中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (12): 1071-1078.doi: 10.35541/cjd.20240321
中华医学会皮肤性病学分会免疫学组 中国研究型医院学会皮肤科学专业委员会
收稿日期:
2024-06-18
修回日期:
2024-09-11
发布日期:
2024-12-03
通讯作者:
姚煦;高兴华;顾恒;陆前进
E-mail:dryao_xu@126.com; gaobarry@hotmail.com; guheng@aliyun.com; qianlu5860@gmail.com
基金资助:
Immunology Group, Chinese Society of Dermatology; Dermatology Professional Committee of Chinese Research Hospital Society
Received:
2024-06-18
Revised:
2024-09-11
Published:
2024-12-03
Contact:
Yao Xu; Gao Xinghua; Gu Heng; Lu Qianjin
E-mail:dryao_xu@126.com; gaobarry@hotmail.com; guheng@aliyun.com; qianlu5860@gmail.com
Supported by:
摘要: 【摘要】 特应性皮炎(AD)是一种慢性炎症性皮肤病。近年来,随着靶向药物的研发和应用,AD的治疗正步入个体化时代。针对不同维度进行分层有助于实现个体化治疗,但目前尚缺乏AD的分层方案和以此指导的个体化治疗。因此,中华医学会皮肤性病学分会免疫学组和中国研究型医院学会皮肤科学专业委员会基于国内外最新研究进展,结合专家临床实践经验,围绕AD系统治疗的个体化综合评估、系统治疗药物、不同维度的治疗方案选择以及系统治疗的模式等内容,制订中重度AD分层个体化系统治疗专家共识,指导临床个体化用药。
中华医学会皮肤性病学分会免疫学组 中国研究型医院学会皮肤科学专业委员会. 中重度特应性皮炎分层个体化系统治疗专家共识[J]. 中华皮肤科杂志, 2024,57(12):1071-1078. doi:10.35541/cjd.20240321
Immunology Group, Chinese Society of Dermatology, Dermatology Professional Committee of Chinese Research Hospital Society. Expert consensus on the stratified individualized systemic treatment of moderate to severe atopic dermatitis[J]. Chinese Journal of Dermatology, 2024, 57(12): 1071-1078.doi:10.35541/cjd.20240321
[1] | Sroka⁃Tomaszewska J, Trzeciak M. Molecular mechanisms of atopic dermatitis pathogenesis[J]. Int J Mol Sci, 2021,22(8):4130. doi: 10.3390/ijms22084130. |
[2] | Laughter MR, Maymone M, Mashayekhi S, et al. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990⁃2017[J]. Br J Dermatol, 2021,184(2):304⁃309. doi: 10.1111/bjd.19580. |
[3] | Dong WL, An J, Yu M, et al. The prevalence and year lived with disability of atopic dermatitis in China: findings from the global burden of disease study 2019[J]. World Allergy Organ J, 2021, 14(11): 100604. doi: 10.1016/j.waojou.2021.100604. |
[4] | Chovatiya R, Silverberg JI. The heterogeneity of atopic dermatitis[J]. J Drugs Dermatol, 2022,21(2):172⁃176. doi: 10.36849/JDD.6408. |
[5] | Mesjasz A, Kołkowski K, Wollenberg A, et al. How to understand personalized medicine in atopic dermatitis nowadays?[J]. Int J Mol Sci, 2023,24(8):7557. doi: 10.3390/ijms24087557. |
[6] | 中华医学会皮肤性病学分会免疫学组. 特应性皮炎的全程管理共识[J]. 中华皮肤科杂志, 2023,56(1):5⁃15. doi: 10.35541/cjd.20220618. |
[7] | 李巍, 尹慧彬. 特应性皮炎的部位异质性[J]. 中华皮肤科杂志, 2022,55(4):349⁃352. doi: 10.35541/cjd.20210865. |
[8] | 中华医学会皮肤性病学分会免疫学组, 特应性皮炎协作研究中心. 中国特应性皮炎诊疗指南(2020版)[J]. 中华皮肤科杂志, 2020,53(2):81⁃88. doi: 10.35541/cjd.20191000. |
[9] | Wei W, Anderson P, Gadkari A, et al. Extent and consequences of inadequate disease control among adults with a history of moderate to severe atopic dermatitis[J]. J Dermatol, 2018,45(2):150⁃157. doi: 10.1111/1346⁃8138.14116. |
