摘要
目的回顾度普利尤单抗治疗以泛发结节性痒疹为主要表现的儿童中重度特应性皮炎(atopic dermatitis,AD)的临床疗效及安全性。方法回顾性分析2021年1月-2021年12月在首都儿科研究所附属儿童医院皮肤科门诊诊断为中重度AD的13例患儿临床资料,年龄2~15岁,皮疹类型以结节性痒疹为主,接受度普利尤单抗注射治疗4次。分别在第0、4、8、12、16周,使用湿疹面积和严重程度指数(eczema area and severity index,EASI),瘙痒的视觉模拟评分(visual analogue score of pruritus,VAS),儿童皮肤病生活质量指数(dermatology life quality index of children,CDLQI)、失眠严重指数量表(insomnia severity index,ISI)评估患儿的临床症状和生活质量,收集0~16周注射后的不良反应,比较组内治疗前后EASI、VAS、CDLQI和ISI评分变化。结果13例患儿均接受16周度普利尤单抗注射治疗。患者基线EASI为(26.25±5.44)分,第16周降至(6.35±2.74)分,瘙痒VAS由9.00(9.00,9.00)降至1.00(1.00,1.50)(P<0.001),CDLQI由30.00(29.50,30.00)降至1.00(0.50,1.00)(P<0.001),ISI由24.00(22.50,25.00)降至1.00(0.00,1.00)(P<0.001),差异有统计学意义。治疗期间1例患儿出现干眼症样表现,1例患儿出现注射部位轻度疼痛,其余患儿未出现不良事件。结论结节性痒疹是AD的一种临床皮损表现,在儿童及青少年AD患者中更为常见,其瘙痒症状显著、严重影响患儿生活质量及心理健康,传统二线治疗往往难以开展或治疗失败。度普利尤单抗治疗儿童以泛发结节性痒疹为主要表现的中重度AD临床疗效显著且安全性好,可作为其治疗新选择。
Objective To review the clinical efficacy and safety of dupilumab in the treatment of moderate to severe atopic dermatitis in children with generalized nodular prurigo.Methods The clinical data of 13 children with moderate to severe atopic dermatitis(aged 2-15 years)diagnosed in the children′s Hospital Affiliated to the Capital Institute of Pediatrics from March 2021 to April 2022 were analyzed retrospectively.The clinical symptoms and quality of life of patients with atopic dermatitis were evaluated by eczema area and severity index(EASI),visual analogue scale of pruritus(VAS),children′s dermatological quality of life index(CDLQI)and insomnia severity index(ISI)at weeks 0,4,8,12 and 16,respectively.At the same time,the adverse reactions from weeks 0 to 16 were collected.In the comparison of EASI,VAS,CDLQI and ISI before and after treatment.Results All of the 13 children were treated with dupilumab for 16 weeks.The baseline EASI of patients was 26.25±5.44,decreased to 6.35±2.74 at the 16th week,VAS decreased from 9.00(9.00,9.00)to 1.00(1.00,1.50)(P<0.001),CDLQI decreased from 30.00(29.50,30.00)to 1.00(0.50,1.00)(P<0.001),and ISI decreased from 24.00(22.50,25.00)to 1.00(0.00,1.00)(P<0.001).The difference was statistically significant.All the four scores showed significant and continuous decline.One child had dry eye like symptoms,and the rest had no common adverse reactions such as skin infection and injection site pain,and no serious adverse events occurred.Conclusion Generalized nodular prurigo is currently considered to be a clinical subtype of moderate to severe atopic dermatitis,which is more common in children and adolescents.Pruritus symptoms significantly affect children′s quality of life and mental health.Traditional second-line treatment is often difficult to carry out or treatment fails.Dupilumab injection is effective and safe in the treatment of severe atopic dermatitis in children with generalized nodular prurigo,which provides a new treatment option for such children with poor traditional treatments.
作者
邓维
苏伟
李倩
刘晓雁
DENG Wei;SU Wei;LI Qian;LIU Xiaoyan(Department of Dermatology,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2023年第3期308-313,共6页
The Chinese Journal of Dermatovenereology
