中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (7): 542-548.doi: 10.12144/zgmfskin202607542

• 综述 • 上一篇    

银屑病关节炎治疗进展

李慧杰1,2,刘崇远1,2,杨青1,2   

  1. 1山东第一医科大学附属皮肤病医院，山东济南，250022; 2山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2026-07-15 发布日期:2026-06-29

Advances in the treatment of psoriatic arthritis

LI Huijie1,2, LIU Chongyuan1,2, YANG Qing1,2   

  1. 1 Dermatology Hospital of Shandong First Medical University, Jinan 250022, China; 2 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2026-07-15 Published:2026-06-29

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摘要： 近年来，随着对银屑病关节炎(psoriatic arthritis, PsA)发病机制研究的不断深入，白细胞介素（interleukin, IL）-23/辅助T细胞(T-helper cell, Th)17轴在疾病发生发展中的核心作用被逐步明确，以此为基础的靶向治疗技术取得突破性进展。本综述系统总结了PsA的治疗进展，首先概述甲氨蝶呤和来氟米特等传统合成改善病情抗风湿药的临床应用现状，重点阐述TNF-α抑制剂、IL-12/23抑制剂、IL-17抑制剂及IL-23抑制剂等生物制剂的临床研究证据与疗效。此外，还讨论了靶向合成药物如Janus激酶抑制剂、磷酸二酯酶4抑制剂阿普米司特的应用现状，以及共刺激阻断、免疫检查点调节剂和维A酸相关孤核受体抑制剂等新型疗法的研发前景。

关键词: 银屑病关节炎, 生物制剂, Janus激酶抑制剂, 磷酸二酯酶4抑制剂

Abstract: In recent years, significant progress has been made in targeted therapies, driven by a deeper understanding of PsA pathophysiology, particularly the elucidation of the pivotal role of the IL-23/Th17 axis. This review systematically summarizes the therapeutic advances in PsA. It covers the applications and limitations of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), such as methotrexate and leflunomide. It focuses on the clinical evidence and efficacy of biologic agents, including tumor necrosis factor (TNF) inhibitors, interleukin (IL)-12/23 inhibitors, IL-17 antagonists, and IL-23 inhibitors. Furthermore, it discusses the current status of targeted synthetic DMARDs (tsDMARDs), such as Janus kinase (JAK) inhibitors and the phosphodiesterase 4 inhibitor apremilast, as well as the development prospects of novel therapies including costimulation blockers, immune checkpoint modulators, and RORγt inhibitors.

Key words: psoriatic arthritis, biologic agents, Janus kinase inhibitors, phosphodiesterase 4 inhibitor apremilast