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0.03% 外用他克莫司单药治疗儿童春季角结膜炎

Monotherapy of topical tacrolimus 0.03% in the treatment of vernal keratoconjunctivitis in the pediatric population.

作者信息

Samyukta Sadasivan K, Pawar Neelam, Ravindran Meenakshi, Allapitchai Fathima, Rengappa Ramakrishnan

机构信息

Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India.

Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India.

出版信息

J AAPOS. 2019 Feb;23(1):36.e1-36.e5. doi: 10.1016/j.jaapos.2018.09.010. Epub 2019 Jan 19.

Abstract

PURPOSE

To report the results of treating children with vernal keratoconjunctivitis (VKC) using a monotherapy of topical tacrolimus 0.03%.

METHODS

This was a prospective, nonrandomized observational study of children newly diagnosed with VKC. The severity of the disease was graded on a 4-point scale of symptoms and signs. Patients were treated with tacrolimus 0.03% ointment and were followed for 8 months according to a schedule based on the severity of the disease. The primary measure of treatment efficacy was the change in the score of objective signs. The incidence and severity of adverse events, if any, were recorded.

RESULTS

A total of 45 children aged 5-15 years were enrolled. The mean composite symptom score was 6.84 ± 2.26 at baseline and 0.71 ± 1.62 at 8 months, a statistically significant reduction (P < 0.001). The mean composite sign score was 9.6 ± 3.14 at baseline and 1.16 ± 1.28 at 8 months, also a statistically significant reduction (P < 0.001). Four patients had to be started on steroids within the first month of treatment and were considered treatment failures. Thus, 89% of patients showed significant improvement. No participant experienced adverse effects, although some reported a transient stinging sensation.

CONCLUSIONS

In our study cohort topical tacrolimus ointment 0.03% as a monotherapy for VKC was successful in the majority of subjects, and there was no adverse effect.

摘要

目的

报告使用0.03%他克莫司局部单一疗法治疗儿童春季角结膜炎(VKC)的结果。

方法

这是一项对新诊断为VKC的儿童进行的前瞻性、非随机观察性研究。根据症状和体征的4分制对疾病严重程度进行分级。患者使用0.03%他克莫司软膏治疗,并根据疾病严重程度按计划随访8个月。治疗效果的主要衡量指标是客观体征评分的变化。记录不良事件的发生率和严重程度(如有)。

结果

共纳入45名5至15岁的儿童。基线时平均综合症状评分为6.84±2.26,8个月时为0.71±1.62,差异有统计学意义(P<0.001)。基线时平均综合体征评分为9.6±3.14,8个月时为1.16±1.28,差异也有统计学意义(P<0.001)。4名患者在治疗的第一个月内不得不开始使用类固醇,被视为治疗失败。因此,89%的患者有显著改善。尽管一些患者报告有短暂的刺痛感,但没有参与者出现不良反应。

结论

在我们的研究队列中,0.03%他克莫司局部软膏作为VKC的单一疗法在大多数受试者中取得成功,且无不良反应。

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