Kapoor Roger, Hoffstad Ole, Bilker Warren, Margolis David J
Department of Dermatology, Massachusetts General Hospital, Harvard University School of Medicine, Boston, Massachusetts 02114, USA.
Pediatr Dermatol. 2009 Nov-Dec;26(6):682-7. doi: 10.1111/j.1525-1470.2009.01013.x.
Atopic dermatitis (AD) is often treated with multiple modalities, including topical medications such as corticosteroids and topical calcineurin inhibitors (TCIs). The aim of this study was to describe the natural history of the utilization characteristics of topical treatment in those with AD. We conducted a longitudinal study of the first 4,105 children with physician-confirmed mild to moderate AD enrolled in an ongoing postmarketing safety study of pimecrolimus. Information was obtained from participants every six months using a questionnaire. Drug utilization was solely determined by the physician and patient. Over the three years of our study, an increasing number of individuals reported at least 6 months of complete control of their disease, without the continued use of a topical medication. While all study participants used pimecrolimus at the start of the study less than 40% continued to use it after 3 years of study participation. If an individual was still using a topical medication after three years of follow-up, it was most likely a topical corticosteroid. For those who continued to use pimecrolimus, the use was limited to about 60 grams of pimecrolimus in 6 months. Community-based use of topical pimecrolimus to treat AD is limited both with respect to the duration of exposure and amount or total dose of the exposure. If a topical therapy is persistent, it is most likely to a topical corticosteroid.
特应性皮炎(AD)通常采用多种治疗方式,包括外用药物,如皮质类固醇和外用钙调神经磷酸酶抑制剂(TCIs)。本研究的目的是描述AD患者外用治疗使用特征的自然病程。我们对纳入正在进行的吡美莫司上市后安全性研究的首批4105例经医生确诊为轻度至中度AD的儿童进行了纵向研究。每六个月通过问卷调查从参与者那里获取信息。药物使用完全由医生和患者决定。在我们研究的三年中,越来越多的人报告其疾病至少有6个月得到完全控制,且无需持续使用外用药物。虽然所有研究参与者在研究开始时都使用了吡美莫司,但在参与研究三年后,继续使用该药的人不到40%。如果个体在随访三年后仍在使用外用药物,最有可能是外用皮质类固醇。对于那些继续使用吡美莫司的人,其使用量在6个月内限制在约60克吡美莫司。在社区中,外用吡美莫司治疗AD在暴露持续时间以及暴露量或总剂量方面都是有限的。如果一种外用疗法持续使用,最有可能是外用皮质类固醇。