Use of biologic agents in combination with other therapies for the treatment of psoriasis.
Use of biologic agents in combination with other therapies for the treatment of psoriasis.
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DOI：
10.1007/s40257-014-0097-1
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发表时间：
2014-12
影响因子：
7.3
通讯作者：
Crowley JJ
中科院分区：
文献类型：
--
作者：
Cather JC;Crowley JJ
牛皮癣是一种慢性炎症性皮肤病，对患者的生活质量有显著的负面影响。银屑病的传统治疗方法往往不能达到预期的治疗目标，高剂量和/或长期使用与可导致终末器官损伤的毒性相关。对细胞因子在银屑病病因学中的作用的进一步了解导致了针对肿瘤坏死因子(TNF)-α和白细胞介素(il)-12/23的生物制剂的发展。虽然生物制剂改善了治疗效果，但它们并不是对所有牛皮癣患者都有效。生物制剂与传统疗法的结合可以为对单一药物反应不足的患者提供更好的治疗选择，或者当补充另一种治疗方法可以提高疗效时。此外，联合治疗可以减少安全性问题和累积毒性，因为单个药物的较低剂量在一起使用时可能有效。本文综述了生物制剂与全身治疗（甲氨蝶呤、环孢素或类维生素a）或光疗联合使用以及生物制剂本身联合使用的有效性和安全性的现有证据。提供指导，以帮助医生确定患者的情况和特点，谁将受益于联合治疗与生物制剂。最后，分析了正在开发的生物疗法（例如，单独靶向IL-17A、IL-17RA或IL-23的生物疗法）的潜在临床影响。
Psoriasis is a chronic inflammatory skin disorder, which is associated with a significant negative impact on a patient’s quality of life. Traditional therapies for psoriasis are often not able to meet desired treatment goals, and high-dose and/or long-term use is associated with toxicities that can result in end-organ damage. An improved understanding of the involvement of cytokines in the etiology of psoriasis has led to the development of biologic agents targeting tumor necrosis factor (TNF)-α and interleukins (ILs)-12/23. While biologic agents have improved treatment outcomes, they are not effective in all individuals with psoriasis. The combination of biologic agents with traditional therapies may provide improved therapeutic options for patients who inadequately respond to a single drug or when efficacy may be increased with supplementation of another treatment. In addition, combination therapy may reduce safety concerns and cumulative toxicity, as lower doses of individual agents may be efficacious when used together. This article reviews the current evidence available on the efficacy and safety of combining biologic agents with systemic therapies (methotrexate, cyclosporine, or retinoids) or with phototherapy, and the combination of biologic agents themselves. Guidance is provided to help physicians identify situations and the characteristics of patients who would benefit from combination therapy with a biologic agent. Finally, the potential clinical impact of biologic therapies in development (e.g., those targeting IL-17A, IL-17RA, or IL-23 alone) is analyzed.
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影响因子：
10.3
作者：
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通讯作者：
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van de Kerkhof, PCM