司库奇尤单抗联合甲氨蝶呤治疗中重度银屑病疗效观察  

Effect of secukinumab in combination with methotrexate in the treatment of moderate-to-severe psoriasis

作　　者：黎平 宋文韬 张家豪 LI Ping;SONG Wentao;ZHANG Jiahao(Department of Dermatology and Medical Cosmetology,903 Hospital of PLA Joint Logistics Support Force,Jiangyou 621700,China)

机构地区：[1]九〇三医院皮肤与医疗美容科,江油621700

出　　处：《实用皮肤病学杂志》2024年第3期155-158,共4页Journal of Practical Dermatology

摘　　要：目的观察司库奇尤单抗联合甲氨蝶呤(MTX)治疗中重度银屑病的临床疗效及不良反应。方法选取九O三医院皮肤与医疗美容科2021年6月至2023年9月收治的中重度银屑病患者97例,根据随机数字表法分为观察组(n=48)和对照组(n=49),对照组采用MTX治疗,观察组在对照组的基础上用司库奇尤单抗治疗。2组患者均治疗12周。比较2组总有效率、炎症因子[包括肿瘤坏死因子(TNF)α、白细胞介素(IL)17、IL-23]、银屑病皮损面积和严重度指数(PASI)评分、体表受累面积(BSA)及不良反应发生情况。结果观察组总有效率97.92%(47/48),对照组总有效率91.84%(45/49),2组总有效率比较差异无统计学意义(P>0.05)。2组治疗后TNF-α、IL-17、IL-23水平均较本组治疗前下降(均P<0.05),且观察组治疗后均低于对照组(均P<0.05)。2组治疗后PASI评分、BSA均较本组治疗前降低(均P<0.05),且观察组治疗后均低于对照组(均P<0.05)。2组不良反应总发生率比较差异无统计学意义[10.42%(5/48)vs8.16%(4/49),P>0.05]。结论司库奇尤单抗联合MTX治疗中重度银屑病患者疗效显著,能有效减轻皮损程度和减少受累面积,不良反应发生率低。Objective To investigate the clinical effects and adverse reactions of secukinumab in combination with methotrexate(MTX)in moderate-to-severe psoriasis.Methods A total of 97 patients with moderate-to-severe psoriasis from the department of Dermatology and Medical Cosmetology at 903 Hospital between June 2021 and September 2023 were enrolled in this study.The patients were randomly divided into the observation group(n=48)and the control group(n=49),in accordance with the random number table.The control group received treatment with MTX,while the observation group received treatment with secukinumab in combination with MTX.Patients in both groups underwent a 12-week treatment period.The clinical parameters of patients in both groups were further compared,including the total effective rates,the levels of inflammatory factors(TNF-α,IL-17 and IL-23),psoriasis area severity index(PASI),the body surface area(BSA)and the incidence of adverse reactions.Results There was no statistical difference in the total effective rates between the two groups(P>0.05),with 97.92%(47/48)for the observation group and 91.84%(45/49)for the control group.After the treatment,the levels of TNF-a,IL-17 and IL-23 were reduced compared with those before the treatment(all P<0.05),and the more reductions were observed in the observation group compared with the control group(all P<0.05).After the treatment,the PASI and BAS scores were decreased compared with those before the treatment(all P<0.05),and the more reductions were observed in the the observation group compared with the control group(all P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P≥>0.05),with 10.42%(5/48)for the observation group and 8.16%(4/49)for the control group.Conclusion The combination of secukinumab and MTT demonstrates remarkable efficacy for patients with moderate-to-severe psoriasis,effectively decreasing psoriasis area,severity,and incidence of adverse reactions.

关 键 词：银屑病 司库奇尤单抗 甲氨蝶呤 皮损程度 不良反应 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]