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首页> 美国卫生研究院文献>other >Prevalence of Past and Reactivated Viral Infections and Efficacy of Cyclosporine A as Monotherapy or in Combination in Patients with Psoriatic Arthritis—Synergy Study: A Longitudinal Observational Study
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Prevalence of Past and Reactivated Viral Infections and Efficacy of Cyclosporine A as Monotherapy or in Combination in Patients with Psoriatic Arthritis—Synergy Study: A Longitudinal Observational Study

机译：银屑病关节炎患者单药治疗或联合治疗既往和复活病毒感染率及环孢菌素A的疗效-协同研究：一项纵向观察研究

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We have prospectively evaluated psoriatic arthritis (PsA) patients for (1) seropositivity for former viral infections and seroconversion and (2) efficacy of cyclosporine A (CsA) alone or in combination with other immunosuppressants in a time period of 12 months. Screening included HBV antibodies and antigens, HCV antibodies and RNA, HSV 1-2, HZV, EBV, and CMV IgG, and IgM, HHV-6 DNA, and HIV 1-2 antibodies. PsA was evaluated by the Psoriasis Area Severity Index (PASI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Visual Analogue Scale (VAS). At baseline, 126 (56%) out of 225 evaluable patients had 2 or more seropositivities indicative of former infections, and 31 patients (13.8%) presented seropositivity for HCV, HBV, HSV-1 and -2, HHV-6, EBV, or parvovirus infection; one of them, positive for HBAg, was treated with lamivudine, while the remaining 30 received no specific treatment. None of the 31 patients developed virus reactivation. A reduction (P < 0.001) of PASI, BASDAI, and VAS scores was observed at 6 and 12 months. The treatment of PsA with CsA as monotherapy or in combination was safe and effective. In vitro experiments and clinical findings, including those from our study, suggest that CsA as monotherapy or in combination with biologics might be the treatment of choice in PsA HCV-positive patients.
机译：我们对银屑病关节炎（PsA）患者进行了前瞻性评估（1）前病毒感染和血清转化的血清阳性，以及（12）单独或与其他免疫抑制剂联合使用环孢素A（CsA）在12个月内的疗效。筛选包括HBV抗体和抗原，HCV抗体和RNA，HSV 1-2，HZV，EBV和CMV IgG，以及IgM，HHV-6 DNA和HIV 1-2抗体。通过牛皮癣区域严重程度指数（PASI），巴斯强直性脊柱炎疾病活动指数（BASDAI）和视觉模拟量表（VAS）评估PsA。基线时，在225名可评估的患者中，有126名（56％）的血清阳性为2例或更多，表明有先前的感染，而31名患者（13.8％）的HCV，HBV，HSV-1和-2，HHV-6，EBV，或细小病毒感染；其中一名对HBAg阳性，用拉米夫定治疗，其余30名未接受特殊治疗。 31例患者均未出现病毒激活。在6和12个月时观察到PASI，BASDAI和VAS评分降低（P <0.001）。将CsA作为单一疗法或联合疗法治疗PsA是安全有效的。体外实验和临床发现（包括我们的研究结果）表明，作为单一疗法或与生物制剂联合使用的CsA可能是治疗PsA HCV阳性患者的首选治疗方法。

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