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低剂量环孢素改善了对局部皮质类固醇单一疗法不满意的日本银屑病患者的健康相关生活质量。

Low-dose cyclosporin improves the health-related quality of life in Japanese psoriasis patients dissatisfied with topical corticosteroid monotherapy.

机构信息

Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, 67 Asahimachi, Fukuoka, Japan.

出版信息

Australas J Dermatol. 2012 Aug;53(3):202-6. doi: 10.1111/j.1440-0960.2011.00870.x. Epub 2012 Feb 23.

Abstract

Psoriasis greatly impacts the health-related quality of life of patients, including any dermatological conditions that are listed in the dermatology life quality index (DLQI). We investigated the relationships between DLQI and the degree of patient satisfaction using questionnaires among psoriasis patients treated only with topical corticosteroids. Patients who were dissatisfied with topical corticosteroids alone and agreed to receive cyclosporin were given low-dose oral cyclosporin. We assessed changes of the DLQI and the psoriasis area and severity index (PASI) scores in patients dissatisfied with treatment during the period of cyclosporin addition. Of 32 enrolled patients, 17 reported dissatisfaction with the current treatment of topical corticosteroids alone. There was a significantly positive correlation between the degree of patient satisfaction questionnaires and the DLQI of these 32 patients. Among the 17 dissatisfied patients, 12 patients agreed to receive additional cyclosporin therapy and five did not. The 12 patients who started on cyclosporin had a significantly lower PASI after 12 weeks than they did at baseline. The DLQI improved significantly after 12 weeks in the cyclosporin-treated patients. The 12 patients who agreed to receive cyclosporin showed a significantly lower DLQI at 12 weeks compared to the five patients who declined the addition of cyclosporin to their treatment. Assessing the degree of patient satisfaction with therapy using a questionnaire could be useful for improving clinical interventions in psoriasis patients. Low-dose oral cyclosporin could be effective in patients who are dissatisfied with topical corticosteroid treatment alone.

摘要

银屑病极大地影响了患者的健康相关生活质量,包括皮肤病生活质量指数(DLQI)中列出的任何皮肤病状况。我们调查了仅使用外用皮质类固醇治疗的银屑病患者中,DLQI 与患者满意度之间的关系,这些患者对单独使用外用皮质类固醇不满意,并同意接受环孢素治疗。我们评估了在添加环孢素期间,对治疗不满意的患者 DLQI 和银屑病面积和严重程度指数(PASI)评分的变化。在 32 名入组的患者中,有 17 名报告对单独使用外用皮质类固醇的当前治疗不满意。这 32 名患者的患者满意度问卷评分与 DLQI 呈显著正相关。在 17 名不满意的患者中,有 12 名患者同意接受额外的环孢素治疗,有 5 名不同意。开始使用环孢素的 12 名患者在 12 周后的 PASI 明显低于基线。接受环孢素治疗的患者在 12 周后 DLQI 显著改善。与拒绝将环孢素添加到治疗中的 5 名患者相比,同意接受环孢素治疗的 12 名患者在 12 周时 DLQI 明显较低。使用问卷评估患者对治疗的满意度可能有助于改善银屑病患者的临床干预措施。对于仅对外用皮质类固醇治疗不满意的患者,低剂量口服环孢素可能有效。

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