银屑病患者使用布达鲁单抗的疗效及治疗失败的风险因素:事后分析综述

IF 3.5 3区 医学 Q1 DERMATOLOGY Dermatology and Therapy Pub Date : 2024-09-12 DOI:10.1007/s13555-024-01264-3
Mark G. Lebwohl, April W. Armstrong, Andrew F. Alexis, Edward L. Lain, Abby A. Jacobson
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引用次数: 0

摘要

肥胖、饮酒和吸烟等因素与银屑病严重程度的增加以及对全身疗法和生物疗法的反应不足有关。肥胖与慢性炎症有关,而慢性炎症可导致银屑病发病。固定剂量疗法可能会降低体重指数较高患者的疗效,而基于体重的剂量会增加药物特异性副作用的负担。烟草中的酒精和尼古丁也被证明会刺激角质细胞和免疫细胞增殖并产生促炎细胞因子。虽然这些风险因素在中重度银屑病患者中普遍存在,但在评估治疗方案时可能会忽略它们对治疗效果的影响。Brodalumab 是一种全人白细胞介素-17 受体 A 拮抗剂,已被批准用于治疗中重度银屑病。在这篇综述中,我们描述了与生活方式相关的导致治疗反应减弱的风险因素。我们进一步总结了两项三期临床试验(AMAGINE-2 和 AMAGINE-3;ClinicalTrials.gov identifiers:分别为 NCT01708603 和 NCT01708629)。我们对临床试验和真实世界数据的审查表明,对于存在增加治疗失败可能性的生活方式因素的患者来说,布达鲁单抗是一种有效而安全的治疗选择,它能让患者实现皮肤清除并改善生活质量。
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Efficacy of Brodalumab in Patients with Psoriasis and Risk Factors for Treatment Failure: A Review of Post Hoc Analyses

Factors such as obesity, alcohol consumption, and tobacco use are associated with both increased psoriasis severity and inadequate response to systemic and biologic therapies. Obesity is linked to chronic inflammation, which can contribute to psoriasis pathogenesis. Fixed-dose therapies may have reduced efficacy in patients with a higher body mass index, while weight-based dosing can increase the burden of drug-specific side effects. Alcohol and nicotine from tobacco have also been shown to stimulate keratinocyte and immune cell proliferation and production of proinflammatory cytokines. While these risk factors are prevalent among patients with moderate-to-severe psoriasis, their influence on treatment outcomes may be overlooked when evaluating therapeutic options. Brodalumab is a fully human interleukin-17 receptor A antagonist approved for the treatment of moderate-to-severe psoriasis. In this review, we describe the lifestyle-related risk factors associated with decreased response to treatment. We further summarize the post hoc analyses of brodalumab in participant subgroups with moderate-to-severe psoriasis and a history of prior biologic failure, obesity, and alcohol or tobacco use from two phase 3 clinical trials (AMAGINE-2 and AMAGINE-3; ClinicalTrials.gov identifiers: NCT01708603 and NCT01708629, respectively). Our review of clinical trial and real-world data suggests that brodalumab is an efficacious and safe treatment option for patients with lifestyle factors that increase the likelihood of treatment failure, allowing them to achieve skin clearance and improve quality of life.

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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