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止痒乳液和乳膏对有特应性病史患者的止痒疗效:与氢化可的松乳膏的比较。

Anti-Pruritic Efficacy of Itch Relief Lotion and Cream in Patients With Atopic History: Comparison With Hydrocortisone Cream.

作者信息

Zirwas Matthew J, Barkovic Sylvia

出版信息

J Drugs Dermatol. 2017 Mar 1;16(3):243-247.

PMID:28301620
Abstract

UNLABELLED

Objective: To evaluate the speed of onset and duration of relief of two ceramide-containing formulations with 1% pramoxine hydroxide (CeraVe® Itch Relief Lotion and Cream,Valeant Pharmaceuticals North America LLC, Irvine, CA) in patients with atopic history, including those with active flare and the comparative efficacy of CeraVe Itch Relief Cream to hydrocortisone 1% cream and night-time itch relief with continued use.

METHODS

Two double-blind, split-body, randomized studies in 66 male and female subjects, ages 11+ years, with history of atopic dermatitis (AD). Itch severity was assessed on a 10-point scale (where 0=none and 7-9=severe). Study one: single applications of ceramide-containing lotion or cream incorporating 1% pramoxine hydrochloride applied to opposite sides of the body. Study two (part 1): single application of ceramide-containing cream or hydrocortisone 1% cream. Study two (part 2): ceramide-containing pramoxine cream applied up to 4 times in a 24-hour period, over the course of 6 days. Itch relief assessed at baseline, 2, and 5 minutes, 1 (2 in study two), 4, and 8 hours post-application. Efficacy and aesthetic attributes were assessed at the same timepoints. Clinical evaluation of performance and mildness of the ceramide-containing 1% pramoxine hydrochloride cream at day 6 (study two, part 2).

RESULTS

Study one: Relief of itching was rapid and long-lasting with significant reductions in severity after 2 minutes, and continued improvement over the 8 hour test period (P less than .001 versus baseline at all timepoints). Mean itch severity scores reduced progressively from 6 (moderate) at baseline to 1-2 (mild) after 8 hours, with all patients experiencing relief from itching. Rapid and long-lasting relief to dry, itchy, irritated skin was confirmed through patient self-assessment. Both lotion and cream formulations were non-greasy, absorbed quickly and easily, and were non-irritating. Study two: Ceramide-containing cream incorporating 1% pramoxine hydrochloride provided comparable improvement in itch relief (24.6% reduction in mean itch severity 2 minutes post-application, and 58.0% reduction 8 hours post-application) compared to hydrocortisone cream 1% (18.5% reduction and 59.7% reduction, respectively). Daily use of the ceramide-containing 1% pramoxine cream over 6-days provided all-night relief (87.5% agreement), and perception of skin looking and feeling healthier with each use (71.9% and 81.3% agreement, respectively).

LIMITATIONS

Results of study one and subsequent comparative study with hydrocortisone 1% cream are based on a single application. There were no placebo controls.

CONCLUSIONS

Ceramide-containing lotion or cream containing 1% pramoxine provides both rapid and long-lasting relief of itching following a single application in atopic patients with or without active flare. Both formulations were well tolerated with aesthetic appeal. Comparable itch relief to hydrocortisone 1% cream was seen with the ceramide-containing cream over an 8-hour period following a single application. Further ceramide-containing 1% pramoxine hydrochloride cream was well tolerated with continued use over 6 days, delivering comfort and all-night relief for patients with atopic history suffering from reoccurrant itching.

J Drugs Dermatol. 2017;16(3):243-247.

.

摘要

未标注

目的:评估两种含神经酰胺且含有1%氢氧化苯坐卡因的制剂(适乐肤止痒乳液和乳膏,加拿大威朗制药北美有限责任公司,加利福尼亚州欧文市)对有特应性病史患者(包括有急性发作的患者)的起效速度和缓解持续时间,以及适乐肤止痒乳膏与1%氢化可的松乳膏的比较疗效,和持续使用时对夜间瘙痒的缓解效果。

方法

对66名年龄在11岁及以上、有特应性皮炎(AD)病史的男性和女性受试者进行两项双盲、身体双侧、随机研究。瘙痒严重程度采用10分制评估(0表示无瘙痒,7 - 9表示严重瘙痒)。研究一:将含1%盐酸苯坐卡因的含神经酰胺乳液或乳膏分别涂抹于身体的对侧。研究二(第一部分):单次涂抹含神经酰胺乳膏或1%氢化可的松乳膏。研究二(第二部分):含神经酰胺的苯坐卡因乳膏在24小时内最多涂抹4次,持续6天。在基线、涂抹后2分钟和5分钟、1小时(研究二为2小时)、4小时和8小时评估瘙痒缓解情况。在相同时间点评估疗效和美学属性。在第6天(研究二,第二部分)对含1%盐酸苯坐卡因的神经酰胺乳膏的性能和温和性进行临床评估。

结果

研究一:瘙痒缓解迅速且持久,2分钟后严重程度显著降低,在8小时测试期内持续改善(与基线相比,所有时间点P均小于0.001)。平均瘙痒严重程度评分从基线时的6分(中度)逐渐降至8小时后的1 - 2分(轻度),所有患者的瘙痒均得到缓解。通过患者自我评估证实了对干燥、瘙痒、受刺激皮肤的快速和持久缓解。乳液和乳膏制剂均不油腻,易于快速吸收,且无刺激性。研究二:含1%盐酸苯坐卡因的神经酰胺乳膏在瘙痒缓解方面提供了与1%氢化可的松乳膏相当的改善(涂抹后2分钟平均瘙痒严重程度降低24.6%,8小时后降低58.0%),而1%氢化可的松乳膏分别降低18.5%和59.7%。连续6天每日使用含1%苯坐卡因的神经酰胺乳膏可提供整夜缓解(一致率87.5%),且每次使用后患者感觉皮肤外观和感觉更健康(一致率分别为71.9%和81.3%)。

局限性

研究一以及随后与1%氢化可的松乳膏的比较研究结果基于单次涂抹。没有安慰剂对照。

结论

含神经酰胺且含有1%苯坐卡因的乳液或乳膏在单次应用后,能为有或无急性发作的特应性患者迅速且持久地缓解瘙痒。两种制剂耐受性良好且具有美学吸引力。单次涂抹含神经酰胺乳膏在8小时内与1%氢化可的松乳膏的瘙痒缓解效果相当。此外,含1%盐酸苯坐卡因的神经酰胺乳膏在连续使用6天时耐受性良好,为有特应性病史且反复瘙痒的患者带来舒适和整夜缓解。

《皮肤用药杂志》。2017年;16(3):243 - 247。

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