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固定剂量卤倍他索-他扎罗汀复方制剂治疗中重度斑块状银屑病的安全性和疗效:两项 3 期随机对照研究结果。

Safety and efficacy of a fixed combination of halobetasol and tazarotene in the treatment of moderate-to-severe plaque psoriasis: Results of 2 phase 3 randomized controlled trials.

机构信息

Henry Ford Hospital, Detroit, Michigan.

Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

J Am Acad Dermatol. 2018 Aug;79(2):287-293. doi: 10.1016/j.jaad.2018.03.040. Epub 2018 Apr 1.

DOI:10.1016/j.jaad.2018.03.040
PMID:29614243
Abstract

BACKGROUND

Topical corticosteroids are the mainstay of psoriasis treatment, with long-term safety considerations limiting their use. Combining them with tazarotene may optimize their efficacy and minimize safety and tolerability concerns.

OBJECTIVE

To investigate the safety and efficacy of halobetasol propionate 0.01% plus tazarotene 0.045% (HP/TAZ) lotion in moderate-to-severe plaque psoriasis.

METHODS

Two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies (N = 418) were conducted. Subjects were randomized (2:1) to HP/TAZ lotion or vehicle once daily for 8 weeks with a 4-week follow-up. The primary efficacy assessment end point was treatment success (at least a 2-grade improvement from baseline in Investigator's Global Assessment score and a score of clear or almost clear). Safety and treatment-emergent adverse events were evaluated throughout.

RESULTS

HP/TAZ lotion demonstrated statistically significant superiority over vehicle within as few as 2 weeks. By week 8, 35.8% (study 1) and 45.3% (study 2) of subjects were treatment successes compared with 7.0% and 12.5% of those treated with vehicle (P < .001). HP/TAZ lotion was also superior in reducing signs and symptoms of psoriasis and body surface area affected by psoriasis. The most frequently reported treatment-related adverse events were contact dermatitis (6.3%), application site pain (2.6%), and pruritus (2.2%).

LIMITATIONS

Studies did not include subjects with more than 12% of their body surface area affected by psoriasis.

CONCLUSIONS

HP/TAZ lotion was associated with significant reductions in the severity of the clinical signs of psoriasis, with no safety concerns.

摘要

背景

局部皮质类固醇是治疗银屑病的主要药物,但由于长期安全性的考虑限制了其使用。将其与他扎罗汀联合使用可能会优化其疗效,并最大程度减少安全性和耐受性问题。

目的

研究卤倍他索丙酸 0.01%加他扎罗汀 0.045%(HP/TAZ)洗剂治疗中重度斑块状银屑病的安全性和疗效。

方法

进行了两项多中心、随机、双盲、对照 3 期研究(N=418)。受试者按 2:1 的比例随机分配至 HP/TAZ 洗剂或赋形剂,每天 1 次,持续 8 周,随后进行 4 周的随访。主要疗效评估终点为治疗成功(研究者全球评估评分至少改善 2 级,且评分达到清晰或几乎清晰)。在整个治疗过程中评估安全性和治疗中出现的不良事件。

结果

HP/TAZ 洗剂在治疗后 2 周内与赋形剂相比表现出统计学上的显著优势。在第 8 周时,研究 1 中有 35.8%的受试者和研究 2 中有 45.3%的受试者治疗成功,而接受赋形剂治疗的受试者中分别只有 7.0%和 12.5%治疗成功(P<0.001)。HP/TAZ 洗剂在减轻银屑病的体征和症状以及受影响的体表面积方面也更具优势。最常见的治疗相关不良事件为接触性皮炎(6.3%)、用药部位疼痛(2.6%)和瘙痒(2.2%)。

局限性

研究未纳入体表面积超过 12%的受试者。

结论

HP/TAZ 洗剂可显著降低银屑病的临床体征严重程度,且无安全性问题。

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