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一种新型的卡泊三醇和倍他米松气雾剂泡沫制剂对泛发性寻常型银屑病患者的下丘脑-垂体-肾上腺轴及钙稳态无影响。

A Novel Aerosol Foam Formulation of Calcipotriol and Betamethasone Has No Impact on HPA Axis and Calcium Homeostasis in Patients With Extensive Psoriasis Vulgaris.

作者信息

Taraska Victoria, Tuppal Raj, Olesen Martin, Bang Pedersen Claus, Papp Kim

机构信息

The Derm Centre, Winnipeg, MB, Canada

Oshawa Clinic, Oshawa, ON, Canada.

出版信息

J Cutan Med Surg. 2016 Jan;20(1):44-51. doi: 10.1177/1203475415597094. Epub 2015 Jul 29.

Abstract

BACKGROUND

Fixed combination calcipotriol 50 µg/g (Cal; as hydrate) plus betamethasone 0.5 mg/g (as dipropionate; BD) has been formulated in an innovative aerosol foam.

OBJECTIVE

To assess systemic safety of Cal/BD aerosol foam.

METHODS

In a multicentre, single-arm, open-label, maximal-use systemic-exposure trial, adult patients with moderate to severe, extensive psoriasis (15%-30% of body surface area, including ≥30% of scalp) applied Cal/BD foam once daily. Endpoints were week 4 abnormal adrenocorticotropic hormone (ACTH) challenge test and change in albumin-corrected serum calcium, 24-hour urinary calcium excretion, and urinary calcium-creatinine ratio.

RESULTS

35 patients reaching week 4 exhibited normal ACTH responses. At week 4, changes in calcium homeostasis were minor and not clinically relevant; no patients experienced elevations above normal. Disease severity generally improved, and 49% of patients achieved treatment success according to the Physician's Global Assessment of Disease Severity.

CONCLUSION

No clinically relevant HPA axis or calcium homeostasis impact was observed with 4 weeks of once-daily Cal/BD foam in patients with extensive psoriasis vulgaris.

摘要

背景

已将50μg/g的卡泊三醇(以水合物形式存在;Cal)与0.5mg/g的倍他米松(以二丙酸酯形式存在;BD)制成一种创新的气雾剂泡沫。

目的

评估卡泊三醇/倍他米松气雾剂泡沫的全身安全性。

方法

在一项多中心、单臂、开放标签、最大使用量全身暴露试验中,患有中度至重度广泛性银屑病(体表面积的15%-30%,包括≥30%的头皮)的成年患者每天使用一次卡泊三醇/倍他米松泡沫。观察终点为第4周的促肾上腺皮质激素(ACTH)激发试验异常以及白蛋白校正血清钙、24小时尿钙排泄和尿钙肌酐比值的变化。

结果

35名进入第4周的患者ACTH反应正常。在第4周,钙稳态变化轻微且无临床相关性;无患者出现高于正常水平的情况。疾病严重程度总体改善,根据医生对疾病严重程度的整体评估,49%的患者治疗成功。

结论

对于广泛性寻常型银屑病患者,每日一次使用卡泊三醇/倍他米松泡沫4周,未观察到对下丘脑-垂体-肾上腺(HPA)轴或钙稳态有临床相关影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25bb/4708614/f52506dee1a2/10.1177_1203475415597094-fig1.jpg

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