古瑟库单抗治疗化脓性汗腺炎多衰竭患者:来自Federico II的真实证据。

IF 2.2 4区 医学 Q3 DERMATOLOGY
Clinical, Cosmetic and Investigational Dermatology Pub Date : 2025-09-19 eCollection Date: 2025-01-01 DOI:10.2147/CCID.S544180
Fabrizio Martora, Nello Tommasino, Luigi Coronella, Luca Potestio, Teresa Battista, Matteo Megna
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引用次数: 0

摘要

化脓性汗腺炎(HS)是一种慢性、衰弱性炎症性皮肤病,其特征是疼痛的结节和脓肿,导致生活质量的严重损害。治疗仍然具有挑战性,特别是对于先前治疗失败或抗tnf α和抗il -17治疗禁忌症的患者。方法:这项前瞻性的、现实的研究评估了guselkumab(一种抗il -23单克隆抗体)在10例中重度HS成人患者中的疗效和安全性,这些患者之前曾失败或禁忌抗tnf α和/或抗il -17治疗。Guselkumab采用牛皮癣批准的给药方案。采用国际化脓性汗腺炎严重程度评分系统(IHS4)、皮肤科生活质量指数(DLQI)和视觉模拟疼痛量表(VAS)在基线(第0周)、第16周、第32周和第48周对患者进行评估。主要终点是在第16周达到化脓性汗腺炎临床缓解(HiSCR)。结果:在第16周,40%的患者达到HiSCR,到第48周增加到50%。平均IHS4评分从基线时的14.3降至第16周时的9.3。与此同时,DLQI平均降低10分,VAS疼痛评分平均降低4分。尽管有这些改善,总体生活质量仍然受到中度损害。一名患者因疗效丧失而停用了guelkumab。讨论:该结果支持先前小型研究和病例报告的发现,表明guselkumab可能在特定的HS人群中提供临床益处,特别是那些合并牛皮癣或克罗恩病的人群。尽管受限于小样本量,这项研究有助于越来越多的现实证据支持guselkumab作为多重难治性HS的潜在治疗选择。需要更大规模的安慰剂对照试验来进一步确定其在治疗算法中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Guselkumab In A Subset Of Multifailure Patients With Hidradenitis Suppurativa: Real-Word Evidence from Federico II.

Introduction: Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disorder characterized by painful nodules and abscesses, leading to substantial impairment in quality of life. Treatment remains challenging, particularly for patients with prior treatment failure or contraindications to anti-TNFα and anti-IL-17 therapies.

Methods: This prospective, real-life study assessed the efficacy and safety of guselkumab, an anti-IL-23 monoclonal antibody, in 10 adult patients with moderate-to-severe HS who had previously failed or were contraindicated for anti-TNFα and/or anti-IL-17 therapy. Guselkumab was administered using the psoriasis-approved dosing regimen. Patients were evaluated at baseline (week 0), week 16, week 32 and week 48 using the International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI), and visual analog scale (VAS) for pain. The primary endpoint was achievement of Hidradenitis Suppurativa Clinical Response (HiSCR) at week 16.

Results: At week 16, 40% of patients achieved HiSCR, increasing to 50% by week 48. Mean IHS4 scores decreased from 14.3 at baseline to 9.3 at week 16. This was accompanied by an average 10-point reduction in DLQI and a 4-point reduction in VAS pain scores. Despite these improvements, overall quality of life remained moderately impaired. One patient discontinued guselkumab due to loss of efficacy.

Discussion: The results support previous findings from smaller studies and case reports, indicating that guselkumab may offer clinical benefit in select HS populations, particularly those with comorbid psoriasis or Crohn's disease. Although limited by a small sample size, this study contributes to the growing real-world evidence supporting guselkumab as a potential treatment option in multi-refractory HS. Larger, placebo-controlled trials are needed to further define its role in treatment algorithms.

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来源期刊
CiteScore
2.80
自引率
4.30%
发文量
353
审稿时长
16 weeks
期刊介绍: Clinical, Cosmetic and Investigational Dermatology is an international, peer-reviewed, open access journal that focuses on the latest clinical and experimental research in all aspects of skin disease and cosmetic interventions. Normal and pathological processes in skin development and aging, their modification and treatment, as well as basic research into histology of dermal and dermal structures that provide clinical insights and potential treatment options are key topics for the journal. Patient satisfaction, preference, quality of life, compliance, persistence and their role in developing new management options to optimize outcomes for target conditions constitute major areas of interest. The journal is characterized by the rapid reporting of clinical studies, reviews and original research in skin research and skin care. All areas of dermatology will be covered; contributions will be welcomed from all clinicians and basic science researchers globally.
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