乌达帕替尼和生物制剂联合疗法治疗耐药银屑病和银屑病关节炎的安全性和有效性

Shivkar Amara, Aarav Patel, M. Lebwohl
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引用次数: 0

摘要

重要性:尽管银屑病和银屑病关节炎(PsA)的现有治疗方法很多,但仍有一些患者对标准常规疗法产生耐药性。对于这些患者来说,生物制剂和达帕替尼的联合疗法可能是一种可行的替代选择;然而,目前有关联合用药的数据还很有限。目的评估奥达替尼和生物制剂联合治疗难治性银屑病和银屑病关节炎的安全性和有效性。设计:我们报告了对一家医疗机构的 3 名患者进行回顾性病历审查的结果,这些患者接受了奥达帕替尼和生物制剂联合治疗银屑病和 PsA。在开始使用达帕替尼和生物制剂联合疗法前,患者已讨论了其风险、益处和安全警告。在与医疗服务提供者共同决策后,患者接受了联合疗法试验。结果这三位患者之前对单药治疗无效,在接受联合治疗后症状均有明显改善。治疗期间未出现不良反应(恶性肿瘤、心血管事件、静脉血栓栓塞)。不过,一名患者在接受联合治疗期间出现了带状疱疹爆发和憩室炎。要确定长期疗效,还需要进行更多的样本研究。
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Safety and Efficacy of Combination Therapy of Upadacitinib and Biologic Agents for Treatment-Resistant Psoriasis and Psoriatic Arthritis
Importance: Although there are many available treatments for psoriasis and psoriatic arthritis (PsA), there are patients resistant to standard conventional therapy. For these patients, combination therapy of biologic agents and upadacitinib may be a viable alternative option; however, there is limited data on concomitant usage. Objective: To evaluate the safety and efficacy of combination therapy of upadacitinib and biologic agents for the treatment of refractory psoriasis and psoriatic arthritis. Design: We report the results of a retrospective chart review of 3 patients in a single practice treated with a combination of upadacitinib and biologics for psoriasis and PsA. The risks, benefits, and safety warnings of combination therapy of upadacitinib and biologic agents were discussed before initiation. After shared decision-making with the provider, patients were placed on a trial of combination therapy. Results: All three patients, previously refractory to monotherapy, experienced significant improvement of their symptoms while on combination therapy. No adverse reactions (malignancy, cardiovascular events, venous thromboembolism) occurred during treatment. However, one patient experienced a shingles outbreak and diverticulitis while on combination treatment. Further studies are needed to determine long-term efficacy with a larger sample size.  
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