环孢素A可改善银屑病关节炎患者的症状

作者：Colombo D 等   翻译：刘蕊

发布者：翟佳羽 审校者：李常虹

背景：

这是一个来自意大利的观察性多中心的协同研究，患者诊断为银屑病关节炎（PSA），至少应用3个月环孢素，作为单一疗法或与其他全身药物联合应用，旨在评估患者应用环孢素时病毒感染的易感性、药物的有效性和安全性。

目的：

这个亚组分析的目的是评价环孢素A单药治疗在超过12个月的观察中对银屑病关节炎的影响。

方法：

银屑病是由体表面积和银屑病面积严重程度指数（PASI）进行评估。银屑病关节炎采用肿胀和压痛关节数、疼痛的附着点及指\趾炎的数量、巴氏强直性脊柱炎活动指数（BASDAI）以及患者和医生视觉模拟尺下的总体评分进行评估。

结果：

环孢素单药治疗能有效地减少所有评估疾病的参数。皮肤和脊柱受累的主要指标，银屑病面积严重程度指数（PASI）和巴氏强直性脊柱炎活动指数（BASDAI）在研究期间均显著减少，肿胀和压痛的外周关节数以及附着点炎和指/趾炎也同样减少。

结论：

环孢素的单药治疗证实对皮肤银屑病有效，且对银屑病关节炎同样有效，可以减少脊柱及外周关节的症状和体征。

附原文：

BACKGROUND: The SYNERGY study is an observational, multicenter Italian study, conducted in patients with diagnosis of psoriatic arthritis (PsA) treated from at least 3 months with cyclosporine and aimed at assessing patients' seropositivity for viral infections and efficacy and safety of cyclosporine, administered as monotherapy or in combination with other systemic drugs in the routine clinical practice. OBJECTIVE: The aim of this subanalysis of the SYNERGY study was to evaluate the effects of CsA as monotherapy only in PsA over 12 months of observation. METHODS: Psoriasis was evaluated by Body Surface Area and the Psoriasis Area Severity Index (PASI). PsA was evaluated by number of swollen and tender joints, painful entheses and fingers with dactylitis, the Bath Ankylosing Spondylitis Activity Index (BASDAI) and by patients' and physicians' global assessment on a 10-point Visual Analogue Scale. RESULTS: Cyclosporine in monotherapy was effective in reducing all the measured disease parameters. The major indexes of cutaneous and spinal involvement, PASI and BASDAI were significantly reduced over the study period, as were the number of swollen and tender peripheral joints, and enthesitis and dactylitis. CONCLUSION: Cyclosporine in monotherapy confirmed its efficacy in cutaneous psoriasis and suggested to be effective also on PsA, reducing spinal and peripheral joints' signs and symptoms.

引自：

Colombo D, Chimenti S, GrossiPA,et al.Efficacy of cyclosporine A as monotherapy in patients with psoriatic arthritis: a subgroup analysis of the synergy study.G Ital DermatolVenereol. 2016 Feb 2. [Epub ahead of print]