度普利尤单抗联合糖皮质激素治疗大疱性类天疱疮:国内首报并文献复习  

Dupilumab combined with systemic glucocorticoid in treatmemt of bullous pemphigoid: the first case report in China and literature review

作　　者：杨璐 曾跃平[1] 晋红中[1] YANG Lu;ZENG Yue-ping;JIN Hong-zhong(Department of Dermatology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院皮肤科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2021年第1期47-52,共6页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的报道国内首例度普利尤单抗联合糖皮质激素治疗大疱性类天疱疮(bullous pemphigoid,BP)患者,结合文献复习总结度普利尤单抗治疗BP的临床经验。方法分析1例BP患者应用度普利尤单抗联合糖皮质激素治疗的临床资料,同时回顾国内外相关文献,选择文献中符合纳入标准的病例进行总结。结果报道了国内首例度普利尤单抗联合糖皮质激素治疗的BP患者。将满足检索策略和纳入标准的3篇文献及本例患者纳入分析,共总结15例使用度普利尤单抗(单独或联合其他药物)治疗BP患者的临床资料。其中14例患者达到不同程度的疾病缓解,包括完全缓解9例,部分缓解5例。完全缓解组比部分缓解组患者的年龄更低[(75±14)岁vs.(81±10)岁]、男性患者比例更低(55.6%vs.100%)、给药频率大于隔周注射的比例更高(44.4%vs.0)。结论IL-4/13通路在BP的发病中起重要作用,度普利尤单抗能够快速控制BP病情,有助于系统性糖皮质激素的快速减量。Objective To report the first case of treatment with dupilumab combined with systemic glucocorticoid for patient with bullous pemphigoid(BP)in China,and to summarize the clinical experience of dupilumab in treatment of BP.Methods The clinical data of one Chinese BP patient who was treated with dupilumab combined with glucocorticoid was analyzed,and literature review was finished,basing on searching results of relevant Chinese and English literatures.Results One case of BP patient who was successfully controlled with dupilumab combined with systemic glucocorticoid was first reported in China.Three articles in literatures which were eligible for inclusion criteria and our case were analyzed,while a total of 15 BP patients who were treated with dupilumab alone or combined with other systemic treatments were analyzed.Among them,remission was shown among 14 patients with different degrees,in which complete remission in 9 cases and partial remission in 5 cases.Subgroup analysis revealed a tendency of younger age[(75±14)vs.(81±10)],fewer male patients(55.6%vs.100%)and higher frequency of the medicine(44.4%vs.0)in complete remission group compared to partial remission group.Conclusions The IL-4/13 pathway plays an important role in the pathogenesis of BP.Dupilumab alone or in combination with other treatments can lead to rapid relief of symptoms and rapid reduction of systemic glucocorticoid.

关 键 词：大疱性类天疱疮 度普利尤单抗 白细胞介素-4 白细胞介素-13 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]