新型全身用药物
这是一个快速发展的领域，有许多正在开发的全身性药物有望成为银屑病的新疗法。托法替尼是一种口服 Janus 激酶抑制剂，已被批准用于治疗类风湿性关节炎，在将其用于治疗中重度慢性斑块型银屑病成人患者的 III 期试验中，该药也显示出了积极的结果。[84]Pfizer Pharmaceutical. Pfizer announces detailed results of OPT Compare phase 3 study of tofacitinib 5 mg and 10 mg twice daily compared to high-dose ENBREL® in adults with moderate-to-severe chronic plaque psoriasis. March 2014 [internet publication].https://www.pfizer.com/news/press-release/press-release-detail/pfizer_announces_detailed_results_of_opt_compare_phase_3_study_of_tofacitinib_5_mg_and_10_mg_twice_daily_compared_to_high_dose_enbrel_in_adults_with_moderate_to_severe_chronic_plaque_psoriasis Ponesimod 是一种口服的鞘氨醇-1-磷酸受体 1 调节剂，将其用于治疗中重度慢性斑块型银屑病的试验正在进行中。[85]Vaclavkova A, Chimenti S, Arenberger P, et al. Oral ponesimod in patients with chronic plaque psoriasis: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet. 2014 Dec 6;384(9959):2036-45.http://www.ncbi.nlm.nih.gov/pubmed/25127208?tool=bestpractice.com 瑞沙单抗是一种靶向白细胞介素 23 的人类单克隆抗体，在 II 期试验中，将皮下注射该药用于治疗中重度斑块型银屑病，显示出良好前景；[86]Gordon KB, Strober B, Lebwohl M, et al. Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials. Lancet. 2018 Aug 7;392(10148):650-61.https://www.sciencedirect.com/science/article/pii/S0140673618317136?via%3Dihubhttp://www.ncbi.nlm.nih.gov/pubmed/30097359?tool=bestpractice.com[87]Papp KA, Blauvelt A, Bukhalo M, et al. Risankizumab versus ustekinumab for moderate-to-severe plaque psoriasis. N Engl J Med. 2017 Apr 20;376(16):1551-60.http://www.ncbi.nlm.nih.gov/pubmed/28423301?tool=bestpractice.com 和 III 期试验。[86]Gordon KB, Strober B, Lebwohl M, et al. Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled phase 3 trials. Lancet. 2018 Aug 7;392(10148):650-61.https://www.sciencedirect.com/science/article/pii/S0140673618317136?via%3Dihubhttp://www.ncbi.nlm.nih.gov/pubmed/30097359?tool=bestpractice.com 在一些欧洲国家，富马酸二甲酯被用于治疗适合使用全身性药物治疗的中重度斑块型银屑病成人患者；目前正在对其进行调查研究，以便在全球范围内使用。[88]Mrowietz U, Szepietowski JC, Loewe R, et al. Efficacy and safety of LAS41008 (dimethyl fumarate) in adults with moderate-to-severe chronic plaque psoriasis: a randomized, double-blind, Fumaderm- and placebo-controlled trial (BRIDGE). Br J Dermatol. 2017 Mar;176(3):615-23.http://www.ncbi.nlm.nih.gov/pubmed/27515097?tool=bestpractice.com 一项研究显示，在 12 周期间，与使用安慰剂相比，使用口服药物 BMS-986165 选择性抑制酪氨酸激酶 2 (Tyk2) 能使银屑病得到更大程度的清除。需要更大规模和更长持续时间的试验来确定该药在银屑病患者中的安全性和疗效持久性。[89]Papp K, Gordon K, Thaçi D, et al. Phase 2 trial of selective tyrosine kinase 2 inhibition in psoriasis. N Engl J Med. 2018 Sep 11;379(14):1313-21.http://www.ncbi.nlm.nih.gov/pubmed/30205746?tool=bestpractice.com
