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氨基葡萄糖与低剂量环孢素联合治疗特应性皮炎:一项随机、安慰剂对照、双盲、平行临床试验。

Combination of glucosamine and low-dose cyclosporine for atopic dermatitis treatment: a randomized, placebo-controlled, double-blind, parallel clinical trial.

作者信息

Jin Sang-Yoon, Lim Won-Suk, Sung Nam Hee, Cheong Kyung Ah, Lee Ai-Young

机构信息

Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University Graduate School of Medicine, Gyeonggi-do, South Korea.

出版信息

Dermatol Ther. 2015 Jan-Feb;28(1):44-51. doi: 10.1111/dth.12163. Epub 2014 Aug 12.

Abstract

Our recent pilot study showed better outcomes using a combination of low-dose cyclosporine and glucosamine than cyclosporine alone in the treatment of atopic dermatitis (AD). Here, a randomized, placebo-controlled, double-blind, parallel-designed study was planned to compare the efficacy and safety of low-dose cyclosporine and glucosamine combination to low-dose cyclosporine alone for the treatment of patients with moderate to severe AD. AD patients with a Severity Scoring of Atopic Dermatitis (SCORAD) index ≥ 30 were randomly assigned in a 1:1 ratio to receive either cyclosporine 2 mg/kg and glucosamine 25 mg/kg (group A) or cyclosporine and placebo (group B) for 8 weeks. SCORAD indices, serum levels of chemokine ligand 17 and interleukin-31, eosinophil counts, and blood cyclosporine levels were examined before and after treatment. The SCORAD indices for group A (n = 19) were significantly reduced after the treatment and a significant correlation between the changes in the SCORAD indices and changes in the serum levels of chemokine ligand 17, but not interleukin-31, was detected. Glucosamine combined with cyclosporine did not increase adverse events and serum cyclosporine levels compared with cyclosporine alone. Therefore, combination of low-dose cyclosporine and glucosamine may be useful to allow the long-term use of cyclosporine in the treatment of patients with moderate to severe AD.

摘要

我们最近的一项初步研究表明,在治疗特应性皮炎(AD)时,低剂量环孢素和氨基葡萄糖联合使用比单独使用环孢素的效果更好。在此,我们计划开展一项随机、安慰剂对照、双盲、平行设计的研究,以比较低剂量环孢素和氨基葡萄糖联合用药与单独使用低剂量环孢素治疗中度至重度AD患者的疗效和安全性。将特应性皮炎严重程度评分(SCORAD)指数≥30的AD患者按1:1比例随机分配,分别接受2 mg/kg环孢素和25 mg/kg氨基葡萄糖治疗(A组)或环孢素与安慰剂治疗(B组),为期8周。在治疗前后检测SCORAD指数、趋化因子配体17和白细胞介素-31的血清水平、嗜酸性粒细胞计数以及血液中环孢素水平。治疗后,A组(n = 19)的SCORAD指数显著降低,并且检测到SCORAD指数变化与趋化因子配体17血清水平变化之间存在显著相关性,但与白细胞介素-31血清水平变化无关。与单独使用环孢素相比,氨基葡萄糖与环孢素联合使用并未增加不良事件和血清环孢素水平。因此,低剂量环孢素和氨基葡萄糖联合使用可能有助于在中度至重度AD患者的治疗中实现环孢素的长期使用。

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