维罗纳大学Prof. Paolo Gisondi在本次访谈中分享了他在银屑病研究与管理方面的深刻见解。
他首先介绍了由欧盟资助的国际项目DoCTIS，该项目通过单细胞RNA测序技术，探索影响患者对生物制剂治疗反应的遗传变异因素。这一研究不仅涵盖银屑病，还包括类风湿关节炎、银屑病关节炎和炎症性肠病等多种免疫介导疾病，旨在为精准医疗提供新的科学依据。
在银屑病共病管理方面，Prof. Gisondi强调了问题的严重性：脂肪肝影响约50%的患者，银屑病关节炎影响高达三分之一患者。这些代谢性共病是心血管危险因素，显著增加了患者的死亡风险。他呼吁皮肤科医生与全科医生共同干预，通过推动生活方式改变（如肥胖患者减重）来改善患者整体健康状况，这同时对系统治疗（包括生物制剂）的反应也有积极影响。
针对当前未满足的临床需求，Prof. Gisondi指出，确保患者能够及早、持续地获得有效且安全的治疗是核心挑战。他强调了缩短中重度患者获得系统治疗时间的重要性，因为早期干预不仅能改善治疗反应，还可能改变疾病进程。生物类似药因其成本优势有助于提高治疗可及性的可持续性，但仍需开发具有不同作用机制和安全性的新药来满足重症及共病患者的需求。同时，无需冷链储存、使用更方便的新型口服疗法也展现出良好的应用前景，为银屑病治疗格局带来了新的希望。
In this interview, Professor Paolo Gisondi from the University of Verona shares profound insights into psoriasis research and management.
He first introduces the EU-funded international DoCTIS project. Utilizing single-cell RNA sequencing, this project investigates genetic variants influencing patient response to biologic therapies. The research extends beyond psoriasis to include various immune-mediated diseases like rheumatoid arthritis, psoriatic arthritis, and inflammatory bowel disease, aiming to provide new scientific foundations for precision medicine.
Regarding comorbidity management, Prof. Gisondi highlights the severity of the issue: fatty liver affects approximately 50% of patients, and psoriatic arthritis affects up to one-third. These metabolic comorbidities are cardiovascular risk factors, significantly increasing patient mortality risk. He advocates for collaborative intervention by dermatologists and general practitioners, promoting lifestyle changes (e.g., weight reduction in obese patients) to improve overall patient health, which also positively impacts response to systemic treatments, including biologics.
Addressing current unmet clinical needs, Prof. Gisondi identifies ensuring timely, continuous access to effective and safe therapies as the core challenge. He emphasizes the importance of shortening the time for patients with moderate-to-severe psoriasis to receive systemic treatment, as early intervention not only improves treatment response but may also alter the disease course. Biosimilars, with their cost advantages, aid the sustainability of treatment access; however, new drugs with different mechanisms of action and safety profiles are still needed for severe cases and patients with comorbidities. Concurrently, new oral therapies, which require no cold chain and offer greater convenience, show promising efficacy and safety, bringing new hope to the psoriasis treatment landscape.
