【杜匹单抗治疗老年人特应性皮炎疗效观察】。

Q3 Medicine
北京大学学报(医学版) Pub Date : 2025-04-18
Ran Sun, Yuhao Wu, Mei DI, Xiaoyang Wang
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引用次数: 0

摘要

目的:评价杜匹单抗治疗老年人特应性皮炎的疗效和安全性。方法:本研究回顾性收集2021年1月至2023年10月在北京安贞医院皮肤性病科接受杜匹单抗治疗至少16周的老年特应性皮炎患者。比较治疗前、治疗中、治疗后的临床指标,包括瘙痒数值评定评分(PNRS)、湿疹面积及严重程度指数(EASI)、皮肤病生活质量指数(DLQI)评分,并记录不良事件发生情况。比较治疗前和治疗16周后外周血中干扰素γ (IFN-γ)、白细胞介素4 (IL-4)、白细胞介素6 (IL-6)的表达情况。结果:共纳入90例老年特应性皮炎患者,EASI、PNRS、DLQI评分在治疗期间均呈逐渐下降趋势,在开始治疗后的前4周表现为快速下降,随后下降逐渐趋于平稳。点对点比较结果显示,治疗后4周EASI、PNRS、DLQI评分均显著低于治疗前(P < 0.001);治疗后第16周,上述治疗指标得分进一步降低,与第4周比较,差异有统计学意义(P < 0.01);各时间点EASI评分均显著低于前一个时间点,说明患者皮肤病变持续显著改善。评估杜普单抗的总体疗效。治疗4周后,62.89%的患者达到EASI-50 (EASI评分下降≥50%),74.4%的患者DLQI评分下降≥4分。治疗16周后,57.8%的患者达到EASI-75分,32.2%达到EASI-90分,所有患者的PNRS和DLQI评分均下降≥4分。治疗16周后,IL-4、IL-6表达水平分别为(31.62±6.23)ng/L、(14.36±2.25)ng/L,均显著低于治疗前(P < 0.001), IFN-γ表达水平为(15.37±3.14)ng/L,均高于治疗前(P < 0.001)。主要不良反应为结膜炎(2例)、注射部位反应(3例)、背部多发细菌性毛囊炎(2例),经对症治疗均可缓解,未发生严重不良反应。结论:Dupilumab治疗老年特应性皮炎疗效良好,可有效改善临床瘙痒、皮损等症状,提高患者生活质量,且治疗过程中未发生严重不良反应,安全可靠,值得临床推广。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Observation of the efficacy of dupilumab for treatment of atopic dermatitis in the elderly].

Objective: To evaluate the efficacy and safety of dupilumab in the treatment of atopic dermatitis in the elderly.

Methods: In this study, elderly patients with atopic dermatitis treated with dupilumab for at least 16 weeks in the Department of Dermatology and Venereology of Beijing Anzhen Hospital from January 2021 to October 2023 were retrospectively collected. Clinical indicators were compared before, during and after treatment, including pruritus numerical rating score (PNRS), eczema area and severity index (EASI), dermatology life quality index (DLQI) score, and the incidence of adverse events was recorded. The expression of interferon γ (IFN-γ), interleukin-4 (IL-4) and interleukin-6 (IL-6) in peripheral blood were compared before treatment and after 16 weeks of treatment.

Results: A total of 90 elder patients with atopic dermatitis were included, EASI, PNRS and DLQI scores all showed a gradual downward trend during the treatment period, which was manifested as a rapid decline in the first 4 weeks after starting treatment, and then the decline gradually leveled off. The results of point-to-point comparison showed that EASI, PNRS and DLQI scores in 4 weeks after treatment were significantly lower than those before treatment (P < 0.001); In the 16th week after treatment, the scores of the above therapeutic indicators were further reduced, and the difference was statistically significant compared with the 4th week (P < 0.01); The EASI score was significantly lower at each time point than the previous time point, indicating that the patients' skin lesions continued to improve significantly. The overall efficacy of dupliumab was evaluated. After 4 weeks of treatment, 62.89% of patients achieved EASI-50 (EASI score decreased by ≥50%), and 74.4% of patients' DLQI score decreased by ≥4 points. After 16 weeks of treatment, 57.8% of the patients achieved EASI-75, 32.2% achieved EASI-90, and the PNRS and DLQI scores of all the patients decreased by ≥4 points. After 16 weeks of treatment, the expression levels of IL-4 and IL-6 were (31.62±6.23) ng/L and (14.36±2.25) ng/L, respectively, which were significantly lower than those before treatment (P < 0.001), and the expression level of IFN-γ was (15.37±3.14) ng/L, which was higher than before treatment (P < 0.001).The main adverse reactions were conjunctivitis (2 cases), injection site reaction (3 cases) and multiple bacterial folliculitis of the back (2 cases), which could be alleviated by symptomatic treatment, and no serious adverse reactions occurred.

Conclusion: Dupilumab has shown good efficacy in the treatment of elderly atopic dermatitis, which can effectively improve clinical symptoms such as itching and skin lesions, improve the quality of life of patients, and no serious adverse reactions occurred during treatment, so it is safe and worthy of clinical promotion.

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来源期刊
北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
9815
期刊介绍: Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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