| 摘要: |
| 目的 观察阿达木单抗治疗中重度斑块型银屑病患者疗效,以及治疗前后患者血清25(OH)D水平变化。方法 选择临床确诊的中重度斑块型银屑病并经常规治疗效果不佳的患者42例,给予阿达木单抗皮下注射,第0周80 mg,第1~12周隔周给药40 mg。观察治疗前后患者血清25(OH)D水平变化以及银屑病面积与严重程度指数(psoriasis area and severity index, PASI)、医生整体评价(physician global assessment,PGA)、皮肤病生活质量指数(dermatology life quality index, DLQI)评分。结果 41例患者完成试验,第12周达到PASI评分改善75%(PASI75)的患者有32例(78.0%),未达到PASI75的患者有9例(22.0%),PASI、PGA、DLQI评分均较治疗前降低,差异均有统计学意义(P<0.01);患者血清25(OH)D水平较治疗前升高,差异有统计学意义(P<0.01);患者均未发生严重不良反应。结论 阿达木单抗治疗中重度斑块型银屑病疗效显著,治疗后患者血清25(OH)D水平较治疗前有所升高,二者可能存在一定的联系,内在机制有待进一步探讨。 |
| 关键词: 阿达木单抗 银屑病 治疗结果 维生素D |
| DOI：10.3724/SP.J.1008.2015.01003 |
| 投稿时间：2015-03-02修订日期：2015-04-28 |
| 基金项目:上海市科委生物医药领域产学研医合作项目(13DZ1930906),第二军医大学军事医学专项基金(2012). |
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| Adalimumab for treatment of moderate to severe plaque psoriasis: observation of efficacy and changes of serum vitamin D level |
| ZHOU Xin,BI Xin-ling*,GU Jun* |
(Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To observe the efficacy of adalimumab for treatment of patients with moderate to severe plaque psoriasis and the changes of serum 25(OH)D level. Methods A total of 42 patients, who were clinically diagnosed with moderate to severe psoriasis and were not improved by normal psoriatic treatment, were given adalimumab subcutaneously(80 mg at week 0, and then 40 mg every other week for totally 12 weeks). The changes of serum 25(OH)D level, psoriasis area and severity index (PASI), the doctor comprehensive assessment indicators (PGA) and dermatology life quality index (DLQI) scores were observed and analyzed. Results Totally 41 patients completed the treatment. At week 12, 32 patients (78.0%) achieved PASI75 (greater than or equal to 75% improvement in PASI score) response, while 9 patients (22.0%) did not. The scores of PASI, PGA and DLQI were all significantly lower after treatment compared with those before treatment (P<0.01). The serum 25(OH)D level after treatment was significantly higher than that before treatment (P<0.01). No severe adverse events were observed during the experiment. Conclusion Adalimumab is effective for treatment of moderate to severe plaque psoriasis, and the serum 25(OH)D level is increased after treatment, which might be related to mechanism of the effect of adalimumab. |
| Key words: adalimumab psoriasis treatment outcome vitamin D |