[10] | 赵作涛, 高兴华. 中重度特应性皮炎系统药物达标治疗专家指导建议[J].中国皮肤性病学杂志, 2022,36(8):855⁃864. doi: 10.13735/j.cjdv.1001⁃7089.202205115. |
[11] | Werfel T, Heratizadeh A, Aberer W, et al. Update "systemic treatment of atopic dermatitis" of the S2k⁃guideline on atopic dermatitis[J]. J Dtsch Dermatol Ges, 2021,19(1):151⁃168. doi: 10.1111/ddg.14371. |
[12] | Boguniewicz M, Alexis AF, Beck LA, et al. Expert perspectives on management of moderate⁃to⁃severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies[J]. J Allergy Clin Immunol Pract, 2017,5(6):1519⁃1531. doi: 10.1016/j.jaip.2017.08.005. |
[13] | Suh TP, Ramachandran D, Patel V, et al. Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): a practice⁃friendly alternative to the Eczema Area and Severity Index to assess atopic dermatitis severity in children[J]. J Am Acad Dermatol, 2020,82(5):1187⁃1194. doi: 10.1016/j.jaad. 2020.01.023. |
[14] | Simpson EL, Bruin⁃Weller M, Flohr C, et al. When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council[J]. J Am Acad Dermatol, 2017,77(4):623⁃633. doi: 10.1016/j.jaad.2017.06.042. |
[15] | 中国医师协会皮肤科医师分会, 中华医学会皮肤性病学分会, 中国医疗保健国际交流促进会皮肤医学分会, 等. 特应性皮炎治疗药物应用管理专家共识(2024版)[J]. 中华皮肤科杂志, 2024,57(2):97⁃108. doi: 10.35541/cjd.20230358. |
[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. 中国中重度特应性皮炎诊疗临床路径专家共识(2023版)[J]. 中华皮肤科杂志, 2023,56(11):1000⁃1007. doi: 10. 35541/cjd.20230247. |
[17] | Wollenberg A, Kinberger M, Arents B, et al. European guideline (EuroGuiDerm) on atopic eczema: part I ⁃ systemic therapy[J]. J Eur Acad Dermatol Venereol, 2022,36(9):1409⁃1431. doi: 10.1111/jdv.18345. |
[18] | Davis D, Drucker AM, Alikhan A, et al. Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies[J]. J Am Acad Dermatol, 2024,90(2):e43⁃e56. doi: 10.1016/j.jaad.2023.08.102. |
[19] | Thyssen JP, Halling AS, Schmid⁃Grendelmeier P, et al. Comorbidities of atopic dermatitis⁃what does the evidence say?[J]. J Allergy Clin Immunol, 2023,151(5):1155⁃1162. doi: 10.1016/j.jaci.2022.12.002. |
[20] | 国家皮肤与免疫疾病临床医学研究中心(北京协和医院), 中国医师协会风湿免疫科医师分会, 中国研究型医院学会风湿免疫专业委员会, 等. 钙调磷酸酶抑制剂治疗风湿免疫性疾病临床应用专家共识[J]. 中华内科杂志, 2023,62(11):1266⁃1281. doi: 10.3760/cma.j.cn112138⁃20230416⁃00198. |
[21] | 中华医学会皮肤性病学分会银屑病专业委员会. 甲氨蝶呤治疗银屑病应用专家共识[J]. 临床皮肤科杂志, 2022, 51(2): 108⁃117. doi: 10.16761/j.cnki.1000⁃4963.2022.02.015. |
[22] | 中国中西医结合学会皮肤性病专业委员会环境与职业性皮肤病学组, 中国老年保健医学研究会皮肤科分会. 系统Janus激酶抑制剂治疗特应性皮炎专家共识[J]. 实用皮肤病学杂志, 2022,15(3):129⁃135. doi: 10.11786/sypfbxzz.1674⁃1293. 20220301. |
[23] | Czarnowicki T, He H, Krueger JG, et al. Atopic dermatitis endotypes and implications for targeted therapeutics[J]. J Allergy Clin Immunol, 2019,143(1):1⁃11. doi: 10.1016/j.jaci. 2018.10.032. |
