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1.2%磷酸克林霉素/0.025%维甲酸制剂治疗寻常痤疮的疗效与安全性:三项随机、双盲、平行组III期研究数据的汇总分析

Efficacy and safety of clindamycin phosphate 1.2%/tretinoin 0.025% formulation for the treatment of acne vulgaris: pooled analysis of data from three randomised, double-blind, parallel-group, phase III studies.

作者信息

Dréno Brigitte, Bettoli Vincenzo, Ochsendorf Falk, Layton Alison M, Perez Montserrat, Dakovic Rada, Gollnick Harald

机构信息

Dept of Dermato-Cancerology, University of Nantes, Place Alexis Ricordeau, 44093, Nantes, France.

Dept of Medical Sciences, Section of Dermatology Azienda Ospedaliera Universitaria of Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.

出版信息

Eur J Dermatol. 2014 Mar-Apr;24(2):201-9. doi: 10.1684/ejd.2014.2293.

Abstract

BACKGROUND

The efficacy and safety of clindamycin phosphate 1.2%/tretinoin 0.025% (Clin-RA) were evaluated in three 12-week randomised studies.

OBJECTIVES

To perform a pooled analysis of data from these studies to evaluate Clin-RA's efficacy and safety in a larger overall population, in subgroups of adolescents and according to acne severity.

MATERIALS & METHODS: 4550 patients were randomised to Clin-RA, clindamycin, tretinoin and vehicle. Evaluations included percentage change in lesions, treatment success rate, proportions of patients with ≥50% or ≥80% continuous reduction in lesions, adverse events and cutaneous tolerability.

RESULTS

In the overall population, the percentage reduction in inflammatory, non-inflammatory and total lesions and the treatment success rate were significantly greater with Clin-RA compared with clindamycin, tretinoin and vehicle alone (all p<0.01). The percentage reduction in all types of lesions was also significantly greater with Clin-RA in the adolescent subgroup (2915 patients, p<0.002) and in patients with mild/moderate acne (3662 patients, p<0.02) versus comparators. In patients with severe acne (n = 880), the percentage reduction in all lesion types was significantly greater with Clin-RA versus vehicle (p<0.0001). A greater proportion of Clin-RA treated patients had a ≥50% or ≥80% continuous reduction in all types of lesions at week 12 compared with clindamycin, tretinoin and vehicle. Adverse event frequencies in the active and vehicle groups were similar. Baseline-adjusted mean tolerability scores over time were <1 (mild) and similar in all groups.

CONCLUSION

Clin-RA is safe, has superior efficacy to its component monotherapies and should be considered as one of the first-line therapies for mild-to-moderate facial acne.

摘要

背景

在三项为期12周的随机研究中评估了1.2%磷酸克林霉素/0.025%维甲酸(Clin-RA)的疗效和安全性。

目的

对这些研究的数据进行汇总分析,以评估Clin-RA在更大总体人群、青少年亚组以及根据痤疮严重程度的疗效和安全性。

材料与方法

4550名患者被随机分配至Clin-RA、克林霉素、维甲酸和赋形剂组。评估包括皮损变化百分比、治疗成功率、皮损持续减少≥50%或≥80%的患者比例、不良事件和皮肤耐受性。

结果

在总体人群中,与单独使用克林霉素、维甲酸和赋形剂相比,Clin-RA治疗的炎症性、非炎症性和总皮损减少百分比以及治疗成功率显著更高(所有p<0.01)。与对照药物相比,Clin-RA在青少年亚组(2915例患者,p<0.002)和轻度/中度痤疮患者(3662例患者,p<0.02)中所有类型皮损的减少百分比也显著更高。在重度痤疮患者(n = 880)中,与赋形剂相比,Clin-RA治疗的所有皮损类型减少百分比显著更高(p<0.0001)。与克林霉素、维甲酸和赋形剂相比,接受Clin-RA治疗的患者在第12周时更大比例的所有类型皮损持续减少≥50%或≥80%。活性药物组和赋形剂组的不良事件频率相似。随时间调整基线后的平均耐受性评分<1(轻度),且所有组相似。

结论

Clin-RA安全,其疗效优于其单一成分的单药治疗,应被视为轻度至中度面部痤疮的一线治疗方法之一。

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