中华皮肤科杂志 ›› 2024, e20240014.doi: 10.35541/cjd.20240014
郑瑀心 郑敏
收稿日期:
2024-01-12
修回日期:
2024-05-30
发布日期:
2024-08-12
通讯作者:
郑敏
E-mail:minz@zju.edu.cn
基金资助:
Zheng Yuxin, Zheng Min
Received:
2024-01-12
Revised:
2024-05-30
Published:
2024-08-12
Contact:
Zheng Min
E-mail:minz@zju.edu.cn
Supported by:
摘要: 【摘要】 近年来,银屑病的管理方式不断发展,但仍存在许多“惑”与“解”的问题,本文主要围绕银屑病的管理目标、早期干预的获益、以患者为中心的治疗方案、生物制剂的选择与转换、复发管理策略、未满足的需求展开综述,旨在为患者和医护人员提供参考。
郑瑀心 郑敏. 从困惑到明晰:银屑病慢病管理的探索与实践[J]. 中华皮肤科杂志, 2024,e20240014. doi:10.35541/cjd.20240014
Zheng Yuxin, Zheng Min. From confusion to clarity: exploration and practice in the chronic disease management of psoriasis[J]. Chinese Journal of Dermatology,2024,e20240014. doi:10.35541/cjd.20240014
[1] | 中华医学会皮肤性病学分会银屑病专业委员会. 中国银屑病诊疗指南(2023版)[J]. 中华皮肤科杂志, 2023,56(7):573⁃625. doi: 10.35541/cjd.20220839. |
[2] | Ghoreschi K, Balato A, Enerbäck C, et al. Therapeutics targeting the IL⁃23 and IL⁃17 pathway in psoriasis[J]. Lancet, 2021,397(10275):754⁃766. doi: 10.1016/S0140⁃6736(21)00184⁃7. |
[3] | Campanati A, Marani A, Martina E, et al. Psoriasis as an immune⁃mediated and inflammatory systemic disease: from pathophysiology to novel therapeutic approaches[J]. Biomedicines, 2021,9(11):1511. doi: 10.3390/biomedicines9111511. |
[4] | Mrowietz U, Steinz K, Gerdes S. Psoriasis: to treat or to manage?[J]. Exp Dermatol, 2014,23(10):705⁃709. doi: 10.1111/exd. 12437. |
[5] | 中华医学会皮肤性病学分会银屑病专业委员会. 银屑病生物制剂达标治疗专家共识[J]. 中华皮肤科杂志, 2023,56(3):191⁃203. doi: 10.35541/cjd.20220652. |
[6] | Wang K, Zhao Y, Cao X. Global burden and future trends in psoriasis epidemiology: insights from the global burden of disease study 2019 and predictions to 2030[J]. Arch Dermatol Res, 2024,316(4):114. doi: 10.1007/s00403⁃024⁃02846⁃z. |
[7] | Strober B, Ryan C, van de Kerkhof P, et al. Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council[J]. J Am Acad Dermatol, 2020,82(1):117⁃122. doi: 10.1016/j.jaad.2019.08.026. |
[8] | Krueger JG, Wharton KA Jr, Schlitt T, et al. IL⁃17A inhibition by secukinumab induces early clinical, histopathologic, and molecular resolution of psoriasis[J]. J Allergy Clin Immunol, 2019,144(3):750⁃763. doi: 10.1016/j.jaci.2019.04.029. |
[9] | Schäkel K, Reich K, Asadullah K, et al. Early disease intervention with guselkumab in psoriasis leads to a higher rate of stable complete skin clearance ('clinical super response'): week 28 results from the ongoing phaseⅢb randomized, double⁃blind, parallel⁃group, GUIDE study[J]. J Eur Acad Dermatol Venereol, 2023,37(10):2016⁃2027. doi: 10.1111/jdv.19236. |
[10] | Huang YW, Tsai TF. Remission duration and long⁃term outcomes in patients with moderate⁃to⁃severe psoriasis treated by biologics or tofacitinib in controlled clinical trials: a 15⁃year single⁃center experience[J]. Dermatol Ther (Heidelb), 2019,9(3):553⁃569. doi: 10.1007/s13555⁃019⁃0310⁃5. |
[11] | Kampylafka E, Simon D, d'Oliveira I, et al. Disease interception with interleukin⁃17 inhibition in high⁃risk psoriasis patients with subclinical joint inflammation⁃data from the prospective IVEPSA study[J]. Arthritis Res Ther, 2019,21(1):178. doi: 10.1186/s13075⁃019⁃1957⁃0. |
