| Abstract | Ciljevi istraživanja: Ispitati učestalost primjene, dugoročnu održivost učinka, primarnu i
sekundarnu neučinkovitost te pojavu nuspojava i razloge zbog kojih je došlo do prekida
primjene pojedinih bioloških lijekova.
Nacrt studije: Retrospektivna opservacijska studija.
Ispitanici i metode: Istraživanje je uključivalo 227 oboljelih od srednje teške do teške
psorijaze liječenih biološkim lijekovima (etanercept, adalimumab, ustekinumab,
sekukinumab, iksekizumab, guselkumab, risankizumab).
Rezultati: Najprimjenjivaniji biološki lijek bio je risankizumab (24 %), dok se najrjeđe
primjenjivao etanercept (2%). Pri primjeni prvog biološkog lijeka risankizumab, iksekizumab
i guselkumab značajno su više postigli odgovor PASI 75 nakon 12 mjeseci primjene, dok su
iksekizumab, risankizumab i sekukinumab značajno više postigli terapijske ciljeve DLQI (0 –
5 i 0 + 1). Odgovor PASI 90 pri primjeni drugog biološkog lijeka, nakon 12 mjeseci imali su
značajno više risankizumab, ustekinumab i guselkumab. Zbog primarne neučinkovitosti
liječenje je prekinuto 16 puta (16,8 %), a zbog sekundarne 35 puta (36,8 %). Najveću
primarnu (20,0 %) i sekundarnu (40,0 %) neučinkovitost pokazao je etanercept, najmanju
primarnu ustekinumab (0), a najmanju sekundarnu risankizumab (1,5 %). Nuspojave su
zabilježene u samo tri pacijenta (1,3 %).
Zaključak: Risankizumab je primjenjivan najviše, a etanercept najmanje. Pri primjeni prvog
lijeka nakon 12 mjeseci, značajno više su PASI 75 postigli risankizumab, iksekizumab i
guselkumab, DLQI (0 – 5 i 0 + 1) iksekizumab, risankizumab i sekukinumab, a PASI 90 pri
primjeni drugog biološkog lijeka risankizumab, ustekinumab i guselkumab. Najveću primarnu
i sekundarnu neučinkovitost imao je etanercept, najmanju primarnu iksekizumab, a
sekundarnu risankizumab. Nuspojave su zabilježene u tri pacijenta. |
| Abstract (english) | Treatment of vulgar psoriasis with biological therapy at the Department of Dermatology
and Venerology of the University Hospital Osijek in a 10-year period
Objectives: Examine the incidence of used biological drugs, long-term efficacy, primary and
secondary failure of different biological drugs, incidence of side effects and reasons for
treatment discontinuation.
Study design: Observational retrospective study.
Participants and methods: The study involved 227 patients with moderate to severe
psoriasis, treated with biological drugs (etanercept, adalimumab, ustekinumab, secukinumab,
ixekizumab, guselkumab, risankizumab).
Results: The most commonly prescribed biological drug was risankizumab (24 %), and the
least prescribed was etanercept (2 %). Among the first prescribed biological drugs,
risankizumab, ixekizumab and guselkumab showed a significantly higher PASI 75 response
after 12 months of treatment, while ixekizumab, risankizumab, and secukinumab achieved
significantly more DLQI (0 – 5 and 0 +1) treatment goals. Among the second prescribed
biological drugs, the PASI 90 response after 12 months is seen significantly more in the
patients treated with risankizumab, ustekinumab i guselkumab. Treatment was disconinued 16
(16.8 %), due to primary failure and 35 times (36.8 %) due to secondary failure. The highest
rates of primary (20 %) and secondary (40 %) failure were seen among patients on etanercept.
Ustekinumab showed the lowest primary (0 %), and risankizumab the lowest secondary
failure (1.5 %) rate. Side effects were documented with only 3 patients (1.3 %).
Conclusion: Risankizumab was the most commonly prescribed, while etanercept was
prescribed the least. After 12 months of treatment with the first prescribed biological drug, the
patients treated with risankizumab, ixekizumab and guselkumab showed a significantly higher
PASI 75 response, and DLQI (0 – 5 and 0 + 1) response was significantly higher for
ixekizumab, risankizumab and secukinumab while the PASI 90 response was significantly
higher for risankizumab, ustekinumab and guselkumab as the second prescribed biological
treatment. Etanercept had shown the highest primary and secondary failure rate, ixekizumab
had the lowest primary, and risankizumab had the lowest secondary failure rate. Side effects
were documented with 3 patients. |
