中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (9): 744-746.doi: 10.35541/cjd.20190757

• 药物与临床 • 上一篇    下一篇

阿达木单抗治疗重度斑块状银屑病的临床观察

刘鸿伟1    胡雪英2    雷东春1    张守民1   

  1. 1河南省人民医院皮肤科，郑州  450003；2漯河市第二人民医院皮肤科，河南  462000
  • 收稿日期:2019-07-18 修回日期:2019-12-15 发布日期:2020-08-31
  • 通讯作者: 张守民 E-mail:1264100668@qq.com

Adalimumab in the treatment of severe plaque psoriasis: a clinical observation

Liu Hongwei1, Hu Xueying2, Lei Dongchun1, Zhang Shoumin1   

  1. 1Department of Dermatology, Henan Provincial People′s Hospital, Zhengzhou 450003, China; 2Department of Dermatology, Luohe Second People′s Hospital, Luohe 462000, Henan, China
  • Received:2019-07-18 Revised:2019-12-15 Published:2020-08-31
  • Contact: Zhang Shoumin E-mail:1264100668@qq.com

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摘要： 【摘要】 目的 观察阿达木单抗治疗重度斑块状银屑病的疗效及安全性。方法 选取2018年6月至2019年4月就诊于河南省人民医院皮肤科的20例重度斑块状银屑病患者，首次治疗予皮下注射阿达木单抗80 mg，之后第1、3、5、7、9、11周注射40 mg，于第4、8、12周时观察并记录患者银屑病皮损面积和严重度指数（PASI），采用反射式共聚焦显微镜观察皮损的演变情况。治疗过程中监测不良反应。结果 4周时，12例PASI改善率达50%（PASI50）；8周时，14例达PASI75；12周时，20例达PASI 75，其中5例达PASI90，2例达PASI100。治疗前，RCM下皮损区域基底层黑素较皮损周围正常皮肤减少，治疗4周时较治疗前逐渐恢复；12周时基本恢复正常水平。20例患者均未发生感染、肿瘤等相关不良反应。结论 隔周皮下注射阿达木单抗治疗重度银屑病临床疗效显著，相关不良反应少。

关键词: 银屑病, 肿瘤坏死因子α, 抗体, 单克隆, 治疗结果, 药物毒性, 阿达木单抗

Abstract: 【Abstract】 Objective To evaluate the efficacy and safety of adalimumab in the treatment of severe plaque psoriasis. Methods From June 2018 to April 2019, 20 patients with severe plaque psoriasis were collected from Department of Dermatology, Henan Provincial People′s Hospital. After initial subcutaneous injection of adalimumab at a dose of 80 mg, these patients were subcutaneously injected with adalimumab at a dose of 40 mg at weeks 1, 3, 5, 7, 9 and 11. At weeks 4, 8 and 12, psoriasis area and severity index （PASI） was recorded, and changes in skin lesions were observed by reflectance confocal microscopy （RCM）. Adverse reactions were monitored during treatment. Results At week 4, 12 patients achieved a 50% reduction in PASI （PASI50）; at week 8, 14 achieved PASI75; at week 12, 20 patients achieved PASI75, of which 5 achieved PASI90 and 2 achieved PASI100. As RCM showed, the melanin content in the basal layer of skin lesions was lower compared with that of perilesional normal skin before treatment,gradually increased at week 4, and nearly returned to normal at week 12. No infections, tumors or other related adverse reactions occurred in the 20 patients. Conclusion Subcutaneous injection of adalimumab every other week is markedly effective in the treatment of severe psoriasis, with few related adverse reactions.

Key words: Psoriasis, Tumor necrosis factor-alpha, Antibodies, monoclonal, Treatment outcome, Drug toxicity, Adalimumab