[24] | 中华医学会内分泌学分会, 中国内分泌代谢病专科联盟. 糖皮质激素类药物临床应用指导原则(2023版)[J]. 中华内分泌代谢杂志, 2023,39(4):289⁃296. doi: 10.3760/cma.j.cn311 282⁃20230116⁃00029. |
[25] | 中华医学会皮肤性病学分会儿童皮肤病学组. 中国儿童特应性皮炎诊疗共识(2017版)[J]. 中华皮肤科杂志, 2017,50(11):784⁃789. doi: 10.3760/cma.j.issn.0412⁃4030.2017.11.002. |
[26] | Flohr C, Rosala⁃Hallas A, Jones AP, et al. Efficacy and safety of ciclosporin versus methotrexate in the treatment of severe atopic dermatitis in children and young people (TREAT): a multicentre parallel group assessor⁃blinded clinical trial[J]. Br J Dermatol, 2023,189(6):674⁃684. |
[27] | 中华医学会皮肤性病学分会特应性皮炎研究中心, 中华医学会皮肤性病学分会儿童学组. 度普利尤单抗治疗特应性皮炎专家共识[J]. 中华皮肤科杂志, 2022,55(6):465⁃470. doi: 10.35541/cjd.20210885. |
[28] | Adam DN, Gooderham MJ, Beecker JR, et al. Expert consensus on the systemic treatment of atopic dermatitis in special populations[J]. J Eur Acad Dermatol Venereol, 2023,37(6):1135⁃1148. doi: 10.1111/jdv.18922. |
[29] | Harb H, Chatila TA. Mechanisms of dupilumab[J]. Clin Exp Allergy, 2020,50(1):5⁃14. doi: 10.1111/cea.13491. |
[30] | Bhatt SP, Rabe KF, Hanania NA, et al. Dupilumab for COPD with type 2 inflammation indicated by eosinophil counts[J]. N Engl J Med, 2023,389(3):205⁃214. doi: 10.1056/NEJMoa 2303951. |
[31] | Barry K, Zancanaro P, Casseres R, et al. Concomitant atopic dermatitis and psoriasis ⁃ a retrospective review[J]. J Dermatolog Treat, 2021,32(7):716⁃720. doi: 10.1080/09546634.2019.170 2147. |
[32] | 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. |
[33] | Gargiulo L, Ibba L, Malagoli P, et al. Management of patients affected by moderate⁃to⁃severe atopic dermatitis with JAK inhibitors in real⁃world clinical practice: an Italian Delphi Consensus[J]. Dermatol Ther (Heidelb), 2024,14(4):919⁃932. doi: 10.1007/s13555⁃024⁃01135⁃x. |
[34] | 中华医学会皮肤性病学分会毛发学组. 中国斑秃诊疗指南(2019)[J]. 临床皮肤科杂志, 2020,49(2):69⁃72. doi: 10. 16761/j.cnki.1000⁃4963.2020.02.002. |
[35] | Passeron T, Ezzedine K, Hamzavi I, et al. Efficacy and safety of upadacitinib in a phaseⅡ randomised, double⁃blind, dose⁃ranging study of adults with extensive non⁃segmental vitiligo[EB/OL]. (2023⁃11⁃23)[2024⁃06⁃17]. https://www.emjreviews.com/dermatology/symposium/efficacy⁃and⁃safety⁃of⁃upadacitinib⁃in⁃a⁃phase⁃ii⁃randomised⁃double⁃blind⁃dose⁃ranging⁃study⁃of⁃adults⁃with⁃extensive⁃non⁃segmental⁃vitiligo⁃j030123/. |
[36] | US Food and Drug Administration. RINVOQ®(upadacitinib) extended⁃release tablets, for oral use; RINVOQ® LQ (upadacitinib) oral solution[DB/OL]. (2024⁃04⁃26)[2024⁃06⁃17]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/211675s021s022lbl.pdf. |
[37] | 《类风湿关节炎超药品说明书用药中国专家共识》制定专家组. 类风湿关节炎超药品说明书用药中国专家共识(2022版)[J]. 中华医学杂志, 2022,102(15):1076⁃1085. doi: 10. 3760/cma.j.cn112137⁃20220120⁃00152. |
