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0.05% 地奈德水凝胶对中重度特应性皮炎患儿下丘脑 - 垂体 - 肾上腺轴的影响。

Effect of desonide hydrogel 0.05% on the hypothalamic-pituitary-adrenal axis in pediatric subjects with moderate to severe atopic dermatitis.

作者信息

Eichenfield Lawrence F, Basu Sarmistha, Calvarese Barry, Trancik Ronald J

机构信息

Rady Children's Hospital, School of Medicine, University of California, San Diego, California, USA.

出版信息

Pediatr Dermatol. 2007 May-Jun;24(3):289-95. doi: 10.1111/j.1525-1470.2007.00405.x.

Abstract

Desonide, a low potency corticosteroid, has been used widely as a topical treatment for inflammatory dermatoses for over 30 years. A recent formulation advance has enabled the development of desonide 0.05% into a novel moisturizing aqueous gel (hydrogel) that is free of alcohol and surfactants. This multicenter, open-label study evaluated the hypothalamic-pituitary-adrenal axis suppression potential, tolerability, and efficacy of this new Class VI topical steroid formulation in pediatric subjects with moderate-to-severe atopic dermatitis (mean body surface area = 51%). Forty children, aged 6 months to 6 years were enrolled and treated twice daily for 4 weeks. Desonide hydrogel 0.05% was well tolerated and no treatment-related adverse events were reported. No suppression of adrenal function was observed in subjects who completed the study without protocol violations related to cosyntropin administration or cortisol testing (n=34). Of the subjects who completed the study with complications in cortisol testing (n=3), there was one subject (1/37=3%) who had a low poststimulation cortisol level at week 4. Efficacy was demonstrated by marked improvement in overall disease state and in the signs and symptoms of atopic dermatitis. This study validates the systemic safety of a novel desonide hydrogel formulation in young pediatric patients and confirms the longstanding tolerability and efficacy profile of desonide.

摘要

地奈德是一种低效皮质类固醇,30多年来一直被广泛用作炎症性皮肤病的局部治疗药物。最近的配方改进使0.05%的地奈德能够开发成一种新型保湿水凝胶(水凝胶),不含酒精和表面活性剂。这项多中心、开放标签研究评估了这种新型VI类局部类固醇制剂对中度至重度特应性皮炎(平均体表面积 = 51%)儿科患者下丘脑-垂体-肾上腺轴抑制潜力、耐受性和疗效。40名年龄在6个月至6岁的儿童入组,每天治疗两次,共4周。0.05%地奈德水凝胶耐受性良好,未报告与治疗相关的不良事件。在未出现与促肾上腺皮质激素给药或皮质醇检测相关方案违规的情况下完成研究的受试者中(n = 34),未观察到肾上腺功能受到抑制。在皮质醇检测出现并发症的情况下完成研究的受试者中(n = 3),有一名受试者(1/37 = 3%)在第4周刺激后皮质醇水平较低。总体疾病状态以及特应性皮炎的体征和症状有显著改善,证明了疗效。这项研究验证了新型地奈德水凝胶制剂在小儿患者中的全身安全性,并证实了地奈德长期以来的耐受性和疗效。

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