Christoffers W A, Politiek K, Coenraads P J, van der Schaft J, de Bruin-Weller M S, Schuttelaar M L A
Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Dermatology & Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
J Eur Acad Dermatol Venereol. 2016 Jan;30(1):63-6. doi: 10.1111/jdv.13057. Epub 2015 Mar 2.
Hand eczema is a common condition; it is often chronic and can be difficult to treat. Cyclosporine is used off-label to treat severe hand eczema; however, the evidence for this treatment is scarce.
To examine the drug survival of cyclosporine in a daily practice cohort of patients with chronic hand eczema.
This retrospective daily use study included hand eczema patients who were treated with cyclosporine between 01-06-1999 and 01-06-2014 in two Dutch university hospitals. Patient and treatment characteristics were retrospectively collected from medical charts. First treatment episodes were analysed by means of Kaplan-Meier drug survival curves. Possible determinants of drug survival were analysed by Cox regression models. Treatment effectiveness was analysed with a retrospective physician's global assessment.
A total of 102 patients were treated with cyclosporine. The median drug survival rate was 0.86 years (10.3 months). The overall drug survival rate after 6 months, 1, 2 and 3 years were 61.7%, 45.2%, 18.6% and 13.9% respectively. Main reasons for discontinuation were adverse events, especially early in treatment, and ineffectiveness. After 3 months, a good response to treatment was recorded in 62.9% of the patients.
Cyclosporine had a median drug survival of 10.3 months. Especially patients with recurrent vesicular hand eczema showed a good treatment response.
手部湿疹是一种常见病症；通常为慢性，且难以治疗。环孢素被用于治疗重度手部湿疹，但属于超说明书用药；然而，关于这种治疗方法的证据很少。
在慢性手部湿疹患者的日常临床队列中研究环孢素的药物留存率。
这项回顾性日常使用研究纳入了1999年6月1日至2014年6月1日期间在两家荷兰大学医院接受环孢素治疗的手部湿疹患者。从病历中回顾性收集患者和治疗特征。通过Kaplan-Meier药物留存率曲线分析首次治疗阶段。通过Cox回归模型分析药物留存率的可能决定因素。用回顾性医生整体评估分析治疗效果。
共有102例患者接受了环孢素治疗。药物留存率中位数为0.86年（10.3个月）。6个月、1年、2年和3年后的总体药物留存率分别为61.7%、45.2%、18.6%和13.9%。停药的主要原因是不良事件，尤其是在治疗早期，以及治疗无效。3个月后，62.9%的患者对治疗有良好反应。
环孢素的药物留存率中位数为10.3个月。尤其是复发性水疱性手部湿疹患者显示出良好的治疗反应。
