4种白细胞介素类生物制剂治疗银屑病的临床综合评价OACSTPCD

OBJECTIVE:To evaluate the four kinds of interleukin biological agents of ustekinumab,ixekizumab,secukinumab and guselkumab,so as to provide scientific basis for drug selection and clinical rational drug use in medical institutions.METHODS:According to the Selection and Evaluation Form of Drug Use(Chemical Drugs)List in the Tertiary Public Medical Institutions in Hebei Province published by Hebei Provincial Health Commission,four kinds of interleukin biological agents were comprehensively evaluated from effectiveness,pharmaceutical characteristics,safety,economy and other properties.RESULTS:The total scores of ustekinumab,ixekizumab,secukinumab and guselkumab were 79.3,77.8,68.3 and 76.3 points respectively.Guselkumab could achieve complete clearing of skin lesions,and the drug retention rate was high.Ustekinumab was the"dual-targeted"interleukin-12 and interleukin-23 inhibitor for moderately to severely active Crohn's disease in addition to psoriasis.Ixekizumab was a non-whole-human biological preparation,with the highest incidence of adverse reactions among the four types of biological preparations,yet was relatively inexpensive.Sekucizumab and ustekinumab were approved for psoriasis in children and adolescents.CONCLUSIONS:Guselkumab may be considered for patients seeking complete clearance and wishing to maintain better outcomes over time.Ustekinumab may be considered for patients with a history of inflammatory bowel disease or a family history of inflammatory bowel disease.Secukinumab and ustekinumab may be considered for pediatric psoriasis.Ixekizumab may be an option for patients wishing to achieve a rapid onset of action and who have limited ability to pay,yet patients who are susceptible to allergies and at high risk for connective tissue disease should be avoided.Ixekizumab and secukinumab may cause or aggravate inflammatory bowel disease and should be used with caution in clinic.