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用于特应性皮炎的丙酸倍氯米松

Methylprednisolone aceponate for atopic dermatitis.

作者信息

Torrelo Antonio

机构信息

Department of Dermatology, Hospital Infantil Niño Jesús, Madrid, Spain.

出版信息

Int J Dermatol. 2017 Jun;56(6):691-697. doi: 10.1111/ijd.13485. Epub 2017 Mar 4.

Abstract

BACKGROUND

The 4th generation topical corticosteroids (TCS) have demonstrated a most favorablerisk-benefit ratio. Methylprednisolone aceponate (MPA) is a non-halogenated corticosteroid with a methyl group at C6, which confers higher intrinsic activity. MPA is included in the group of potent TCS (category III/IV).

METHODS

A literature review is carried out of the clinical efficacy, pharmacokinetics, and adverse effects of MPA, especially for the treatment of atopic dermatitis (AD).

RESULTS

Several clinical studies support the use of MPA in infants and children, with minimal local or systemic adverse effects reported. The pharmacokinetic profile and the low rate of adverse effects of MPA are most suitable for the treatment of atopic dermatitis (AD), a chronic disease with frequent flaring that can involve extensive areas of the skin.

CONCLUSIONS

Most patients with AD can be easily brought into control with the use of only TCS. Achieving a complete healing of eczema is key in AD, and once the skin is clinically healthy, emollients can be used according to the physician and patient preferences. Physicians should be trained in the recognition of early or subtle manifestations of active eczema that are most suitably treated with topical TCS to achieve a most rapid and satisfactory control of the disease. If the whole area with eczema is not treated, active eczema will remain and treatment will be ineffective. Insufficient use of TCS will lead to inefficiency and frustration.

摘要

背景

第四代外用糖皮质激素(TCS)已显示出极为有利的风险效益比。醋丙甲泼尼龙(MPA)是一种在C6位带有甲基的非卤化糖皮质激素,这赋予了它更高的内在活性。MPA属于强效TCS类别(III/IV类)。

方法

对MPA的临床疗效、药代动力学和不良反应进行文献综述,尤其针对特应性皮炎(AD)的治疗。

结果

多项临床研究支持在婴幼儿和儿童中使用MPA,报告的局部或全身不良反应极少。MPA的药代动力学特征和低不良反应发生率最适合用于治疗特应性皮炎(AD),这是一种慢性疾病,频繁发作且可累及大面积皮肤。

结论

大多数AD患者仅使用TCS就能轻松实现病情控制。实现湿疹的完全治愈是AD治疗的关键,一旦皮肤临床症状恢复健康,可根据医生和患者的偏好使用润肤剂。医生应接受培训,以识别最适合用外用TCS治疗的活动性湿疹的早期或细微表现,从而最快速且满意地控制病情。如果湿疹的整个区域未得到治疗,活动性湿疹将持续存在且治疗将无效。TCS使用不足会导致治疗效率低下和患者沮丧。

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