《实用精神皮肤病学》主编Anthony Bewley教授对李欣教授团队的Meta分析作出了点评[5]:AD患者的心理-社会共病问题需要重视,这项分析基于不同文献综合探讨了成人和儿童AD患者的心理-社会共病,具有临床意义,能够提高皮肤科医生对于患者心理-社会共病的认识,并在治疗时考虑心理干预。重要的是,作者还提到了神经炎症过程是诱发AD患者心理-社会共病的主要因素,这表明心理-社会共病的焦点从患者转移到了疾病本身。
注:EASI,湿疹面积和严重程度指数;SCORAD,特应性皮炎评分;DLQI,皮肤病生活质量指数;HADS,医院焦虑和抑郁量表
图1 乌帕替尼治疗中重度特应性皮炎患者16周不同临床应答下患者报告结局的平均改善百分比
(数据来源:参考文献4)
[1] 赵作涛, 高兴华. 中重度特应性皮炎系统药物达标治疗专家指导建议[J]. 中国皮肤性病学杂志, 2022,36(8):855-864. doi: 10.13735/j.cjdv.1001-7089.202205115.
[2] 中华医学会皮肤性病学分会免疫学组, 特应性皮炎协作研究中心. 中国特应性皮炎诊疗指南(2020版)[J]. 中华皮肤科杂志, 2020,53(2):81-88. doi: 10.35541/cjd.20191000.
[3] Cai XC, Wang SH, Wang CX, et al. Epidemiology of mental health comorbidity in patients with atopic dermatitis: an analysis of global trends from 1998 to 2022[J]. J Eur Acad Dermatol Venereol, 2024,38(3):496-512. doi: 10.1111/jdv.19686.
[4] Reich K, de Bruin-Weller MS, Deleuran M, et al. Higher levels of response on clinical atopic dermatitis severity measures are associated with meaningful improvements in patient-reported symptom and quality of life measures: integrated analysis of three Upadacitinib phase 3 trials[J]. J Eur Acad Dermatol Venereol, 2023,doi: 10.1111/jdv.18995.
[5] Bewley A. Commentary on Epidemiology of mental health comorbidity in patients with atopic dermatitis: an analysis of global trends from 1998 to 2022[J]. J Eur Acad Dermatol Venereol, 2024,38(3):464-465. doi: 10.1111/jdv.19788.
[6] Guttman-Yassky E, Waldman A, Ahluwalia J, et al. Atopic dermatitis: pathogenesis[J]. Semin Cutan Med Surg, 2017,36(3):100-103. doi: 10.12788/j.sder.2017.036.
[7] Cameron S, Donnelly A, Broderick C, et al. Mind and skin: exploring the links between inflammation, sleep disturbance and neurocognitive function in patients with atopic dermatitis[J]. Allergy, 2024,79(1):26-36. doi: 10.1111/all.15818.
[8] 何荣国, 武钦学, 田华, 等. 社区综合性心理行为干预对学龄儿童特应性皮炎疗效的影响[J]. 中国全科医学, 2009,12(15):1406-1409.
[9] Butala S, Castelo-Soccio L, Seshadri R, et al. Biologic versus small molecule therapy for treating moderate to severe atopic dermatitis: clinical considerations[J]. J Allergy Clin Immunol Pract, 2023,11(5):1361-1373. doi: 10.1016/j.jaip.2023.03.011.
[10] Ständer S, Simpson EL, Guttman-Yassky E, et al. Clinical relevance of skin pain in atopic dermatitis[J]. J Drugs Dermatol, 2020,19(10):921-926. doi: 10.36849/JDD.2020.5498.
[11] Ali F, Vyas J, Finlay AY. Counting the burden: atopic dermatitis and health-related quality of life[J]. Acta Derm Venereol, 2020,100(12):adv00161. doi: 10.2340/00015555-3511.
[12] Silverberg JI, Gooderham M, Katoh N, et al. 403 Achievement of minimal disease activity is associated with improvements in symptoms, quality of life and treatment satisfaction in patients with atopic dermatitis[J]. Br J Dermatol, 2023, 188(suppl 3): ljad162.026. doi: 10.1093/bjd/ljad162.026.
[13] Chovatiya R, Paller AS. JAK inhibitors in the treatment of atopic dermatitis[J]. J Allergy Clin Immunol, 2021,148(4):927-940. doi: 10.1016/j.jaci.2021.08.009.
[14] Guttman-Yassky E, Teixeira HD, Simpson EL, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials[J]. Lancet, 2021,397(10290):2151-2168. doi: 10.1016/S0140-6736(21)00588-2.
[15] Reich K, Teixeira HD, de Bruin-Weller M, et al. Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): results from a randomised, double-blind, placebo-controlled, phase 3 trial[J]. Lancet, 2021,397(10290):2169-2181. doi: 10.1016/S0140-6736(21)00589-4.
[16] Simpson EL, Sinclair R, Forman S, et al. Efficacy and safety of abrocitinib in adults and adolescents with moderate-to-severe atopic dermatitis (JADE MONO-1): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial[J]. Lancet, 2020,396(10246):255-266. doi: 10.1016/S0140-6736(20)30732-7.
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