Gooderham M, Debarre J-M, Keddy-Grant J, Xu Z, Kurvits M, Goodfield M
SKiN Centre for Dermatology, 743 Lansdowne Street West, Peterborough, ON, Canada, K9J 1Z.
Br J Dermatol. 2014 Dec;171(6):1470-7. doi: 10.1111/bjd.13235. Epub 2014 Oct 22.
Plaque psoriasis has a relatively high prevalence in adolescence, resulting in a significant impact on quality of life, including social interactions.
The primary objective was to assess the safety of once-daily application of fixed-combination calcipotriol plus betamethasone dipropionate gel in adolescent scalp psoriasis. Assessment of efficacy was a secondary objective.
This phase II, multicentre, single-arm, open-label, 8-week trial included patients aged 12-17 years with moderate-to-very severe scalp psoriasis according to Investigator's Global Assessment (IGA) (≥ 10% of the scalp area affected).
Seventy-eight patients received treatment. Twenty-seven patients (35%) reported a total of 64 adverse events (AEs); most were mild (33/64) or moderate (22/64) in severity and there were no serious AEs. No cases of hypercalcaemia were reported, and the mean changes from baseline to end of treatment in albumin-corrected serum calcium (0·00 mmol L(-1)), 24-h urinary calcium excretion (-0·03 mmol per 24 h) and urinary calcium-to-creatinine ratio (-0·12 mmol g(-1)) were not considered clinically relevant. At the end of treatment 66 patients (85%) were clear or almost clear according to IGA. There was an 80% improvement in mean Total Sign Score from baseline to end of treatment. In total, at the end of treatment, 87% of patients rated their scalp psoriasis as clear or very mild, and 75 (96%) had no or mild pruritus compared with 14 (18%) at baseline.
Once-daily calcipotriol plus betamethasone dipropionate gel is well tolerated and efficacious for scalp psoriasis in adolescents.
斑块状银屑病在青少年中的患病率相对较高,对包括社交互动在内的生活质量产生重大影响。
主要目的是评估每日一次外用卡泊三醇倍他米松二丙酸酯固定复方凝胶治疗青少年头皮银屑病的安全性。疗效评估为次要目的。
这项II期、多中心、单臂、开放标签、为期8周的试验纳入了年龄在12 - 17岁、根据研究者整体评估(IGA)为中度至重度头皮银屑病(头皮受累面积≥10%)的患者。
78例患者接受了治疗。27例患者(35%)共报告了64例不良事件(AE);大多数为轻度(33/64)或中度(22/64),无严重不良事件。未报告高钙血症病例,从基线到治疗结束时白蛋白校正血清钙(0.00 mmol/L)、24小时尿钙排泄量(每24小时 - 0.03 mmol)和尿钙肌酐比值( - 0.12 mmol/g)的平均变化不被认为具有临床相关性。治疗结束时,根据IGA评估,66例患者(85%)病情清除或几乎清除。从基线到治疗结束时,总体征评分平均改善了80%。总体而言,治疗结束时,87%的患者将其头皮银屑病评为清除或非常轻度,75例(96%)患者无瘙痒或仅有轻度瘙痒,而基线时为14例(18%)。
每日一次外用卡泊三醇倍他米松二丙酸酯凝胶治疗青少年头皮银屑病耐受性良好且有效。