比较依那西普单药与联合光疗治疗依那西普单药难治性银屑病

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J Dermatolog Treat. 2011 Aug 10. [Epub ahead of print]   A randomized study comparing the combination of nbUVB and etanercept to etanercept monotherapy in patients with psoriasis who do not exhibit an excellent response after 12 weeks of etanercept.   Lynde CW, Gupta AK, Guenther L, Poulin Y, Levesque A, Bissonnette R.   Source Lynderm Research, Markham, ON , Canada.   Abstract Abstract Background: There is a lack of data on the combination of phototherapy with etanercept in patients who have not shown an excellent response to etanercept monotherapy. Objectives: To study the combination of narrow-band ultraviolet B (nbUVB) phototherapy with etanercept in patients not demonstrating an improvement of 90% in their Psoriasis Area Severity Index (PASI-90) after 12 weeks of etanercept. Patients and methods: Psoriatic patients not reaching PASI-90 after 12 weeks of etanercept therapy were randomized (1:1) to receive either etanercept (50 mg once a week) monotherapy or in combination with nbUVB three times weekly for periods of 4 weeks. Results: Seventy-five patients were randomized. Only 21.6% of patients achieved adherence of 80% or more for nbUVB treatments. At week 24, PASI-90 was reached by 16.2% of patients in the etanercept plus nbUVB group when compared with 15.8% of patients in the etanercept monotherapy group (p = 1.000). In patients with high adherence to nbUVB, the PASI-90 at week 16 was 42.9% for etanercept with nbUVB when compared with 3.4% for etanercept monotherapy (p = 0.018). Both treatments were well tolerated. Conclusion: Addition of nbUVB after 12 weeks of etanercept did not significantly improve the clinical response except for a subset of patients with high adherence to nbUVB.   Clinical Trials Registration number: NCT00640393.   PMID: 21797805

比较依那西普单药与联合光疗治疗依那西普单药难治性银屑病   Lynde CW, et al. J Dermatolog Treat. 2011 Aug 10. 提前在线.     背景: 对于依那西普单药疗效不佳的银屑病患者是否能应用依那西普联合光疗，目前尚缺乏数据。 目的: 研究窄谱UVB(nbUVB)光疗与依那西普联合治疗依那西普单药疗效不佳的患者，疗效不佳的定义是治疗12周未达到PASI90。 患者和方法: 依那西普单药治疗12周后未获得PASI90的银屑病患者被随机(1:1)分入依那西普单药(50mg，一周一次)治疗组，或nbUVB (每周3次, 连续治疗4周)联合依那西普治疗组。 结果: 共有75例银屑病病人被随机分组。只有21.6%的银屑病病人能坚持接受总剂量≥80%的nbUVB治疗。24周时，依那西普联合nbUVB治疗组的PASI90达标率为16.2%，而依那西普单药组达标率为15.8% (p = 1.000)。对nbUVB依从性高的患者中，16周时联合治疗组的PASI90达标率为42.9%，而依那西普单药组仅为3.4% (p = 0.018)。银屑病患者对两种治疗均耐受良好。 结论: 依那西普单药治疗12周疗效不佳的银屑病患者加用nbUVB后的疗效并未显著提高，但联合治疗对nbUVB依从性高的患者有较好的疗效。