治疗银屑病生物制剂相关矛盾反应研究进展  

Research progress in paradoxical reactions related to biological agents in the treatment of psoriasis

作　　者：马璟玥[1] 王惠平[1] Ma Jingyue;Wang Huiping(Department of Dermatovenereology,Tianjin Medical University General Hospital/Tianjin Institute of Sexually Transmitted Disease,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院皮肤性病科/天津性传播疾病研究所,天津300052

出　　处：《药物不良反应杂志》2023年第6期366-370,共5页Adverse Drug Reactions Journal

基　　金：天津市医学重点学科(专科)建设项目(TJYXZDXK⁃057B)。

摘　　要：生物制剂相关矛盾反应为生物制剂治疗期间出现与治疗目的相反的或使治疗疾病病情加重的矛盾现象。首次报道引发矛盾反应的生物制剂是肿瘤坏死因子α(TNF⁃α)抑制剂,首先出现在风湿性疾病患者的治疗中,随后是银屑病和炎症性肠病;其他类型生物制剂(白细胞介素12/23抑制剂乌司奴单抗、白细胞介素17抑制剂司库奇尤单抗和依奇珠单抗)也可引起矛盾反应。本文综述了生物制剂治疗银屑病相关矛盾反应的发生机制,常见矛盾反应(矛盾性银屑病、关节炎、炎症性肠病、化脓性汗腺炎等)的发生情况及临床表现,以及生物制剂治疗银屑病矛盾反应的处理原则。Paradoxical reactions related to biological agents refers to the contradictory phenomenon that occurs during the treatment of biological agents,which is contrary to the treatment purpose or exacer⁃bates the condition of the treated disease.The first biological agent reported to trigger paradoxical reactions is TNF⁃αinhibitors,which appeared firstly in the treatment of patients with rheumatic diseases,followed by psoriasis and inflammatory bowel diseases.Other types of biological agents such as interleukin(IL)12/23 inhibitor ustekinumab and IL⁃17 inhibitors secukinumab and ixekizumab can also cause paradoxical reac⁃tions.The mechanism of paradoxical reactions related to biological agents in the treatment of psoriasis,the occurrence and clinical manifestations of common paradoxical reactions(paradoxical psoriasis,arthritis,inflammatory bowel disease,hidradenitis suppurativa,etc.),and the management principles of paradoxical reactions related to biological agents in the treatment of psoriasis are reviewed in this article.

关 键 词：银屑病 生物制剂 矛盾反应 肿瘤坏死因子α抑制剂 白细胞介素17抑制剂 白细胞介素12/23抑制剂 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]