Trindade Patrícia, Gelpi Alice, Salgado Ana, Marto Joana, Machado Paula, Mateus Dinis, Gonçalves Humberto, Sachse M Fernanda, Gouveia António Melo, Ribeiro Helena
Department of Pharmacy, Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisbon, Portugal.
Department of Nanomedicine and Drug Delivery Systems, iMed.UL (Research Institute for Medicines and Pharmaceutical Sciences) Faculdadec de Farmácia da Universidade de Lisboa, Lisbon, Portugal.
Eur J Hosp Pharm. 2018 Jan;25(1):43-47. doi: 10.1136/ejhpharm-2016-001052. Epub 2016 Dec 1.
Primary cutaneous lymphomas (extranodular non-Hodgkin lymphomas) are rare (incidence 1:100 000). Mycosis fungoides is the most common cutaneous T-cell lymphoma (CTCL) subtype. Treatment options are based on the diagnosis and the stage of the disease. Skin-directed therapies are useful for the initial stages and include topical treatments such as corticosteroids. Betamethasone dipropionate (BD) is a synthetic glucocorticoid with high anti-inflammatory activity, potency and immunosuppressant effects. It is used for topical treatment of CTCL within the following dosage 0.025-0.1% (w/w). In the Portuguese market only one topical cream contains BD at 0.05% (w/w).
To develop a new and stable emulsion containing 0.1% of BD.
To accomplish this aim, development, stability, in vitro release and clinical studies of a new topical water-in-oil emulsion containing BD 0.1% w/w were assessed for the topical treatment of CTCL.
The three batches prepared were physically, chemically and microbiologically stable over a period of 90 days. 40% of BD was released over 6 hours and evaluation of skin lesions showed a favourable clinical effect (less itching, less infiltration, fewer patches and a reduced area of plaque).
The clinical results show the effective cutaneous improvement of skin barrier conditions during the study.
原发性皮肤淋巴瘤(结外非霍奇金淋巴瘤)较为罕见(发病率为1:100 000)。蕈样肉芽肿是最常见的皮肤T细胞淋巴瘤(CTCL)亚型。治疗方案基于疾病的诊断和分期。皮肤定向治疗对疾病初期有效,包括局部治疗,如使用皮质类固醇。二丙酸倍他米松(BD)是一种具有高抗炎活性、效力和免疫抑制作用的合成糖皮质激素。它用于局部治疗CTCL的剂量为0.025 - 0.1%(w/w)。在葡萄牙市场上,只有一种局部乳膏含有0.05%(w/w)的BD。
开发一种含0.1% BD的新型稳定乳剂。
为实现这一目标,对一种含0.1% w/w BD的新型局部油包水乳剂进行了开发、稳定性、体外释放和临床研究,用于CTCL的局部治疗。
制备的三批产品在90天内物理、化学和微生物学性质稳定。6小时内释放了40%的BD,对皮肤病变的评估显示出良好的临床效果(瘙痒减轻、浸润减少、斑片减少、斑块面积减小)。
临床结果表明,在研究期间皮肤屏障状况有有效的改善。