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1%吡美莫司乳膏与一种外用医疗器械乳膏治疗特应性皮炎患者的双侧对照研究。

A bilateral comparison study of pimecrolimus cream 1% and a topical medical device cream in the treatment of patients with atopic dermatitis.

作者信息

Emer Jason J, Frankel Amylynne, Sohn Andrew, Lebwohl Mark

机构信息

Mount Sinai School of Medicine, Department of Dermatology, New York, NY 10029, USA.

出版信息

J Drugs Dermatol. 2011 Jul;10(7):735-43.

Abstract

Corticosteroids are the mainstay of therapy for atopic dermatitis, but long-term use is associated with adverse effects. We sought to evaluate the clinical efficacy of two steroid-sparing creams for atopic dermatitis. Twenty patients were enrolled in an investigator-blinded, bilateral comparison study. Patients applied pimecrolimus cream twice daily to a target lesion on one side of the body and also applied a topical medical device cream three times daily on a symmetrical target lesion on the opposite side of the body for four weeks. Clinical assessments including Physician Global Assessment (PGA), Target Lesion Symptom Score (TLSS), subject self-assessment and digital photography were performed at the baseline, 2 week, and 4 week visits. Seventy-five percent of patients (pimecrolimus, 15 of 20; topical medical device, 15 of 20) were rated "clear" (0) or "almost clear" (1) by PGA for both medications after four weeks. Percent improvement of the PGA from randomization for pimecrolimus cream and the topical medical device cream were 72.50 and 71.67 respectively (P=0.9283). PGA scores decreased significantly from baseline for both treatments (P=0.004). Overall, there was no statistically significant difference between treatment groups for PGA scores throughout the study (P=0.8236). No cutaneous side effects were noted. Our study was limited by a small sample size and lack of double-blinding; however, both treatments were found to be safe and effective in treating atopic dermatitis over four weeks. Significant improvements were noted for all efficacy variables. In conclusion, a lipid-rich, non-steroidal, topical medical device cream was as effective in improving atopic dermatitis as pimecrolimus cream.

摘要

皮质类固醇是特应性皮炎治疗的主要药物,但长期使用会产生不良反应。我们旨在评估两种治疗特应性皮炎的类固醇替代乳膏的临床疗效。20名患者参与了一项研究者设盲的双侧对照研究。患者每天两次将吡美莫司乳膏涂抹于身体一侧的目标皮损上,同时每天三次将一种外用医疗器械乳膏涂抹于身体另一侧对称的目标皮损上,持续四周。在基线、第2周和第4周就诊时进行了包括医生整体评估(PGA)、目标皮损症状评分(TLSS)、受试者自我评估和数码摄影在内的临床评估。四周后,两种药物在PGA评估中,75%的患者(吡美莫司组20例中的15例;外用医疗器械组20例中的15例)被评为“清除”(0)或“几乎清除”(1)。吡美莫司乳膏和外用医疗器械乳膏从随机分组至研究结束时PGA的改善百分比分别为72.50和71.67(P = 0.9283)。两种治疗方法的PGA评分均较基线显著降低(P = 0.004)。总体而言,在整个研究过程中,治疗组之间的PGA评分无统计学显著差异(P = 0.8236)。未观察到皮肤副作用。我们的研究受样本量小和缺乏双盲的限制;然而,发现两种治疗方法在四周内治疗特应性皮炎均安全有效。所有疗效变量均有显著改善。总之,一种富含脂质的非甾体外用医疗器械乳膏在改善特应性皮炎方面与吡美莫司乳膏一样有效。

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