度普利尤单抗治疗老年性特应性皮炎的疗效及安全性研究  

Efficacy and safety of dupilumab in the treatment of atopic dermatitis in the elderly

作　　者：杨子靖 陈利红[1] 阮叶平 文莞廷 张嘉艺 王海伦 潘萌[1] 赵肖庆[1] Yang Zijing;Chen Lihong;Ruan Yeping;Wen Wanting;Zhang Jiayi;Wang Hailun;Pan Meng;Zhao Xiaoqing(Department of Dermatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院皮肤科,上海200025

出　　处：《中华皮肤科杂志》2025年第1期65-69,共5页Chinese Journal of Dermatology

基　　金：国家自然科学基金(82173407、82430100);上海市自然科学基金(21ZR1440500)。

摘　　要：目的探讨度普利尤单抗治疗老年(≥60岁)特应性皮炎(AD)患者的疗效和安全性,尤其关注罕见不良反应。方法本研究为单中心回顾性分析,收集2020年1月至2024年5月在上海交通大学医学院附属瑞金医院皮肤科接受标准方案度普利尤单抗治疗的老年AD患者281例,统计分析其性别、病程、皮疹、瘙痒程度等临床特征,记录0~16周随访期间皮疹、瘙痒程度变化及相关不良事件,分析度普利尤单抗治疗老年AD患者的疗效及安全性。结果281例老年AD患者中,男214例(76.16%),女67例(23.84%),年龄x±s为(71.13±7.91)岁,发病年龄(59.92±15.72)岁,病程[M(IQR)]为[5.00(13.00)]年。经标准方案度普利尤单抗治疗后,临床疗效指标AD评分(SCORAD)及主观瘙痒数值评定量表(NRS)分数的改善率逐渐增加,第16周时,SCORAD和NRS的中位改善率均达到最大值,分别为[72.37%(23.89%)]和[75.00%(29.72%)]。不良事件发生率整体较低,仅16例(6.05%)患者报告了不良事件,其中常见不良反应如结膜炎(2例,0.71%)、面部红斑(1例,0.36%)等均轻微可耐受。10例(3.56%)出现免疫漂移。结论度普利尤单抗治疗老年AD疗效可靠和安全,但有可能发生免疫漂移。Objective To investigate the efficacy and safety of dupilumab in the treatment of elderly patients(≥60 years old)with atopic dermatitis(AD),with particular attention paid to rare adverse reactions.Methods A single-center retrospective analysis was conducted on data collected from 281 elderly AD patients who received the standard regimen of dupilumab at the Department of Dermatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2020 to May 2024.Clinical characteristics such as gender,disease duration,skin lesion manifestations,and itch severity were analyzed.Changes in skin lesions and itch severity,as well as related adverse events were recorded during the follow-up period of 0-16 weeks.The efficacy and safety of dupilumab in the treatment of elderly AD patients were evaluated.Results Among the 281 elderly AD patients,214 were males(76.16%)and 67 were females(23.84%),with the age being 71.13±7.91 years and the age at onset being 59.92±15.72 years.The disease duration(M[IQR])was 5.00(13.00)years.After standard-regimen dupilumab treatment,the improvement rates of clinical outcome indicators SCORing Atopic Dermatitis(SCORAD)and pruritus numerical rating scale(NRS)scores gradually increased.At week 16,the improvement rates of SCORAD and NRS scores(M[IQR])reached the maxima of 72.37%(23.89%)and 75.00%(29.72%),respectively.The overall incidence of adverse events was relatively low,with only 16 patients(6.05%)reporting adverse events.Common adverse reactions such as conjunctivitis(2 cases,0.71%)and facial erythema(1 case,0.36%)were mild and well-tolerated.Phenotype switching occurred in 10 cases(3.56%).Conclusion Dupilumab was an effective and safe treatment for elderly AD,but phenotype switching may occur.

关 键 词：皮炎 特应性 老年人 生物因子 治疗结果 药物相关性副作用和不良反应 Th1-Th2平衡 度普利尤单抗 

分 类 号：R73[医药卫生—肿瘤]