To determine if measuring ET with OCT can detect a subclinical therapeutic response in psoriasis treated with the biological therapy, secukinumab (an IL-17A antagonist).
Phase IV, single-center, open-label, and single-arm study.
Twenty-six consecutive patients with moderate to severe plaque psoriasis.
Clinical, dermoscopic, and OCT images were obtained at each visit. The clinician measured disease severity with the Investigator\'s Global Assessment (IGA) and Psoriasis Area And Severity Index (PASI). OCT was used to scan the ET at the center of lesional skin (ET-L), along the border, and normal skin (ET-N) on the same body plane; their difference was noted as ΔET.
Initially, ET-L was greater than ET-N (p < 0.0001), their differences decreased throughout the study, and there were no significant differences at Week 16 (p = 0.48). Twenty-four (92%) patients achieved a 50% reduction in PASI score (PASI50); they had lower ΔET at Weeks 0, 1, 3, 4, and 8 compared to those who did not clear (p < 0.04). Having a lower ΔET at Week 4 was associated with a shorter time to reach PASI50 (p = 0.02).
ET measurements using OCT can detect an early subclinical response to secukinumab compared to clinical scoring and identify nonresponders as early as 4 weeks.
为了确定使用OCT测量ET是否可以检测到使用生物疗法治疗的银屑病的亚临床治疗反应,苏金单抗(IL-17A拮抗剂)。
第四阶段,单中心,开放标签,和单臂研究。
26例中度至重度斑块型银屑病患者。
临床,皮肤镜,每次访视时获得OCT图像.临床医生使用研究者的全球评估(IGA)和银屑病面积和严重程度指数(PASI)测量疾病严重程度。使用OCT扫描皮损中心的ET(ET-L),沿着边界,和正常皮肤(ET-N)在同一身体平面上;它们的差异被标记为ΔET。
最初,ET-L大于ET-N(p<0.0001),在整个研究过程中,他们的差异减少了,在第16周没有显著差异(p=0.48)。24名(92%)患者的PASI评分(PASI50)降低了50%;与未清除的患者相比,他们在第0、1、3、4和8周的ΔET较低(p<0.04)。在第4周具有较低的ΔET与较短的达到PASI50的时间相关(p=0.02)。
与临床评分相比,使用OCT的ET测量可以检测到苏金单抗的早期亚临床反应,并在4周时识别无反应者。