Clinical Study On The Efficacy And Safety Of Different Target Biologics In The Treatment Of Psoriasis

Psoriasis is a chronic,recurrent,inflammatory,and systemic disease mediated by genetics and immunity.It is mainly characterized by keratinocyte proliferation,abnormal differentiation,and infiltration of multiple inflammatory cells.With the continuous in-depth research on the pathogenesis of psoriasis,targeted biologics for the treatment of psoriasis emerge in an endless stream,such as TNF-α inhibitor Adalimumab,IL12/23 inhibitor Ustekinumab,IL-17 inhibitors Secukinumab and Ixekizumab,the IL-23 inhibitor Guselkumab and so on.This article aims to observe and discuss the efficacy and safety of different target biological agents in the treatment of psoriasis in the real world,so as to provide real world data and provide reference for the treatment selection of more patients with psoriasis.ObjectiveTo observe and investigate the efficacy and safety of TNF-α inhibitor Adalimumab,IL17 inhibitors Secukinumab and Ixekizumab,IL-23 inhibitor Guselkumab,and IL 12/23 inhibitor Ustekinumab in the treatment of psoriasis in the real world.MethodsThe cases included in the study were patients with chronic moderate to severe plaque psoriasis and patients with special types of psoriasis who were admitted to the Department of Dermatology of the Shanghai Tenth People’s Hospital and Shanghai Skin Disease Hospital from June 2019 to December 2020.All patients had informed consent to receive biological treatment,the dosage used was the same as the instructions,and they were followed up regularly.The patient’s efficacy was evaluated at 0,4,8,12,16,and 24 weeks,with PASI75 response at week 12 as the primary endpoints.Efficacy evaluation indicators include:Psoriasis Areas and Severity Index(PASI),Body Surface Area(BSA),Physician’s Global Assessment(PGA),Dermatology Quality of Life Index(DLQI).At the same time,safety observations were carried out and adverse reactions and events were recorded.ResultsA total of 125 patients with moderate to severe chronic plaque psoriasis and 5 patients with special types of psoriasis were included in this study.1.Thirty people were included in Adalimumab group.At the 12th week,the PASI75 response rate was 60%,respectively;adverse reactions occurred in 10%of patients.2.Twenty-two people were included in Ustekinumab group.At the 12th week,the PASI75 response rate was 63.6%,respectively;adverse reactions occurred in 9.1%of patients.3.Twenty-two people were included in Secukinumab group 1(300mg dose group),and the PASI75 response rate was 95.5%at the 12th week;group 2(150mg dose group)included 2 people,at the 12th week the response rate of PASI75 was 100%respectively;group 3(adjusted dose group as needed)included 2 people,and the PASI75 response rate was 100%at week 12.Adverse reactions occurred in 53.8%of patients.4.Twenty-six people were included in Ixekizumab group,and the PASI75 response rate was 100%respectively at the 12th week;adverse reactions occurred in 50.0%of patients.5.Twenty-one people were included in Guselkumab group,and the PASI75 response rate was 81%at week 12.Adverse reactions occurred in 9.5%of patients.6.Five cases:Ixekizumab treated pustular psoriasis and palmoplantar pustulosis,Secukinumab treated reverse psoriasis,and Adalimumab treated erythrodermic psoriasis or combined with MTX treatment of arthritis-type psoriasis are effective.Adverse reactions occurred in 2 patients.ConclusionBiological agents are effective in treating chronic moderate to severe plaque psoriasis and special types of psoriasis,with controllable adverse reactions.The longer-term efficacy and safety of biological agents need to be confirmed by subsequent studies with larger samples.