Siadat Amir Hossein, Iraji Fariba, Khodadadi Mehdi, Jary Maryam Kalateh
Department of Dermatology and Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Science, Isfahan, Iran.
Adv Biomed Res. 2013 Nov 30;2:90. doi: 10.4103/2277-9175.122520. eCollection 2013.
Current treatment strategies of psoriasis are not completely satisfactorily. By inhibiting inflammatory cytokines, nicotinamide may enhance the effects of current topical treatments. We investigated whether the combination of topical calcipotriol and nicotinamide is more effective than calcipotriol alone in treatment of psoriasis.
Adult patients with mild to moderate psoriasis were randomized to receive topical calcipotriol 0.005% and nicotinamide 4% in combination or calcipotriol 0.005% alone, twice daily for 12 weeks. Patients were visited by a dermatologist at baseline and then after the first and third month of therapy, and psoriasis severity was evaluated using the modified psoriasis area and severity index (PASI). Also, patient's satisfaction was evaluated at the end of the trial using a 10-point rating scale.
Sixty-five patients (35 males, mean age = 36.5 ± 8.5 years) completed the trial. Lesions on both sides were similar regarding baseline PASI score. At the end of the trial, PASI score was more reduced with calcipotriol+nicotinamide compared to calcipotriol alone (83.6 ± 7.9% vs. 77.8 ± 9.7%, P < 0.001). Patients were also more satisfied with the improvement of lesions with calcipotriol+nicotinamide compared with calcipotriol alone (P < 0.001). Side effects included mild erythema and pruritus (4.6%) and moderate burning and sensitivity to light (3.0%).
Nicotinamide can enhance the efficacy of calcipotriol when used in combination for topical psoriasis treatment, and it may be a good adjuvant to the current treatment regimens of psoriasis.
目前银屑病的治疗策略并不完全令人满意。通过抑制炎性细胞因子，烟酰胺可能会增强当前局部治疗的效果。我们研究了局部用卡泊三醇和烟酰胺联合使用是否比单独使用卡泊三醇治疗银屑病更有效。
将成年轻至中度银屑病患者随机分为两组，一组接受0.005%卡泊三醇和4%烟酰胺联合治疗，另一组仅接受0.005%卡泊三醇治疗，均每日两次，持续12周。皮肤科医生在基线时以及治疗的第一个月和第三个月后对患者进行访视，并使用改良的银屑病面积和严重程度指数（PASI）评估银屑病严重程度。此外，在试验结束时使用10分制评分量表评估患者满意度。
65例患者（35例男性，平均年龄 = 36.5 ± 8.5岁）完成了试验。两侧皮损的基线PASI评分相似。试验结束时，与单独使用卡泊三醇相比，卡泊三醇 + 烟酰胺组的PASI评分降低更多（83.6 ± 7.9%对77.8 ± 9.7%，P < 0.001）。与单独使用卡泊三醇相比，患者对卡泊三醇 + 烟酰胺联合治疗后皮损改善的满意度也更高（P < 0.001）。副作用包括轻度红斑和瘙痒（4.6%）以及中度烧灼感和对光敏感（3.0%）。
烟酰胺与卡泊三醇联合用于局部治疗银屑病时可增强疗效，可能是当前银屑病治疗方案的良好辅助药物。
