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一项关于超红斑量准分子激光联合氯倍他索喷雾剂和骨化三醇软膏治疗泛发性斑块状银屑病的开放标签试点研究。

An open label pilot study of supraerythemogenic excimer laser in combination with clobetasol spray and calcitriol ointment for the treatment of generalized plaque psoriasis.

作者信息

Levin Ethan, Nguyen Catherine M, Danesh Melissa J, Beroukhim Kourosh, Leon Argentina, Koo John

机构信息

a San Francisco School of Medicine, University of California , San Francisco , CA , USA .

b Irvine School of Medicine, University of California , Irvine , CA , USA , and.

出版信息

J Dermatolog Treat. 2016;27(3):210-3. doi: 10.3109/09546634.2015.1088640. Epub 2015 Sep 28.

DOI:10.3109/09546634.2015.1088640
PMID:26329774
Abstract

A common therapeutic modality for psoriasis includes the combination of phototherapy with topical treatments. The recent development of targeted phototherapy with the excimer laser and spray formulations for topical treatments has increased the efficacy and convenience of these combinational therapies. Herein, we aim to assess the efficacy of a novel combination of therapies using the 308 nm excimer laser, clobetasol propionate spray and calcitriol ointment for the treatment of moderate to severe generalized psoriasis. In this 12-week study, patients with moderate to severe psoriasis received twice weekly treatments with a 308-nm excimer laser combined with clobetasol proprionate twice daily for a month followed by calcitriol ointment twice daily for the next month. Of the 30 patients enrolled, 83% of patients (25/30) achieved PASI-75 [65-94%, 95% confidence interval (CI)] at week 12. For PGA, there was an estimated decrease of 3.6 points (3.1-4.1, 95% CI, p < 0.0005) by week 12. In conclusion, the combination of excimer laser with alternating clobetasol and calcitriol application has shown to be a promising combination of therapies for the treatment of moderate to severe generalized psoriasis. Further evaluation may be conducted with a larger study inclusive of control groups and head-to-head comparisons against topical steroid and UVB therapy as monotherapies.

摘要

银屑病的一种常见治疗方式包括光疗与局部治疗相结合。准分子激光靶向光疗和局部治疗喷雾制剂的最新进展提高了这些联合疗法的疗效和便利性。在此,我们旨在评估一种新型联合疗法的疗效,该疗法使用308nm准分子激光、丙酸氯倍他索喷雾和骨化三醇软膏治疗中度至重度泛发性银屑病。在这项为期12周的研究中,中度至重度银屑病患者接受每周两次的308nm准分子激光治疗,同时每天两次外用丙酸氯倍他索,持续一个月,随后在下一个月每天两次外用骨化三醇软膏。在纳入的30例患者中,有83%(25/30)的患者在第12周时达到了银屑病面积和严重程度指数改善75%(65%-94%,95%置信区间)。对于医师整体评估,到第12周时估计下降了3.6分(3.1-4.1,95%置信区间,p<0.0005)。总之,准分子激光与交替使用丙酸氯倍他索和骨化三醇的联合应用已显示出是一种治疗中度至重度泛发性银屑病的有前景的联合疗法。可通过纳入对照组的更大规模研究以及与局部类固醇和UVB单一疗法进行直接比较来进一步评估。

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