在牛皮中针对性治疗的排序:这是否重要?
Nicole D Boswell1, Shikha Singla2, Kenneth B Gordon3
1Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA. nboswell@mcw.edu.
American journal of clinical dermatology
|July 13, 2024
概括
对于那些对初始治疗没有反应或随着时间的推移而失去疗效的牛皮患者,需要推的生物序列. 本综述提出了基于疗效和非反应数据的TNF,IL-17和IL-23抑制剂的序列.
科学领域:
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 生物疗法已经推进了牛皮的治疗,但在初级或二级不响应后的最佳测序仍然没有定义.
- 对生物药物的不响应,包括瘤亡因子 (TNF),干白素-17 (IL-17) 和干白素-23 (IL-23) 抑制剂,在治疗牛皮和牛皮性关节炎方面存在挑战.
- 治疗决策因疾病严重程度,关节参与,并发症和患者偏好而进一步复杂化.
研究的目的:
- 建立用于牛皮和牛皮性关节炎的推生物治疗序列.
- 解决生物失效 (初级或二级不响应) 后缺乏确定的治疗指南的问题.
主要方法:
- 对治疗牛皮和牛皮性关节炎的生物类疗效的审查和分析.
- 从临床试验中评估初级和二级不响应率.
- 纳入临床经验和专家意见,以获得拟议的生物序列.
主要成果:
- 在所有生物类 (TNF,IL-17,IL-23抑制剂) 中都可能发生初级和二级不响应.
- 不响应的类型会影响转换生物类或生物类之间的决定.
- 一个拟议的序列旨在优化生物失败患者的治疗结果.
结论:
- 确定的生物序列对于有效管理牛皮和牛皮性关节炎至关重要,特别是在治疗失败后.
- 拟议的序列考虑了疗效,非反应模式和临床专业知识,以指导治疗决策.
- 该框架旨在通过提供对生物疗法选择的结构化方法来改善患者的治疗结果.
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