[12] | von Stebut E, Reich K, Thaçi D, et al. Impact of secukinumab on endothelial dysfunction and other cardiovascular disease parameters in psoriasis patients over 52 weeks[J]. J Invest Dermatol, 2019,139(5):1054⁃1062. doi: 10.1016/j.jid.2018. 10.042. |
[13] | Eyerich K, Krueger J, Stahle M, et al. An international Delphi consensus to define a clinically appropriate definition of disease modification for plaque psoriasis[J]. J Eur Acad Dermatol Venereol, 2024,38(5):e424⁃e427. doi: 10.1111/jdv.19652. |
[14] | Iversen L, Eidsmo L, Austad J, et al. Secukinumab treatment in new⁃onset psoriasis: aiming to understand the potential for disease modification ⁃ rationale and design of the randomized, multicenter STEPIn study[J]. J Eur Acad Dermatol Venereol, 2018,32(11):1930⁃1939. doi: 10.1111/jdv.14979. |
[15] | Iversen L, Conrad C, Eidsmo L, et al. Secukinumab demonstrates superiority over narrow⁃band ultraviolet B phototherapy in new⁃onset moderate to severe plaque psoriasis patients: week 52 results from the STEPIn study[J]. J Eur Acad Dermatol Venereol, 2023,37(5):1004⁃1016. doi: 10.1111/jdv.18846. |
[16] | 中华医学会皮肤性病学分会, 中国医师协会皮肤科医师分会, 中国中西医结合学会皮肤性病专业委员会. 中国银屑病生物制剂治疗指南(2021)[J]. 中华皮肤科杂志, 2021,54(12):1033⁃1047. doi: 10.35541/cjd.20210643. |
[17] | Balakirski G, Gerdes S, Beissert S, et al. Therapy of psoriasis during pregnancy and breast⁃feeding[J]. J Dtsch Dermatol Ges, 2022,20(5):653⁃683. doi: 10.1111/ddg.14789. |
[18] | Griffiths C, Armstrong AW, Gudjonsson JE, et al. Psoriasis[J]. Lancet, 2021,397(10281):1301⁃1315. doi: 10.1016/S0140⁃6736(20)32549⁃6. |
[19] | Reich K, Armstrong AW, Langley RG, et al. Guselkumab versus secukinumab for the treatment of moderate⁃to⁃severe psoriasis (ECLIPSE): results from a phase 3, randomised controlled trial[J]. Lancet, 2019,394(10201):831⁃839. doi: 10.1016/S0140⁃6736(19)31773⁃8. |
[20] | Cai L, Zhang JZ, Yao X, et al. Secukinumab demonstrates high efficacy and a favorable safety profile over 52 weeks in Chinese patients with moderate to severe plaque psoriasis[J]. Chin Med J (Engl), 2020,133(22):2665⁃2673. doi: 10.1097/CM9.0000000 000001163. |
[21] | Blauvelt A, Papp KA, Griffiths CE, et al. Efficacy and safety of guselkumab, an anti⁃interleukin⁃23 monoclonal antibody, compared with adalimumab for the continuous treatment of patients with moderate to severe psoriasis: results from the phaseⅢ, double⁃blinded, placebo⁃ and active comparator⁃controlled VOYAGE 1 trial[J]. J Am Acad Dermatol, 2017,76(3):405⁃417. doi: 10.1016/j.jaad.2016.11.041. |
[22] | Schett G, McInnes IB, Neurath MF. Reframing immune⁃mediated inflammatory diseases through signature cytokine hubs[J]. N Engl J Med, 2021,385(7):628⁃639. doi: 10.1056/NEJMra1909094. |
[23] | Blair HA. Secukinumab: a review in psoriatic arthritis[J]. Drugs, 2021,81(4):483⁃494. doi: 10.1007/s40265⁃021⁃01476⁃3. |
[24] | Coates LC, Soriano ER, Corp N, et al. Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA): updated treatment recommendations for psoriatic arthritis 2021[J]. Nat Rev Rheumatol, 2022,18(8):465⁃479. doi: 10.1038/s41584⁃022⁃00798⁃0. |
