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外用他卡西醇的临床疗效与安全性概况

Profile of clinical efficacy and safety of topical tacalcitol.

作者信息

Leone Giovanni, Pacifico Alessia

机构信息

Phototherapy Service, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.

出版信息

Acta Biomed. 2005 Apr;76(1):13-9.

Abstract

Several topical treatments such as ointments, keratolytics, dithranol, tar, corticosteroids and Vitamin D3 analogues are commonly used in the treatment of mild and/or moderate psoriasis. These treatments can be associated with a variety of local and systemic side effects, as well as to very often unsatisfactory results. The purpose of this critical review of the literature is to evaluate the efficacy and tolerability of the synthesis of new analogues of the Vitamin D3 Tacalcitol, which is formulated in ointment form at a concentration of 4 microg/g, for the treatment of mild and/or moderate psoriasis (involvement of <20% of the surface of the skin) and to evaluate whether this drug can be used in the treatment of other skin conditions. Based on existing data in the literature, Tacalcitol is an effective drug for the topical treatment of psoriasis and is also able to ensure that the effects last over time, even after treatment has stopped. Tacalcitol is also well tolerated because the onset of side effects, such as local irritation, pruriginous or burning sensations, were reported in only a small percentage of the subjects who were treated. Lastly, the marked regulatory effects it has on the proliferation and differentiation of keratinocytes, as well as on the immunocompetent cells, has led to suggestions that Tacalcitol may be used in other keratinisation disorders and in some hyperproliferative skin diseases. Evaluation of the effective indications to use in these conditions still requires further data confirming its effectiveness, opening the way to wider use of this molecule in dermatology.

摘要

几种局部治疗方法,如软膏、角质剥脱剂、地蒽酚、焦油、皮质类固醇和维生素D3类似物,常用于治疗轻度和/或中度银屑病。这些治疗方法可能会伴有各种局部和全身副作用,而且常常效果不尽人意。这篇文献综述的目的是评估维生素D3他卡西醇新类似物合成制剂(以软膏形式配制,浓度为4μg/g)治疗轻度和/或中度银屑病(皮肤受累面积<20%)的疗效和耐受性,并评估该药物是否可用于治疗其他皮肤疾病。根据文献中的现有数据,他卡西醇是一种有效的银屑病局部治疗药物,即使在治疗停止后,也能确保疗效持久。他卡西醇的耐受性也很好,因为只有一小部分接受治疗的受试者报告出现副作用,如局部刺激、瘙痒或烧灼感。最后,它对角质形成细胞的增殖和分化以及免疫活性细胞具有显著的调节作用,这使得有人提出他卡西醇可能用于其他角化异常疾病和一些增殖性皮肤病。评估在这些情况下的有效适应证仍需要进一步的数据来证实其有效性,从而为该分子在皮肤科的更广泛应用开辟道路。

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