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卤米松与他扎罗汀固定复方洗剂治疗中度至重度斑块状银屑病的安全性和有效性:两项3期研究的汇总分析

Safety and Efficacy of a Fixed Combination Halobetasol and Tazarotene Lotion in the Treatment of Moderate-to-Severe Plaque Psoriasis: A Pooled Analysis of Two Phase 3 Studies.

作者信息

Sugarman Jeffrey L, Weiss Jonathan, Tanghetti Emil A, Bagel Jerry, Yamauchi Paul S, Stein Gold Linda, Lin Tina, Martin Gina, Pillai Radhakrishnan, Israel Robert

出版信息

J Drugs Dermatol. 2018 Aug 1;17(8):855-861.

Abstract

BACKGROUND

Topical corticosteroids (TCS) are the mainstay of psoriasis treatment. Safety concerns may limit use. Combination with tazarotene may optimize efficacy and minimize safety and tolerability concerns.

OBJECTIVE

Investigate safety and efficacy of halobetasol propionate 0.01%/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). Subjects randomized (2:1) to HP/TAZ lotion or vehicle once-daily for 8 weeks, 4-week follow-up. Primary efficacy assessment: treatment success (at least a 2-grade improvement from baseline in IGA score and 'clear' or 'almost clear'). Safety and treatment emergent AEs evaluated throughout.

RESULTS

HP/TAZ lotion demonstrated statistically significant superiority over vehicle as early as week 2 (P equals 0.002). By week 8, 40.6% of subjects were treatment successes compared with 9.9% on vehicle (P less than 0.001). A third of subjects remained treatment successes post-treatment. HP/TAZ lotion was also superior in reducing psoriasis signs and symptoms, and Body Surface Area (BSA) involvement. Most frequently reported treatment related AEs were contact dermatitis (6.3%), application site pain (2.6%), and pruritus (2.2%).

LIMITATIONS

No data were collected beyond the 4-week follow-up.

CONCLUSIONS

HP/TAZ lotion provides synergistic efficacy that is both rapid and sustained, with good tolerability and safety over 8 weeks use. J Drugs Dermatol. 2018;17(8):855-861.

摘要

背景

外用糖皮质激素(TCS)是银屑病治疗的主要药物。安全性问题可能会限制其使用。与他扎罗汀联合使用可能会优化疗效,并将安全性和耐受性问题降至最低。

目的

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

方法

两项多中心、随机、双盲、赋形剂对照的3期研究(N = 418)。受试者按2:1随机分为HP/TAZ洗剂组或赋形剂组,每日一次,共8周,随访4周。主要疗效评估:治疗成功(静态医师全面评估[IGA]评分较基线至少改善2级且“清除”或“几乎清除”)。全程评估安全性和治疗中出现的不良事件。

结果

HP/TAZ洗剂早在第2周就显示出在统计学上显著优于赋形剂(P = 0.002)。到第8周,40.6%的受试者治疗成功,而赋形剂组为9.9%(P < 0.001)。三分之一的受试者在治疗后仍保持治疗成功。HP/TAZ洗剂在减轻银屑病体征和症状以及体表面积受累方面也更具优势。最常报告的与治疗相关的不良事件是接触性皮炎(6.3%)、用药部位疼痛(2.6%)和瘙痒(2.2%)。

局限性

随访期超过4周后未收集数据。

结论

HP/TAZ洗剂具有协同疗效,起效迅速且持续,在8周的使用期内耐受性和安全性良好。《药物皮肤病学杂志》。2018;17(8):855 - 861。

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