银屑病的全身免疫炎症指数及其与生物治疗转换和反应的关系

Gregg Murray, Niamh Kearney, Conor Smith, Kieran Carty, Yasmine Safta, Olwyn Conlon, Brian Kirby, Ali Alsharqi
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引用次数: 0

摘要

生物疗法通过靶向免疫途径彻底改变了牛皮癣的治疗。尽管取得了这些进展,但一些患者的治疗效果并不理想,需要频繁更换治疗方法。全身性免疫炎症指数(SII)是一种新的全身性炎症生物标志物。其在牛皮癣生物转换中的作用仍未被探索。目的评价中重度银屑病患者SII基线水平与生物治疗转换之间的关系。方法本研究为单中心回顾性队列研究,纳入2017年开始生物治疗的98例中重度银屑病患者。患者随访5年以记录生物转换。分析基线人口统计学、疾病严重程度和SII水平。统计比较和多项逻辑回归评估了SII和生物转换之间的关联。结果98例患者中,48例(49%)患者在随访期间切换生物制剂,23例(23.5%)患者为单药切换,25例(25.5%)患者为多药切换(≥2种)。切换组的基线SII明显高于非切换组(p < 0.001)。非切换者的平均SII值为560 (95% CI: 456-663),单个切换者的平均SII值为1068 (95% CI: 915-1220),多个切换者的平均SII值为1275 (95% CI: 1129-1421)。较高的PASI、DLQI、银屑病关节炎(PsA)患病率、吸烟和体重也与转换相关(p < 0.05)。结论:基线SII升高与生物转换密切相关,特别是在多个转换者中,突出了其作为分层工具的潜力。将SII整合到牛皮癣治疗算法中可以使临床医生早期识别高风险患者,优化生物选择,并改善长期预后。这项研究强调了将炎症标志物纳入个体化牛皮癣管理策略的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Systemic Immune-Inflammation Index and Its Association With Biologic Therapy Switching and Response in Psoriasis

Background

Biologic therapies have revolutionised psoriasis treatment by targeting immune pathways. Despite these advances, some patients experience suboptimal outcomes, necessitating frequent therapeutic switches. The systemic immune-inflammation index (SII) is a novel biomarker for systemic inflammation. Its role in biologic switching in psoriasis remains unexplored.

Objectives

To evaluate the association between baseline SII levels and biologic therapy switching in patients with moderate-to-severe psoriasis.

Methods

This single-centre retrospective cohort study included 98 patients with moderate-to-severe psoriasis initiating biologic therapy in 2017. Patients were followed for 5 years to document biologic switches. Baseline demographics, disease severity, and SII levels were analysed. Statistical comparisons and multinomial logistic regression assessed associations between SII and biologic switching.

Results

Of the 98 patients, 48 (49%) switched biologics during follow-up: 23 (23.5%) made a single switch, and 25 (25.5%) were multiple switchers (≥ 2 biologics). Baseline SII was significantly higher in switchers compared to non-switchers (p < 0.001). Mean SII values were 560 (95% CI: 456–663) for non-switchers, 1068 (95% CI: 915–1220) for single switchers, and 1275 (95% CI: 1129–1421) for multiple switchers. Higher PASI, DLQI, psoriatic arthritis (PsA) prevalence, smoking, and body weight were also linked to switching (p < 0.05).

Conclusions

Elevated baseline SII is strongly associated with biologic switching, particularly among multiple switchers, highlighting its potential as a stratification tool. Integrating SII into psoriasis treatment algorithms may enable clinicians to identify high-risk patients early, optimise biologic selection, and improve long-term outcomes. This study underscores the importance of incorporating inflammatory markers into personalised psoriasis management strategies.

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