生物制剂对银屑病患者纤维化-4指数的影响。

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Takashi Morita, Susumu Ichiyama, Michiko Ito, Saeko Ozaki, Taeang Arai, Masanori Atsukawa, Katsuhiko Iwakiri, Teppei Hagino, Toshihiko Hoashi, Naoko Kanda, Hidehisa Saeki
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引用次数: 0

摘要

背景:银屑病伴有包括肝脏在内的全身性炎症。纤维化-4 (FIB-4)指数用于预测肝纤维化。本研究评估了包括TNF抑制剂在内的生物制剂对银屑病患者FIB-4指数的影响。方法:所有2014年6月至2024年1月在日本医学院首次开生物制剂(TNF抑制剂、IL-17抑制剂或IL-23抑制剂)的成年牛皮癣患者(biologic-naïve患者)纳入本研究。分别在生物制剂治疗前后6个月计算FIB-4指数。结果:共纳入105例患者。TNF抑制剂(P=0.0018)和IL-17抑制剂(P=0.045)治疗6个月后FIB-4指数升高,但IL-23抑制剂没有变化。在TNF抑制剂、IL-17抑制剂或IL-23抑制剂治疗后,天冬氨酸转氨酶和丙氨酸转氨酶水平没有变化。TNF抑制剂(P=0.0011)和IL-23抑制剂(P=0.039)治疗后血小板计数下降,但IL-17抑制剂无变化。结论:血小板下调似乎是TNF抑制剂治疗患者FIB-4指数升高的主要因素。虽然FIB-4指数是筛选肝纤维化的简单标记,但该指数的变化应谨慎解释,并且成像结果(如瞬时弹性成像)也应用于评估肝纤维化的状态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Biologics on Fibrosis-4 Index in Patients with Psoriasis.

Background: Psoriasis is accompanied by systemic inflammation that includes the liver. The fibrosis-4 (FIB-4) index was developed to predict significant liver fibrosis. The present study evaluated the effects of biologics, including TNF inhibitors, on the FIB-4 index in psoriasis patients.

Methods: All adult patients with psoriasis who were prescribed biologics (TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors) at Nippon Medical School from June 2014 to January 2024 for the first time (biologic-naïve patients) were included in this study. The FIB-4 index was calculated before and after 6 months of treatment with biologics.

Results: A total of 105 patients were enrolled. The FIB-4 index was higher after 6 months of treatment with TNF inhibitors (P=0.0018) and IL-17 inhibitors (P=0.045) but did not change with IL-23 inhibitors. Aspartate aminotransferase and alanine aminotransferase levels did not change after treatment with TNF inhibitors, IL-17 inhibitors, or IL-23 inhibitors. Platelet count decreased after treatment with TNF inhibitors (P=0.0011) and IL-23 inhibitors (P=0.039) but did not change with IL-17 inhibitors.

Conclusions: Downregulation of platelets seems to be a major contributing factor for the increase in FIB-4 index in patients treated with TNF inhibitors. Although the FIB-4 index is a simple marker to screen for liver fibrosis, changes in this index should be interpreted with caution, and imaging findings such as transient elastography should also be used to evaluate the status of liver fibrosis.

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来源期刊
Journal of Nippon Medical School
Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-
CiteScore
1.80
自引率
10.00%
发文量
118
期刊介绍: The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.
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