Winter and spring alternate, warm and cold, allergens increase; During the festival, the daily routine and eating rules are disrupted; After the holiday, work pressure increases and mood swings ......These can lead to or worsen the condition of people with psoriasis**. Psoriasis is also known as "psoriasis" by the common people, and it is a "long-standing problem" in medicine. Professor Zhang Jianzhong of the Department of Peking University People's Hospital said in an interview with the Beijing News a few days ago that innovative drugs have emerged one after another around the world, from topical drugs to biological agents and oral small molecule targeted drugs, the history of "external non-cure" has changed, and psoriasis has entered the "precision era".
More than half of people with psoriasis are severely ill.
Psoriasis is not a simple ** disease, but a systemic, immune-mediated, inflammatory disease that affects the whole body. According to Professor Zhang Jianzhong, there are 6.5 million to 7 million psoriasis patients in China, most of whom are psoriasis vulgaris, and more than half of them are seriously ill, and the problem cannot be solved by external ointment alone. In addition, there are some special types of psoriasis such as acute generalized pustular psoriasis, erythrodermic psoriasis, articular psoriasis, etc., which are more serious.
Psoriasis has a great impact on the quality of life, not only the rash, itching, pain, but also the disability that can lead to some special types of psoriasis, such as generalized pustular psoriasis, can even be life-threatening. Professor Zhang Jianzhong pointed out that 10%-20% of psoriasis patients often have other diseases, the most common is arthritis, and it is disruptive arthritis, which can cause deformity and loss of labor.
In terms of age of onset, psoriasis can occur at any age, with about 2 3 patients developing before the age of 40 and 1 3 patients developing after the age of 40.
In terms of **, Zhang Jianzhong emphasized the ladder**, small treatment of minor diseases, medium treatment of medium diseases, and major treatment of major diseases". Clinically, the first means of psoriasis include external drugs, physics, and systems (including traditional oral drugs, biological agents, small molecule targeted drugs, etc.). When psoriasis seriously affects the quality of life of patients, it is necessary to start the system in time**, and select appropriate drugs according to the patient's condition, medication habits, medication reactions, etc.
Psoriasis** has entered the "era of precision".
With the emergence of innovative drugs such as biologics and small molecule oral targeted drugs, psoriasis** has entered the "precision era". In terms of drug development, Professor Zhang Jianzhong introduced that as an immune-mediated inflammatory disease, psoriasis will cause many immune cells in the patient's body to be activated, and these cells secrete many kinds of cytokines, leading to inflammation. At present, it is relatively clear that interleukin 17 (IL-17) and interleukin-23 (IL-23) are developed around these two targets. In addition, there is a third pathway, the tumor necrosis factor-pathway.
Professor Zhang Jianzhong introduced that in targeting, biological agents are administered by injection, and the corresponding cytokine pathway is blocked after entering the body. There is also a small molecule targeted drug such as TYK2 (tyrosine kinase 2) allosteric inhibitors, etc., which are administered orally and can block multiple inflammatory pathways.
Three, one-to-five precise role.
After the biologics are marketed, some problems are solved, and some new problems are also discovered, such as secondary failure, and some patients are reluctant to take injections. The advent of small molecule oral targeted drugs will provide more options. "New options are available for patients with needle sickness, blood sickness, or secondary failure after biologics**.
With so many good medicines, psoriasis has changed from an unavoidable disease to a disease that can be 'clinical', which is the earth-shaking change brought by the progress of medical science to psoriasis. Professor Zhang Jianzhong said.
Beijing News reporter Wang Kara.
Proofreading by Liu Baoqing.