背景:局部(TT)和生物疗法(BT)的组合在常规临床实践中是常见的事情。然而,关于TT是如何的科学医学文献,实际上,在BT启动后使用很少,特别是与抗IL17或抗IL23组合。
目的:描述在基线和6个月疗程的几种药物(抗IL17,ustekinumab,和反IL23)。我们的次要终点是描述使用的局部治疗类型,比较不同BT组使用TT的频率,描述这些患者局部治疗的存活率,并确定可能影响这些患者使用或停止局部治疗的因素(临床反应,生活质量,药物类型,等。).
方法:这是一个回顾性研究,观察,和使用抗IL17治疗的中度至重度银屑病患者的单中心研究(苏金单抗,ixekizumab),抗IL17R(Brodalumab),ustekinumab,和guselkumab从2015年1月到2020年12月。
结果:我们共纳入138例患者。当治疗开始时,82.7%的人接受TT(55%每日),六个月后,86.6%的人停止了TT。关于药物类型的分析,6个月时,我们发现100%的BRO患者停止了局部治疗.根据6个月疗程中使用的BT,我们没有发现TT的使用频率有任何显着差异。TT的估计平均病程为4.3个月(SD,6.7).此外,在获得PASI100的患者组中,TT的估计平均病程显著较短(2.8个月vs8.1个月).
结论:在我们的队列中,在常规临床实践中,我们发现在开始BT治疗后6个月,TT的使用频率显著下降.这种减少发生在改善客观临床反应和生活质量的患者中。
BACKGROUND: Combinations of topical (TT) and biological therapies (BT) are a common thing in the routine clinical practice. However, the scientific medical literature on how TT is, actually, used after the initiation of BT is scarce, particularly in combination with anti-IL17, or anti-IL23.
OBJECTIVE: To describe the frequency of the concomitant use of TT + BT at baseline and after a 6-month course of several drugs (anti-IL17, ustekinumab, and anti-IL23). Our secondary endpoints are to describe the type of topical therapy used, compare the frequency of use of TT among the different groups of BT, describe the survival of topical therapy in these patients, and identify the factors that can impact the use or discontinuation of topical therapy in these patients (clinical response, quality of life, type of drug, etc.).
METHODS: This was a retrospective, observational, and single-center study of patients with moderate-to-severe psoriasis treated with anti-IL17 (secukinumab, ixekizumab), anti-IL17R (brodalumab), ustekinumab, and guselkumab from January 2015 through December 2020.
RESULTS: We included a total of 138 patients. When treatment started, 82.7% were on TT (55% daily), and after 6 months, 86.6% had discontinued TT. Regarding the analysis by type of drug, at 6 months, we found that 100% of the patients with BRO had discontinued topical treatment. We did not find any significant differences in the frequency of use of TT based on the BT used during the 6-month course of treatment. The estimated mean course of TT was 4.3 months (SD, 6.7). Also, the estimated mean course of TT was significantly shorter in the group of patients who achieved PASI100 (2.8 months vs. 8.1 months).
CONCLUSIONS: In our cohort, we saw a significant decrease in the frequency of use of TT at 6 months after starting BT in the routine clinical practice. This reduction occurred earlier in patients who improved their objective clinical response and quality of life.