Abstract:

Ying Li, Su Yuhua, Shi Xin, Lu Dandan, Ding Lan, Chen Xiaojian, Xie Lixia, Jing Jing, Yang Xiaowen, Xu Qianqian, Zhang Yun, Chen Jingjing, Chen Lingling Department of Dermatology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu, China （Ying L ［current affiliation: Department of Dermatology, The Second People′s Hospital of Xiangcheng, Suzhou 215143, China］, Su YH, Shi X, Lu DD, Ding L, Xie LX, Jing J, Yang XW, Xu QQ, Zhang Y, Chen JJ）; Department of Dermatology, Suzhou Municipal Hospital, Suzhou 215006, Jiangsu, China （Chen XJ, Chen LL） Corresponding authors: Shi Xin, Email: shx9@163.com; Chen Lingling, Email: chenlingling031@126.com 【Abstract】 Objective To evaluate the efficacy of recombinant human tumor necrosis factor receptor Ⅱ: IgG Fc fusion protein （rhTNFR∶Fc） for the treatment of erythrodermic psoriasis. Methods A total of 23 patients with erythrodermic psoriasis were subcutaneously injected with rhTNFR∶Fc 25 mg （starting dose, 50 mg） twice a week for 12 weeks. Thereafter, they were followed up for 2 years. Outcome measures included the proportion of patients achieving 50%, 75% and 90% reduction in psoriasis area and severity index （PASI50, PASI75 and PASI90）, the serum level of tumor necrosis factor-α （TNF-α）, and incidence of adverse reactions. Statistical analysis was carried out by using nonparametric Friedman test and repeated measures ANOVA with the software SPSS 19.0. Results After 12-week treatment, the PASI score significantly decreased from 57.35 ± 3.45 at the baseline to 5.57 ± 3.60 in the patients with erythrodermic psoriasis （P < 0.01）, with the proportion of patients achieving PASI50, PASI75 and PASI90 being 100% （23 cases）, 95.65% （22 cases）, and 60.87% （14 cases） respectively. The serum level of TNF-α showed a significant decrease from 62.87 ± 15.23 ng/L before the treatment to 4.57 ± 2.99 ng/L （P < 0.01） after 12-week treatment. No adverse reactions were observed during the treatment. After 24-month follow-up, PASI scores experienced no significant changes in these patients compared with those at the end of 12-week treatment, and the number of patients achieving PASI50, PASI75 and PASI90 was 23, 20 and 15 respectively. The serum level of TNF-α was significantly lower at the end of 24-month follow-up than at that of 12-week treatment （3.37 ± 1.62 vs. 4.57 ± 2.99 ng/L, P < 0.05 ）. Conclusion rhTNFR∶Fc is effective for the control of acute inflammation in erythrodermic psoriasis.