Haw Sik, Shin Min-Kyung, Haw Choong-Rim
Department of Dermatology, School of Medicine, Kyung Hee University, Seoul, Korea.
Ann Dermatol. 2010 Feb;22(1):9-15. doi: 10.5021/ad.2010.22.1.9. Epub 2010 Feb 28.
Steroids are used in conventional treatment of atopic dermatitis (AD) and they are very effective for improving the symptoms, but they also have several complications. Many studies have reported that short-term use of cyclosporine (CsA) is effective for severe AD as a substitute for steroid. However, there are very few studies on the long-term use of CsA for AD in the Korean population.
The purpose of this study was to investigate whether long-term CsA therapy is effective and safe for treating AD.
We performed a retrospective study of the patients with AD and who were treated with CsA at Kyung Hee Medical Center between January 2001 and February 2008. Among 147 patients, 61 received CsA treatment for more than 6 months. To evaluate the efficacy of CsA treatment, the objective SCORAD was checked for all 61 patients at every visit. Extensive laboratory tests were performed every two months to assess the safety of treatment.
The mean duration of CsA treatment was 13.5+/-8.4 months and the mean initial dose of CsA was 2.7+/-0.9 mg/kg/day. The mean objective SCORAD values significantly decreased from 34.1+/-11.2 at baseline to 11.4+/-10.7 after 6-month of CsA treatment (p<0.05). A significant decline of the SCORAD score was observed starting from 1-month of CsA treatment. The mean duration of remission was 4.5+/-2.9 months. A total of 13 adverse events in 10 patients were recorded during the study period. One patient dropped out due to renal dysfunction. Elevation of peripheral blood pressure was noted in 8 patients. Three patients complained of gastrointestinal troubles, and one patient had hypertrichosis, but the problems of these 4 patients were mild and easily treated.
We suggest that long-term, low-dose CsA treatment is safe and effective for patients who suffer from AD.
类固醇用于特应性皮炎（AD）的传统治疗，对改善症状非常有效，但也有一些并发症。许多研究报告称，短期使用环孢素（CsA）作为类固醇的替代品对重度AD有效。然而，关于韩国人群长期使用CsA治疗AD的研究非常少。
本研究的目的是调查长期CsA治疗对AD的治疗是否有效且安全。
我们对2001年1月至2008年2月在庆熙医疗中心接受CsA治疗的AD患者进行了一项回顾性研究。在147例患者中，61例接受CsA治疗超过6个月。为了评估CsA治疗的疗效，每次就诊时对所有61例患者检查客观SCORAD。每两个月进行一次全面的实验室检查以评估治疗的安全性。
CsA治疗的平均持续时间为13.5±8.4个月，CsA的平均初始剂量为2.7±0.9mg/kg/天。客观SCORAD平均值从基线时的34.1±11.2显著降至CsA治疗6个月后的11.4±10.7（p<0.05）。从CsA治疗1个月开始观察到SCORAD评分显著下降。缓解的平均持续时间为4.5±2.9个月。在研究期间共记录了10例患者的13起不良事件。1例患者因肾功能不全退出。8例患者外周血压升高。3例患者主诉胃肠道问题，1例患者有多毛症，但这4例患者的问题较轻且易于治疗。
我们建议长期、低剂量CsA治疗对患有AD的患者是安全有效的。
