摘要
目的:评价阿布昔替尼和度普利尤单抗治疗中重度特应性皮炎(atopic dermatitis,AD)患者的有效性和安全性。方法:回顾性分析2023年1~6月就诊于我院皮肤科的104例中重度AD患者临床资料。51例(A组)口服阿布昔替尼200 mg每天,53例(D组)患者皮下注射度普利尤单抗300 mg每2周(基线负荷剂量为600 mg),治疗周期均为24周。分析治疗后0周、4周、8周、12周、16周、24周的湿疹面积和严重程度指数(EASI)、皮肤病生活质量指数(DLQI)、瘙痒数字评定量表(P-NRS)。分析治疗后0周、8周、16周、24周的血清总IgE水平、嗜酸性粒细胞计数。分析与治疗直接相关不良反应发生情况。结果:治疗后A组、D组患者EASI、P-NRS、DLQI水平与治疗前比较,均明显降低,差异均有统计学意义(均P<0.05)。与D组患者比较,A组EASI、P-NRS、DLQI水平下降更明显。随着疗程延长,两组患者血清总IgE水平、嗜酸性粒细胞计数呈逐渐下降趋势,组间差异均无统计学意义(均P>0.05)。D组患者结膜炎发生率明显高于A组患者,差异有统计学意义(P<0.05)。A组患者恶心发生率明显高于D组患者,差异有统计学意义(P<0.05)。结论:阿布昔替尼和度普利尤单抗在治疗后24周均可明显缓解中重度特应性皮炎患者的瘙痒症状并改善患者生活质量,但阿布昔替尼在缓解瘙痒症状方面效果更佳。阿布昔替尼和度普利尤单抗均具有较高的安全性,但分别需要警惕胃肠道症状和结膜炎。
Objective:To evaluate efficacy and safety of abrocitinib and dupilumab in the treatment of moderate to severe atopic dermatitis(AD).Methods:The clinical data of 104 patients with moderate and severe AD who were admitted to dermatology department of our hospital from January to June 2023 were retrospectively analyzed.Fifty-one patients(group A)received abrocitinib 200 mg/day orally,and 53 patients(group D)received subcutaneous dupilumab 300 mg every two weeks(baseline load dose 600 mg).The treatment period was 24 weeks.EASI scores,dermatological life quality index(DLQI)and numeric rating scale for pruritus(P-NRS)were analyzed at 0,4,8,12,16 and 24 weeks after treatment.Serum total IgE levels and eosinophilic counts were analyzed at week 0,week 8,week 16 and week 24 after treatment.Treatment-emergent adverse events were analyzed.Results:After treatment,EASI,P-NRS and DLQI levels in group A and Group D were significantly decreased compared with those before treatment,with significant differences(P s<0.05).Compared with group D,EASI,P-NRS and DLQI levels in group A were more significantly decreased.With the extension of treatment course,the serum total IgE level and eosinophils count showed a gradually decreasing trend between the two groups,with no significant difference(P s>0.05).The incidence of conjunctivitis in group D was significantly higher than that in group A,with a significant difference(P<0.05).The incidence of nausea in group A was significantly higher than that in group D,with a significant difference(P<0.05).Conclusion:Both abrocitinib and dupilumab can significantly relieve pruritis and improve quality of life in patients with moderate to severe atopic dermatitis at 24 weeks after treatment,but abrocitinib is more effective in relieving pruritis.Both abrocitinib and dupilumab have high safety,but require attention for gastrointestinal symptoms and conjunctivitis,respectively.
作者
迪丽努尔·塔西买买提
帕丽达·阿布利孜
Dilinuer TAXIMAIMAITI;Palida ABULIZI(The First Affiliated Hospital of Xinjiang Medical University,Urumchi 830000,China)
出处
《中国麻风皮肤病杂志》
2024年第8期533-537,共5页
China Journal of Leprosy and Skin Diseases
基金
国家重点研发计划项目(编号:2022YFC2504802)。
