摘要
目的了解接受生物制剂治疗的中重度斑块状银屑病患者新型冠状病毒(简称新冠)感染疫情期间病情变化情况和相关影响因素。方法通过纸质或电子调查问卷在2023年2月10-20日,回顾性收集2019年6月至2023年1月于河南省人民医院就诊且应用生物制剂治疗的中重度斑块状银屑病患者的资料,获取其在新冠疫情期间银屑病病情变化情况。组间比较采用t检验或χ2检验,采用单因素分析和logistic回归分析银屑病病情加重的影响因素,分层分析接受不同生物制剂治疗的患者在延误治疗后病情加重情况。结果共收集177例中重度斑块状银屑病患者,男115例,女62例,年龄6~83(38.69±14.18)岁,病程1~50(13.48±9.70)年。74例(41.81%)银屑病病情加重,154例(87.01%)发生新冠感染,90例(50.85%)因新冠疫情延误银屑病治疗。单因素分析显示,银屑病患者病情加重与延误治疗、新冠疫情前未规律治疗及皮损未完全清除等因素显著相关(P<0.001或0.05),与新冠感染和性别(均P>0.05)的相关性无统计学意义。多因素分析显示,银屑病加重与新冠造成的延误治疗(OR=3.34,95%CI:1.35~8.22,P=0.009)和皮损未完全清除(OR=3.10,95%CI:1.28~7.50,P=0.012)相关,与疫情前是否接受规律治疗的关联无统计学意义(P=0.130)。应用阿达木单抗、司库奇尤单抗、乌司奴单抗、依奇珠单抗的患者中,延误治疗者病情加重发生率均高于未延误治疗者(均P<0.05)。结论接受生物制剂治疗的中重度斑块状银屑病患者在新冠引起延误治疗的情况下容易出现疾病加重,特别是对皮损未完全清除的患者。
Objective To investigate changes in disease status and their influencing factors in patients with moderate to severe plaque psoriasis treated with biologics during the coronavirus disease 2019(COVID-19)pandemic.Methods Through printed or electronic questionnaires during February 10th-20th,2023,data were collected from patients with moderate to severe plaque psoriasis treated with biologics in Henan Provincial People′s Hospital from June 2019 to January 2023,and changes in the disease condition during the COVID-19 pandemic were investigated.The t test or chi-square test was used for comparisons between groups,univariate analysis and multivariate logistic regression analysis were conducted to investigate the factors contributing to the exacerbation of psoriasis,and stratified analysis was employed to evaluate the disease progression among the patients receiving different biologic therapies following treatment delays.Results A total of 177 patients with moderate to severe plaque psoriasis were collected,including 115 males and 62 females;they were aged 6-83(38.69±14.18)years,with disease duration of 1-50(13.48±9.70)years.Among the patients,74(41.81%)experienced psoriasis exacerbation,154(87.01%)developed COVID-19,and 90(50.85%)experienced delays in psoriasis treatment due to the pandemic.The results of univariate analysis indicated significant associations of psoriasis exacerbation with treatment delays,irregular treatment before the pandemic,and incomplete clearance of skin lesions(P<0.001 or 0.05),while no correlations were observed between psoriasis exacerbation and COVID-19 or gender(both P>0.05).Multivariate logistic regression analysis demonstrated that psoriasis exacerbation was associated with treatment delays due to COVID-19(OR=3.34,95%CI:1.35-8.22,P=0.009)and incomplete clearance of skin lesions(OR=3.10,95%CI:1.28-7.50,P=0.012),but not associated with irregular treatment before the pandemic(P=0.130).Among the patients treated with adalimumab,secukinumab,ustekinumab,and ixekizumab,those experiencing treatment delays exhibited higher rates of psoriasis exacerbation than those without treatment delays(all P<0.05).Conclusion Patients with moderate to severe plaque psoriasis undergoing biologic therapy are prone to disease exacerbation when treatment is delayed due to COVID-19,especially those with incomplete lesion clearance.
作者
窦进法
王建波
张帅
李建国
刘鸿伟
张守民
Dou Jinfa;Wang Jianbo;Zhang Shuai;Li Jianguo;Liu Hongwei;Zhang Shoumin(Department of Dermatology,Henan Provincial People′s Hospital,Zhengzhou University People′s Hospital,Henan University People′s Hospital,Zhengzhou 450003,China)
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2024年第8期739-742,共4页
Chinese Journal of Dermatology
关键词
银屑病
生物制剂
冠状病毒感染
细胞因子类
回归分析
病情变化
Psoriasis
Biological agents
Coronavirus infections
Cytokines
Regression analysis
Disease severity
作者简介
通讯作者:刘鸿伟,E-mail:1831824589@qq.com。
