延胡索酸酯治疗重症银屑病的58例病例回顾

作     者：Harries M.J. Chalmers R.J.G. Griffiths C.E.M. 刘艳 

作者机构：Dermatology Centre University of Manchester Hope Hospital Stott Lane Salford Manchester United Kingdom 

出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)

年 卷 期：2005年第1卷第12期

页      面：43-43页

学科分类：1002[医学-临床医学] 100206[医学-皮肤病与性病学] 10[医学] 

主　　题：银屑病 延胡索酸酯 用药记录 淋巴细胞减少症 基本治愈 面部潮红 系统性回顾 

摘      要：Background: Fumaric acid esters (FAE) have been used to treat severe psoriasis in northern Europe for over 20 years. A recent systematic review has shown FAE to be an effective systemic treatment for severe psoriasis. However, FAE remain unlicensed in the U.K. Objectives: To present data relating to the efficacy and tolerability of FAE in severe psoriasis and report our experiences of FAE therapy at one U.K. centre. Methods: Patients who had received FAE for severe psoriasis at one U.K. regional referral centre between June 1999 and October 2003 were identified from pharmacy records. Their records were analysed retrospectively. Results: Fifty- eight patients (25 women, 33 men) were identified. Fifty- five (95% ) of the 58 patients had previously used other systemic antipsoriatic therapies with over 70% previously using two or more agents. Thirty- two patients (55% ) showed improvement in their psoriasis with 10 (17% ) being rated as ‘ clear’ or ‘ virtually clear’ by the attending physician. No improvement was seen in 28% patients and 16% showed worsening of their disease. Adverse events were common and were reported in 66% patients. These mainly consisted of abdominal pain (61% ), diarrhoea (55% ), flushing (45% ), nausea (21% ) and malaise (15% ). They led to discontinuation of treatment in 15 patients after a mean period of 4- 7 months. Lymphocytopenia developed during treatment in 57% of patients, all of whom had had a baseline value within the normal range. In only one patient was this considered severe enough to warrant withdrawal of treatment. Conclusions: Our study has shown that FAE are an effective therapy in selected patients with severe psoriasis, even in those who have previously been intolerant of systemic therapy or where it has failed.