van de Kerkhof P C M, Hoffmann V, Anstey A, Barnes L, Bolduc C, Reich K, Saari S, Segaert S, Vaillant L
Department of Dermatology, University Hospital Nijmegen, Centrum St Radboud, Postbus 9101, 6525 GL Nijmegen, The Netherlands.
Br J Dermatol. 2009 Jan;160(1):170-6. doi: 10.1111/j.1365-2133.2008.08927.x. Epub 2008 Nov 25.
There is a need for new treatments for scalp psoriasis, as many topical treatments are cosmetically unacceptable and difficult to apply, resulting in poor compliance.
To compare the efficacy and safety of a new, once-daily, two-compound scalp formulation (Xamiol; LEO Pharma A/S, Ballerup, Denmark) containing calcipotriol 50 microg g(-1) plus betamethasone 0.5 mg g(-1) (as dipropionate), with the active ingredients as single compounds in the same vehicle.
This 8-week, multicentre, double-blind, parallel-group study, randomized adult patients with scalp psoriasis involving > 10% of the scalp to the two-compound scalp formulation (n = 568), betamethasone dipropionate 0.5 mg g(-1) (n = 563), or calcipotriol 50 microg g(-1) (n = 286). The primary efficacy measure was the proportion of patients with 'absence of disease' or 'very mild disease' according to investigators' assessments at week 8.
The proportion of patients with 'absence of disease' or 'very mild disease' at week 8 was significantly higher in the two-compound group (68.4%) than the betamethasone dipropionate (61.0%, P = 0.0079) or calcipotriol (43.4%, P < 0.0001) groups. The proportion of patients rating their scalp psoriasis as 'clear' or 'almost clear' was significantly higher for the two-compound scalp formulation (69.6%) than for betamethasone dipropionate (59.9%, P = 0.0006) or calcipotriol (44.7%, P < 0.0001). The incidence of lesional/perilesional adverse events was lower in the two-compound and betamethasone dipropionate groups than the calcipotriol group.
The two-compound scalp formulation was well tolerated and more effective in the treatment of scalp psoriasis than either of its individual components in the same vehicle.
由于许多局部治疗在外观上难以接受且难以应用,导致依从性差,因此需要新的头皮银屑病治疗方法。
比较一种新的每日一次的双组分头皮制剂(Xamiol;丹麦巴勒鲁普LEO制药公司)的疗效和安全性,该制剂含有50μg/g的卡泊三醇加0.5mg/g的倍他米松(作为二丙酸酯),其活性成分在同一载体中为单一化合物。
这项为期8周的多中心、双盲、平行组研究,将头皮银屑病累及头皮超过10%的成年患者随机分为双组分头皮制剂组(n = 568)、二丙酸倍他米松0.5mg/g组(n = 563)或卡泊三醇50μg/g组(n = 286)。主要疗效指标是根据研究者在第8周的评估,“无疾病”或“非常轻度疾病”患者的比例。
双组分组在第8周时“无疾病”或“非常轻度疾病”患者的比例(68.4%)显著高于二丙酸倍他米松组(61.0%,P = 0.0079)或卡泊三醇组(43.4%,P < 0.0001)。双组分头皮制剂将头皮银屑病评为“清除”或“几乎清除”的患者比例(69.6%)显著高于二丙酸倍他米松组(59.9%,P = 0.0006)或卡泊三醇组(44.7%,P < 0.0001)。双组分组和二丙酸倍他米松组皮损/皮损周围不良事件的发生率低于卡泊三醇组。
双组分头皮制剂耐受性良好,在治疗头皮银屑病方面比同一载体中的任何一种单一成分更有效。