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一项前瞻性、开放标签研究,评估0.005%卡泊三醇/0.064%二丙酸倍他米松泡沫剂对生物治疗反应不佳的银屑病患者的辅助治疗效果。

A Prospective, Open-Label Study Evaluating Adjunctive Calcipotriene 0.005%/Betamethasone Dipropionate 0.064% Foam in Psoriasis Patients With Inadequate Response to Biologic Therapy.

作者信息

Bagel Jerry, Zapata James, Nelson Elise

出版信息

J Drugs Dermatol. 2018 Aug 1;17(8):845-850.

Abstract

OBJECTIVE

To assess the effectiveness and safety of combining calcipotriene 0.005%/betamethasone dipropionate 0.064% (Cal/BD) foam with biologic therapies for patients with plaque psoriasis who have not obtained an adequate response with biologic therapy.

METHODS

This was a prospective, open-label, single-arm study of patients with chronic plaque-type psoriasis (body surface area [BSA] ≤5%) who were being treated with biologic agents for ≥24 weeks. All patients received once-daily Cal/BD foam for 4 weeks, followed by twice-weekly use on consecutive days for 12 weeks (maintenance regimen). The end points were assessed at weeks 4 and 16, and included the Physician's Global Assessment (PGA), BSA, PGA×BSA, Dermatology Life Quality Index (DLQI), and Treatment Satisfaction Questionnaire for Medication (TSQM)-9. Safety evaluations included assessments of local skin reactions and adverse events (AEs).

RESULTS

Enrolled were 25 patients (18 men and 7 women; mean age, 53 ± 11 years). Patients had significant disease activity despite being on stable biologic therapy (median values: BSA, 3%; PGA, 3; PGA×BSA, 8). At weeks 4 and 16 versus baseline, adjunctive therapy with Cal/BD foam significantly improved PGA score (1 vs 1 vs 3; P less than .01), BSA involvement (1% vs 1% vs 3%; P less than .01), and PGA×BSA measure (1 vs 1 vs 8; P less than .01). Most patients achieved treat-to-target criteria for BSA ≤1% and PGA ≤1 at week 4 (both 76%) and week 16 (both 68%) versus 12% and 4%, respectively, at baseline. Quality of life was improved at both weeks 4 and 16, with high treatment satisfaction. Overall, adjunctive Cal/BD foam was safe and well-tolerated, with no serious AEs.

CONCLUSIONS

Adjunctive therapy with Cal/BD foam was associated with an improvement of every measure of disease activity in patients with inadequate response to biologics, an effect that was maintained throughout the study. The majority of patients achieved treat-to-target goals. J Drugs Dermatol. 2018;17(8):845-850.

摘要

目的

评估0.005%卡泊三醇/0.064%倍他米松二丙酸酯(Cal/BD)泡沫剂联合生物疗法用于对生物治疗反应欠佳的斑块状银屑病患者的有效性和安全性。

方法

这是一项针对慢性斑块型银屑病(体表面积[BSA]≤5%)患者的前瞻性、开放标签、单臂研究,这些患者接受生物制剂治疗≥24周。所有患者每日一次使用Cal/BD泡沫剂,持续4周,随后连续两天每周使用两次,持续12周(维持方案)。在第4周和第16周评估终点,包括医生整体评估(PGA)、BSA、PGA×BSA、皮肤病生活质量指数(DLQI)和药物治疗满意度问卷(TSQM)-9。安全性评估包括局部皮肤反应和不良事件(AE)评估。

结果

纳入25例患者(18例男性和7例女性;平均年龄53±11岁)。尽管接受稳定的生物治疗,但患者仍有显著的疾病活动(中位数:BSA,3%;PGA,3;PGA×BSA,8)。与基线相比,在第4周和第16周,Cal/BD泡沫剂辅助治疗显著改善了PGA评分(1 vs 1 vs 3;P<0.01)、BSA受累情况(1% vs 1% vs 3%;P<0.01)和PGA×BSA指标(1 vs 1 vs 8;P<0.01)。大多数患者在第4周(均为76%)和第16周(均为68%)达到BSA≤1%和PGA≤1的治疗目标,而基线时分别为12%和4%。在第4周和第16周生活质量均得到改善,治疗满意度高。总体而言,Cal/BD泡沫剂辅助治疗安全且耐受性良好,无严重不良事件。

结论

Cal/BD泡沫剂辅助治疗可使对生物制剂反应欠佳的患者的各项疾病活动指标得到改善,且在整个研究过程中效果持续存在。大多数患者实现了治疗目标。《药物皮肤病学杂志》。2018;17(8):845 - 850。

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