[25] | Singla S, Putman M, Liew J, et al. Association between biological immunotherapy for psoriasis and time to incident inflammatory arthritis: a retrospective cohort study[J]. Lancet Rheumatol, 2023,5(4):e200⁃e207. doi: 10.1016/S2665⁃9913(23)00034⁃6. |
[26] | Morita A, Tsai TF, Yee E, et al. Efficacy and safety of spesolimab in Asian patients with a generalized pustular psoriasis flare: results from the randomized, double⁃blind, placebo⁃controlled Effisayil™ 1 study[J]. J Dermatol, 2023,50(2):183⁃194. doi: 10.1111/1346⁃8138.16609. |
[27] | Rosi E, Fastame MT, Di Cesare A, et al. Targeting IL⁃17A for the treatment of pustular psoriasis: a comprehensive review[J]. Expert Opin Biol Ther, 2022,22(12):1475⁃1487. doi: 10.1080/14712598.2022.2116978. |
[28] | Megna M, Camela E, Ruggiero A, et al. Use of biological therapies for the management of pustular psoriasis: a new era?[J]. Clin Cosmet Investig Dermatol, 2023,16:1677⁃1690. doi: 10.2147/CCID.S407812. |
[29] | 中国医师协会皮肤科医师分会,中国中西医结合学会皮肤性病学分会. 红皮病型银屑病诊疗中国专家共识(2024版)[J].中华皮肤科杂志,2024,57(5):409⁃417. doi: 10.35541/cjd. 20230570. |
[30] | Potestio L, Camela E, Cacciapuoti S, et al. Biologics for the management of erythrodermic psoriasis: an updated review[J]. Clin Cosmet Investig Dermatol, 2023,16:2045⁃2059. doi: 10. 2147/CCID.S407813. |
[31] | 周颖, 沙扬, 于浈, 等. 红皮病型银屑病治疗的研究进展[J]. 中国医学前沿杂志(电子版), 2023,15(11):21⁃28. doi: 10. 12037/YXQY.2023.11⁃04. |
[32] | Ruiz⁃Villaverde R, Rodriguez⁃Fernandez⁃Freire L, Armario⁃Hita JC, et al. Guselkumab as a switching strategy after anti⁃TNFα, anti⁃IL17, or anti⁃IL12/23 therapies in moderate⁃to⁃severe psoriasis[J]. Dermatol Ther, 2022,35(10):e15760. doi: 10.1111/dth.15760. |
[33] | Megna M, Potestio L, Ruggiero A, et al. Guselkumab is efficacious and safe in psoriasis patients who failed anti⁃IL17: a 52⁃week real⁃life study[J]. J Dermatolog Treat, 2022,33(5):2560⁃2564. doi: 10.1080/09546634.2022.2036674. |
[34] | Liu S, He M, Jiang J, et al. Triggers for the onset and recurrence of psoriasis: a review and update[J]. Cell Commun Signal, 2024,22(1):108. doi: 10.1186/s12964⁃023⁃01381⁃0. |
[35] | Wang W, Qiu Y, Zhao F, et al. Poor medication adherence in patients with psoriasis and a successful intervention[J]. J Dermatolog Treat, 2019,30(6):525⁃528. doi: 10.1080/09546634. 2018.1476652. |
[36] | Blauvelt A, Reich K, Warren RB, et al. Secukinumab re⁃initiation achieves regain of high response levels in patients who interrupt treatment for moderate to severe plaque psoriasis[J]. Br J Dermatol, 2017,177(3):879⁃881. doi: 10.1111/bjd.15656. |
[37] | Gordon KB, Armstrong AW, Foley P, et al. Guselkumab efficacy after withdrawal is associated with suppression of serum IL⁃23⁃regulated IL⁃17 and IL⁃22 in psoriasis: VOYAGE 2 study[J]. J Invest Dermatol, 2019,139(12):2437⁃2446.e1. doi: 10.1016/j.jid.2019.05.016. |
[38] | McInnes IB, Gravallese EM. Immune⁃mediated inflammatory disease therapeutics: past, present and future[J]. Nat Rev Immunol, 2021,21(10):680⁃686. doi: 10.1038/s41577⁃021⁃00603⁃1. |
[39] | Tang X, Li Q, Zhou Y, et al. Predictive factors of atopic⁃like dermatitis induced by IL⁃17A inhibitors in patients with psoriasis: a 2⁃year follow⁃up study[J]. J Eur Acad Dermatol Venereol, 2023,37(12):2509⁃2516. doi: 10.1111/jdv.19394. |
