Bowman Paul H, Maloney Jack E, Koo John Y M
Department of Dermatology, University of California at San Francisco, 94118, USA.
J Am Acad Dermatol. 2002 Jun;46(6):907-13. doi: 10.1067/mjd.2002.120453.
Both calcipotriene and tazarotene have been shown to be effective in the treatment of psoriasis. No study has evaluated the effect of using both agents simultaneously.
Our purpose was to evaluate the effectiveness of combination treatment of psoriasis with calcipotriene ointment and tazarotene gel by comparing them with clobetasol ointment, a class I topical corticosteroid. A secondary objective was to evaluate the clinical compatibility of applying both agents at the same time.
This pilot study was a prospective, single-center, open-label, right/left comparison of 28 lesion pairs in 15 patients. It consisted of a 2-week treatment phase, followed by a 4-week post-treatment observation phase.
All 15 patients completed the treatment phase of the study. At the end of the active treatment phase (end of week 2), calcipotriene- and tazarotene-treated lesions showed nearly identical reductions in scaling (P =.93), plaque elevation (P =.76), and overall lesional severity scores (P =.29) compared with their matched clobetasol-treated counterparts. Erythema improved significantly more in clobetasol-treated lesions (P <.05) during the treatment period, but differences became statistically insignificant during the post-treatment period (;P =.20). No patients had significant irritation from the treatments. During the post-treatment phase (weeks 3-6), all lesions worsened; plaque elevation returned somewhat more rapidly in calcipotriene- and tazarotene-treated lesions (P <.01), whereas changes in scaling, erythema, and overall lesional severity were not significantly different between the two treatment groups (P >.05).
The nonsteroid combination of twice-daily calcipotriene ointment and once-daily tazarotene gel was not statistically different from twice-daily application of the class I corticosteroid clobetasol ointment in reducing psoriatic scaling, plaque elevation, and overall lesional severity over a 2-week period. There does not seem to be any chemical incompatibility between calcipotriene ointment and tazarotene gel that is clinically significant.
已证明卡泊三烯和他扎罗汀在治疗银屑病方面均有效。尚无研究评估同时使用这两种药物的效果。
我们的目的是通过将卡泊三烯软膏和他扎罗汀凝胶联合治疗银屑病的效果与I类外用皮质类固醇氯倍他索软膏进行比较，来评估其有效性。次要目的是评估同时应用这两种药物的临床相容性。
这项初步研究是一项前瞻性、单中心、开放标签、对15例患者的28对皮损进行左右比较的研究。它包括一个为期2周的治疗阶段，随后是一个为期4周的治疗后观察阶段。
所有15例患者均完成了研究的治疗阶段。在积极治疗阶段结束时（第2周结束时），与匹配的氯倍他索治疗的皮损相比，卡泊三烯和他扎罗汀治疗的皮损在鳞屑减少（P = 0.93）、斑块隆起（P = 0.76）和整体皮损严重程度评分（P = 0.29）方面显示出几乎相同的降低。在治疗期间，氯倍他索治疗的皮损红斑改善更显著（P < 0.05），但在治疗后期间差异无统计学意义（P = 0.20）。没有患者因治疗出现明显刺激。在治疗后阶段（第3 - 6周），所有皮损均加重；卡泊三烯和他扎罗汀治疗的皮损斑块隆起恢复得稍快一些（P < 0.01），而鳞屑、红斑和整体皮损严重程度的变化在两个治疗组之间无显著差异（P > 0.05）。
在为期2周的时间内，每日两次的卡泊三烯软膏和每日一次的他扎罗汀凝胶的非类固醇联合治疗在减少银屑病鳞屑、斑块隆起和整体皮损严重程度方面与每日两次应用I类皮质类固醇氯倍他索软膏在统计学上无差异。卡泊三烯软膏和他扎罗汀凝胶之间似乎不存在任何具有临床意义的化学不相容性。
