Omalizumab在異位性皮膚炎的治療效果––初步報告

Effectiveness of omalizumab therapy for atopic dermatitis – a preliminary report

目的：探討喜瑞樂（omalizumab）對於異位性皮膚炎的療效。方法：針對在西元2012年至2015年間於台北榮民總醫院使用過omalizumab的12位嚴重型異位性皮膚炎病患進行回溯性分析。結果：12位嚴重型異位性皮膚炎的患者，因傳統治療無效。在接受三個月omalizumab治療後（150毫克或300毫克／月），其異位性皮膚炎嚴重度評分表（SCORAD）及皮膚學生活品質指數（DLQI）降幅分別為64.9 ± 12.3 至 38.9 ± 8.4（p < 0.001）和 21.9 ± 4.47 至 13.0 ± 4.5（p < 0.001）。且SCORAD分數越高者（> 60），其降幅程度比較低者（≤ 60）有顯著意義（32.8 ± 8.1% vs. 16.5 ± 10.4%, p = 0.010）。病患不論是否有使用針劑類固醇，其SCORAD及DLQI的降幅程度並未達到統計意義（SCORAD, p = 0.310; DLQI, p = 0.937）。結論：初步看起來Omalizumab似乎針對反覆性異位性皮膚炎具有療效，但還需要更多臨床研究來佐證。

Objectives: Given that the effect of omalizumab in atopic dermatitis (AD) is controversial, the aim of this study was to evaluate its efficacy. Methods: We retrospectively reviewed the medical records of twelve patients with severe refractory AD who had received either dose of 150 or 300mg omalizumab therapy between 2012 and 2015. Scoring atopic dermatitis (SCORAD) and dermatology life quality index (DLQI) scores were evaluated before and 3 months after omalizumab therapy. Results: All our 12 patients had severe refractory AD (SCORAD > 40). The SCORAD and DLQI scores after 3 months of omalizumab therapy were from 64.9 ± 12.3 to 38.9 ± 8.4 (p < 0.001), and 21.9 ± 3.3 to 13.0 ± 4.5 (p < 0.001) respectively. There was no statistically significant difference in the values of SCORAD and DLQI between patients treated with 150mg and 300mg omalizumab (SCORAD, p = 0.485; DLQI, p = 0.818). The reduction of SCORAD by omalizumab was significantly greater in AD patients with a very high SCORAD score (SCORAD > 60) compared to those with a low SCORAD score (32.8 ± 8.1% vs. 16.5 ± 10.4%, p = 0.010). In addition, the degree of reduction of SCORAD or DLQI did not achieve significant difference between patients with or without received systemic glucocorticoid (SCORAD, p = 0.310; DLQI, p = 0.937). Conclusion: Omalizumab may be an effective therapy for AD patients, but further studies are needed to substantiate our findings.