[40] | van der Schoot LS, van den Reek J. Data⁃driven prediction of biologic treatment responses in psoriasis: steps towards precision medicine[J]. Br J Dermatol, 2021,185(4):698⁃699. doi: 10. 1111/bjd.20625. |
[41] | Mrowietz U, Leonardi CL, Girolomoni G, et al. Secukinumab retreatment⁃as⁃needed versus fixed⁃interval maintenance regimen for moderate to severe plaque psoriasis: a randomized, double⁃blind, noninferiority trial (SCULPTURE)[J]. J Am Acad Dermatol, 2015,73(1):27⁃36.e1. doi: 10.1016/j.jaad.2015.04.011. |
[42] | Blauvelt A, Ferris LK, Yamauchi PS, et al. Extension of ustekinumab maintenance dosing interval in moderate⁃to⁃severe psoriasis: results of a phaseⅢb, randomized, double⁃blinded, active⁃controlled, multicentre study (PSTELLAR)[J]. Br J Dermatol, 2017,177(6):1552⁃1561. doi: 10.1111/bjd.15722. |
[43] | Ye LR, Yan BX, Chen XY, et al. Extended dosing intervals of ixekizumab for psoriasis: a single⁃center, uncontrolled, prospective study[J]. J Am Acad Dermatol, 2022,86(6):1348⁃1350. doi: 10.1016/j.jaad.2021.04.093. |
[44] | Chen XB, Zheng YX, Ye LR, et al. Gradually increasing the dosing interval of secukinumab for moderate to severe plaque psoriasis: a single⁃center, uncontrolled, prospective study in 36 weeks[J]. Dermatol Ther, 2022,35(12):e15911. doi: 10.1111/dth.15911. |
[45] | Zheng YX, Zheng M. A multidisciplinary team for the diagnosis and management of psoriatic arthritis[J]. Chin Med J (Engl), 2021,134(12):1387⁃1389. doi: 10.1097/CM9.0000000000001588. |
[46] | Liu Z, Wang X, Ma Y, et al. Artificial intelligence in psoriasis: where we are and where we are going[J]. Exp Dermatol, 2023,32(11):1884⁃1899. doi: 10.1111/exd.14938. |
[1] | 中华医学会皮肤性病学分会银屑病学组. [开放获取] 阿普米司特治疗银屑病专家指导意见(2025版)[J]. 中华皮肤科杂志, 2025, 58(5): 416-424. |
[2] | 中国医师协会皮肤科医师分会 中华医学会皮肤病学分会治疗学组 中国医疗保健国际交流促进会皮肤医学分会 国家皮肤与免疫疾病临床医学研究中心 中国罕见病联盟皮肤罕见病专业委员会. 大疱性类天疱疮诊疗专家共识(2025版)[J]. 中华皮肤科杂志, 2025, 58(5): 405-415. |
[3] | 李紫钰 鲁严. 关注新型冠状病毒感染后重症皮肤病[J]. 中华皮肤科杂志, 2025, 58(4): 378-383. |
[4] | 许秋云 纪超. 坏疽性脓皮病系统合并症的研究进展[J]. 中华皮肤科杂志, 2025, 58(4): 369-373. |
[5] | 中国医师协会皮肤科医师分会儿童学组 中华医学会皮肤性病学分会银屑病学组. 【开放获取】 儿童脓疱型银屑病诊疗中国专家共识(2025版)[J]. 中华皮肤科杂志, 2025, 58(4): 297-306. |
[6] | 何春霞 晋红中. 【开放获取】 急危重皮肤病的诊疗原则、现状、挑战和展望[J]. 中华皮肤科杂志, 2025, 58(4): 307-314. |
[7] | 木葵 郭慧 文海泉 龙海 刘昱 罗帅寒天 黄馨 周星雨 肖嵘 李亚萍. 基于标准治疗联合泰它西普治疗25例系统性红斑狼疮的疗效和安全性分析[J]. 中华皮肤科杂志, 2025, 58(4): 322-327. |
[8] | 王彩霞 徐凡 石晶 朱海莲 卢桂玲 王红梅. 奥马珠单抗和度普利尤单抗治疗大疱性类天疱疮的疗效和安全性系统综述[J]. 中华皮肤科杂志, 2025, 0(3): 20220929-e0220929. |
[9] | 李秀珍 徐秀莲. 白细胞介素23抑制剂治疗对银屑病共病的影响[J]. 中华皮肤科杂志, 2025, 58(3): 268-272. |
[10] | 陈良宏 孙艳 王敬玉 吴严. 本维莫德在皮肤病中的研究进展[J]. 中华皮肤科杂志, 2025, 58(3): 266-268. |
[11] | 许焯红 胡煜 顾恒. 间充质干细胞来源的外泌体在皮肤病中的作用[J]. 中华皮肤科杂志, 2025, 0(3): 20220881-e20220881. |
[12] | 叶慧 邓仕琳 梁景耀 张锡宝. 特应性皮炎复发控制与组织驻留记忆性T细胞的相关性研究进展[J]. 中华皮肤科杂志, 2025, 0(3): 20240192-e20240192. |
[13] | 李翔倩 张建中 周城. 系统小分子药物和生物制剂治疗斑秃的临床研究进展[J]. 中华皮肤科杂志, 2025, 0(3): 20240247-e20240247. |
[14] | 王文秋 李承新 王睿. 生物制剂治疗银屑病复发的研究现状[J]. 中华皮肤科杂志, 2025, 0(3): 20230301-e20230301. |
[15] | 张笑旭 罗素菊. 乌帕替尼治疗6例掌跖脓疱病的临床疗效与安全性分析[J]. 中华皮肤科杂志, 2025, 0(2): 20230772-e20230772. |
|