FROM Presidio Ospedaliero Matteo Rota Via Garibaldi 13/15 24122 BergamoItaly; Department of Dermatology Inselspital University Hospital Freiburgstrasse 323010 Bern Switzerland.
FROM Presidio Ospedaliero Matteo Rota Via Garibaldi 13/15 24122 Bergamo Italy; Department of Dermatology Azienda Ospedaliera papa Giovanni XXIII Piazza OMS 124127 Bergamo Italy.
Pharmacol Res Perspect. 2016 Apr 27;4(3):e00225. doi: 10.1002/prp2.225. eCollection 2016 Jun.
The aim of this study was to assess the prevalence of exposure to topical nonsteroidal anti-inflammatory drugs (NSAIDs), particularly ketoprofen, in a convenience sample of the population, to obtain estimates of the incidence of severe photosensitivity leading to hospitalization, and to assess causative factors in three catchment areas: the Paris metropolitan area, the Lombardy region (Italy) and the Prague area. All cases of severe photosensitivity not explained by underlying conditions and admitted to hospitals in the selected areas were included in the study. Controls were patients consecutively admitted to hospitals, in the same areas, for an acute condition or for an elective procedure not suspected of being related to medication use. From October 2012 to September 2013, 920 controls were recruited (median age 44 years, 50.8% females); 8 severe photosensitivity cases were reported in the population aged 18-74 years of the 3 geographical areas during the 1-year surveillance period, corresponding to an incidence rate of 4.81 cases per 10 million person-years (95% confidence interval - CI, 2.07-9.48). Six controls reported 1-month exposure to topical ketoprofen, with an estimated prevalence of 0.65% (95% CI, 0.24-1.42). The population attributable risk for severe photosensitivity reactions linked to ketoprofen was 11.92% (95% CI, -0.12-52.99). This study was conducted in selected European areas and showed that the incidence of severe photosensitivity reactions leading to hospitalization as well as the exposure rate to topical ketoprofen were low. Among topical NSAIDs, topical ketoprofen was the leading cause of photosensitivity reactions but accounted for a limited number of hospitalized cases. Probably most of the relevant reactions were managed in the outpatient setting and a community based case-control study is advisable.
本研究旨在评估在人群中，使用非甾体类抗炎药（NSAIDs）特别是酮洛芬的暴露率，以获得导致住院的严重光敏反应的发病率估计值，并在三个集水区评估致病因素：巴黎大都市区、伦巴第地区（意大利）和布拉格地区。在选定的地区，所有因基础疾病无法解释而住院的严重光敏反应患者都纳入研究。对照组为连续因急性疾病或非怀疑与药物使用有关的择期手术住院的患者。从 2012 年 10 月至 2013 年 9 月，招募了 920 名对照（中位年龄 44 岁，50.8%为女性）；在 3 个地理区域的 18-74 岁人群中，在 1 年监测期间报告了 8 例严重光敏反应病例，发病率为每 100 万人年 4.81 例（95%置信区间，2.07-9.48）。6 名对照报告在 1 个月内使用过酮洛芬局部制剂，估计患病率为 0.65%（95%置信区间，0.24-1.42）。与酮洛芬相关的严重光敏反应的人群归因风险为 11.92%（95%置信区间，-0.12-52.99）。本研究在选定的欧洲地区进行，表明导致住院的严重光敏反应发病率以及酮洛芬局部制剂的暴露率较低。在局部 NSAIDs 中，酮洛芬是光敏反应的主要原因，但导致的住院病例数量有限。可能大多数相关反应都在门诊管理，因此建议进行社区基于病例对照的研究。