[38] | Torres T, Gonçalo M, Paiva Lopes MJ, et al. Portuguese recommendations for the treatment of atopic dermatitis with biologic therapy and JAK inhibitors in adult patients[J]. Drugs Context, 2021,10:2021⁃2029⁃5. doi: 10.7573/dic.2021⁃9⁃5. |
[39] | 甲泼尼龙片说明书[Z/OL]. (2020⁃09⁃09)[2024⁃06⁃17]. https://zy.yaozh.com/instruct/sms20201022/20201020147.pdf. |
[40] | Xiao X, Zhang T, Huang J, et al. Effect of CYP3A4 on liver injury induced by triptolide[J]. Biomed Chromatogr, 2020,34(8):e4864. doi: 10.1002/bmc.4864. |
[41] | Zheng N, Wei A, Wu T, et al. Triptolide and atorvastatin synergistically promote hepatotoxicity in cultured hepatocytes and female Sprague⁃Dawley rats by inhibiting pregnane X receptor⁃mediated transcriptional activation of CYP3A4[J]. Toxicol Lett, 2021,342:85⁃94. doi: 10.1016/j.toxlet.2021.02.008. |
[42] | Chen L, Chen X, Liu J, et al. Effects of two commonly used antidepressants amitriptyline and fluoxetine on the pharmacokinetics of abrocitinib in rats[J]. Chem Biol Interact, 2024,397:111041. doi: 10.1016/j.cbi.2024.111041. |
[43] | Siegfried EC, Arkin LM, Chiu YE, et al. Methotrexate for inflammatory skin disease in pediatric patients: consensus treatment guidelines[J]. Pediatr Dermatol, 2023,40(5):789⁃808. doi: 10.1111/pde.15327. |
[44] | Wu S, Zhou B, Yue X, et al. The changes of platelets counts in atopic dermatitis patients after treatment of abrocitinib: a systematic review and meta⁃analysis[J]. Postepy Dermatol Alergol, 2024,41(2):232⁃235. doi: 10.5114/ada.2024.138659. |
[45] | US Food and Drug Administration. CIBINQOTM (abrocitinib) tablets, for oral use[DB/OL]. (2022⁃01⁃14) [2024⁃06⁃17]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/213871s000lbl.pdf. |
[46] | Silverberg JI, Gooderham M, Katoh N, et al. Combining treat⁃to⁃target principles and shared decision⁃making: international expert consensus⁃based recommendations with a novel concept for minimal disease activity criteria in atopic dermatitis[J]. J Eur Acad Dermatol Venereol, 2024. doi: 10.1111/jdv.20229. |
[47] | 杨冬梅, 刘俊. 雷公藤多苷临床应用及不良反应的研究进展[J]. 中国医院药学杂志, 2018,38(20):2185⁃2190. doi: 10. 13286/j.cnki.chinhosppharmacyj.2018.20.22. |
[48] | 《中成药治疗优势病种临床应用指南》标准化项目组. 中成药治疗类风湿关节炎临床应用指南(2022年)[J]. 中国中西医结合杂志, 2023,43(3):261⁃273. doi: 10.7661/j.cjim.20230128. 125. |
[49] | Lee Y, Kim ME, Nahm DH. Real clinical practice data of monthly dupilumab therapy in adult patients with moderate⁃to⁃severe atopic dermatitis: clinical efficacy and predictive markers for a favorable clinical response[J]. Allergy Asthma Immunol Res, 2021,13(5):733⁃745. doi: 10.4168/aair.2021.13.5.733. |
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