鉴于批准用于治疗银屑病 (PsO) 和银屑病关节炎 (PsA) 的疗法数量不断增加，头对头 (H2H) 比较研究至关重要。这些主要目的是对治疗效果进行比较分析。 H2H 研究表明，在 PsO 和 PsA 中，生物疾病缓解抗风湿药物 (bDMARD) 均优于传统疗法。在 PsO 中，多项研究证明白细胞介素 17 (IL-17) 和 IL-23 抑制剂比肿瘤坏死因子 (TNF) 抑制剂（依那西普和阿达木单抗）具有优越性。 Ustekinumab 比依那西普更有效，但不如 IL-17 和 IL-23 抑制剂有效。关于 PsA 治疗的 H2H 研究仅发表了几项。在 Spirit H2H 研究中，使用关节炎和银屑病反应的联合终点（ACR-50 和 PASI-100），ixekizumab 优于阿达木单抗。仅考虑关节炎症状时 (ACR-20)，EXCEED 研究中苏金单抗并不显着优于阿达木单抗，但在对皮肤受累的影响方面优于阿达木单抗 (PASI90)。其他 H2H 研究重点关注附着点炎的治疗（ECLIPSA 研究）、Janus 激酶 (JAK) 抑制 (SELECT-PSA-1) 的疗效或在 bDMARD 治疗中额外施用甲氨蝶呤（MUST 研究）。 H2H 数据已纳入治疗指南，并导致在 PsA 相关皮肤受累的情况下，IL-17 和 IL-23 抑制优于 TNF 抑制。© 2024。作者获得 Springer 独家许可Medizin Verlag GmbH，施普林格自然出版社。

Given the ever-increasing number of approved therapies for the treatment of psoriasis (PsO) and psoriatic arthritis (PsA), head-to-head (H2H) comparative studies are essential. These are aimed primarily at a comparative analysis of treatment effectiveness. In both PsO and PsA, biological disease-modifying antirheumatic drugs (bDMARD) have been shown to be superior to conventional therapies in H2H studies. In PsO interleukin 17 (IL-17) and IL-23 inhibitors proved superiority compared to tumor necrosis factor (TNF) inhibitors (etanercept and adalimumab) in several studies. Ustekinumab was more effective than etanercept, but less effective than IL-17 and IL-23 inhibitors. Only a few H2H studies have been published on the treatment of PsA. In the Spirit H2H study ixekizumab was superior to adalimumab using a combined endpoint of arthritis and psoriasis response (ACR-50 and PASI-100). When looking at arthritic symptoms only (ACR-20), secukinumab was not significantly superior to adalimumab in the EXCEED study but was superior in terms of the effect on skin involvement (PASI90). Other H2H studies focused on the treatment of enthesitis (ECLIPSA study), the efficacy of Janus kinase (JAK) inhibition (SELECT-PSA-1) or the additional administration of methotrexate to bDMARD treatment (MUST study). The H2H data have been incorporated into the treatment guidelines and have led to IL-17 and IL-23 inhibition being preferred over TNF inhibition in cases of relevant skin involvement in PsA.© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.