古塞奇尤单抗与英夫利西单抗治疗重度斑块状银屑病的效果对比

Comparison of the effects of guselkumab and infliximab in the treatment of severe plaque psoriasis

摘要:

目的 对比古塞奇尤单抗与英夫利西单抗治疗重度斑块状银屑病的效果。方法 回顾性分析2022年2月—2023年7月在天津市天津医院接受靶向免疫治疗的126例重度斑块状银屑病患者的病历资料，根据治疗方法分为古塞奇尤组64例和英夫利西组62例，古塞奇尤组皮下注射古塞奇尤单抗，连续44周；英夫利西组静脉滴注英夫利西单抗，连续46周。评价两组的疗效及不良反应，比较两组银屑病面积严重指数（PASI）评分、皮肤病生活质量指数（DLQI）、白细胞介素-23（IL-23）、白细胞介素-17（IL-17）、抗肿瘤坏死因子-α（TNF-α）水平。结果 古塞奇尤组与英夫利西组治疗前、治疗后4和12周、治疗结束时PASI、DLQI评分比较，结果 ①不同时间点PASI、DLQI评分比较，差异有统计学意义（P <0.05）；②古塞奇尤组与英夫利西组PASI、DLQI评分比较，差异有统计学意义（P <0.05）；③两组PASI、DLQI评分变化趋势比较，差异有统计学意义（P <0.05）。古塞奇尤组治疗前后IL-23、IL-17的差值均高于英夫利西组（P <0.05），TNF-α的差值低于英夫利西组（P <0.05）。古塞奇尤组治疗有效率高于英夫利西组（P <0.05）。两组总不良反应发生率比较，差异无统计学意义（P >0.05）。结论 相比英夫利西单抗，古塞奇尤单抗治疗重度斑块状银屑病能够获得更好的临床疗效，且安全性较好。

Abstract:

Objective To compare the effects of guselkumab and infliximab in treating severe plaque psoriasis.Methods A retrospective analysis was conducted on the medical records of 126 patients with severe plaque psoriasis who received targeted immunotherapy in our hospital from February 2022 to July 2023. Based on the treatment method, the patients were divided into a guselkumab group (64 cases) and an infliximab group (62 cases). The guselkumab group received subcutaneous injections of guselkumab for 44 consecutive weeks, while the infliximab group received intravenous infusions of infliximab for 46 consecutive weeks. The efficacy and adverse reactions of the two groups were evaluated, and comparisons were made regarding their Psoriasis Area and Severity Index (PASI) scores, Dermatology Life Quality Index (DLQI), and levels of interleukin (IL)-23, IL-17, and tumor necrosis factor (TNF)-α.Results The PASI and DLQI scores before treatment, 4 and 12 weeks after treatment, and at the end of the treatment were compared between the guselkumab group and the infliximab group, and the results showed that they were different among the time points (P < 0.05) and between the two groups (P < 0.05), and that the change trends of PASI and DLQI scores differed between the two groups (P < 0.05). The guselkumab group exhibited higher differences in levels of IL-23 and IL-17, and lower differences in levels of TNF-α compared to the infliximab group (P < 0.05). The treatment effectiveness of the guselkumab group was superior to that of the infliximab group (P < 0.05). The incidence of adverse reactions did not exhibit a statistically significant difference between the two groups (P > 0.05).Conclusions Compared to infliximab, guselkumab offers better clinical efficacy and safety in the treatment of severe plaque psoriasis.