinical experience with expert opinion.

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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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