度普利尤单抗治疗老年顽固性重度特应性皮炎30例临床观察  

Clinical Observation of Dupilumab in the Treatment of Severe Refractory Atopic Dermatitis in 30 Elderly Patients

作　　者：鞠延娇 门月华[1] 谢志强[1] JU Yanjiao;MEN Yuehua;XIE Zhiqiang(Department of Dermatology,the Third Hospital of Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院皮肤科,北京100191

出　　处：《中国皮肤性病学杂志》2022年第9期1026-1031,共6页The Chinese Journal of Dermatovenereology

基　　金：中央高校基本科研业务费资助;北大医学交叉研究种子基金(BMU2021MX021)。

摘　　要：目的评估临床实践中度普利尤单抗(dupilumab)治疗老年顽固性重度特应性皮炎(AD)的疗效及安全性。方法回顾2020年8月-2021年10月在北京大学第三医院皮肤科接受度普利尤单抗规律治疗至少16周,并联合丙酸氟替卡松乳膏治疗4周的老年顽固性重度AD患者的多方面疗效评估数据,包括治疗前后AD病情控制(ADCT)、瘙痒数值评分量表(NRS)、湿疹面积和严重程度指数(EASI)、皮肤病生活质量指数(DLQI)评分变化,以及药物安全性。结果共30例符合标准的老年顽固性重度AD患者纳入研究。治疗后第2周,23.33%的患者达病情控制(ADCT<7分);瘙痒NRS评分下降45.52%,73.33%的患者瘙痒NRS评分下降≥4分;EASI评分下降42.37%,46.67%的患者达EASI-50;DLQI评分下降≥4分的患者达73.33%。治疗后第16周,所有患者(100%)均达到病情控制(ADCT<7分);瘙痒NRS评分下降87.92%,所有患者瘙痒NRS下降幅度均≥4分;EASI评分下降93.83%,达到EASI-50、EASI-75和EASI-90的患者分别为100%、96.67%和86.67%;DLQI评分下降≥4分的患者达100%。1例患者出现多发性细菌性毛囊炎,其余患者均未出现不良反应。结论度普利尤单抗能显著改善并持续控制老年顽固性重度AD患者的病情。Objective To evaluate efficacy and safety of dupilumab in elderly patients with severe refractory atopic dermatitis(AD)in clinical practice.Methods A retrospective study was conducted on efficacy assessment data of elderly patients with severe refractory AD who were treated with regular dupilumab for 16 weeks and combined with fluticasone propionate cream for 4 weeks in the Department of Dermatology,The Third Hospital of Peking University from June 2020 to October 2021.Treatment outcome was assessed by Atopic dermatitis control tool(ADCT),pruritus Numerical rating scale(NRS),Eczema area and severity index(EASI),and Dermatology Life Quality Index(DLQI)score before and after treatment.The safety of dupilumab was also evaluated.Results A total of 30 patients with severe refractory AD that met the criteria were enrolled in the study.At two weeks after treatment,23.33%of the patients were under control(ADCT<7 points);the mean pruritus NRS score decreased by 45.52%,and 73.33%of the patients had reduced NRS≥4 points;the mean EASI score decreased by 42.37%,and 46.67%of the patients reached EASI-50;73.33%of patients had a DLQI score decrease of≥4 points.At 16 weeks after treatment,all the patients(100%)were under control(ADCT<7);mean pruritus NRS score decreased by 87.92%and all patients′pruritus NRS score decreased≥4 points;mean EASI score decreased by 93.83%,all the patients reached EASI-50,96.67%of the patients achieved EASI-75 and 86.67%achieved EASI-90;all patients′DLQI score decreased≥4 points.One patient developed bacterial folliculitis,and the other patients reported no adverse reactions.Conclusion Dupilumab can significantly improve and sustainably control the condition of elderly patients with severe refractory AD.

关 键 词：特应性皮炎 度普利尤单抗 老年 特应性皮炎病情控制工具 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]