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健康成年人长期使用专利透皮维生素D贴片的安全性、耐受性及血浆维生素D反应评估:一项随机平行先导研究。

Evaluation of the safety, tolerability and plasma vitamin D response to long-term use of patented transdermal vitamin D patches in healthy adults: a randomised parallel pilot study.

作者信息

Jefferson Angie, Borges Clarice

机构信息

Nutrition & Dietetics, Freelance Dietitian, Bracknell, UK.

To Better Days, London, UK.

出版信息

BMJ Nutr Prev Health. 2022 Jul 27;5(2):217-226. doi: 10.1136/bmjnph-2022-000471. eCollection 2022 Dec.

Abstract

BACKGROUND

Vitamin D delivered transdermally may suppress hyperactivity in nociceptor pain receptors and alter pain intensity, offering a useful addition to localised pain management in varying clinical settings. Currently, little is known about long-term usage of continuous-release vitamin D patches.

METHOD

We conducted a randomised parallel pilot trial to evaluate safety and tolerability of daily application of patented (US8821921B2) transdermal vitamin D patches over 8 weeks and assess time-level profile of serum vitamin D. Compliance, tolerance and sun exposure were monitored daily, serum 25(OH)D measured 2-weekly and dietary intake and safety markers 4-weekly.

RESULTS

Thirty healthy adults were randomised to two treatment groups: big patch and small patch. mean age was 36 years (20-68 years) with a 63% female to 37% male split. Patches differed in size but contained identical ingredients including 30 000 IU cholecalciferol. Physical and blood safety markers remained stable, within normal clinical parameters, and with no clinically meaningful changes throughout. Five big patch participants experienced skin irritation, which was mild and occasional for three, but continuous for two leading to patch withdrawal. There were no skin reactions in small patch group. average, serum 25(OH)D levels increased by +14 nmol/L (SD 11.63, range, -4 to 40 nmol/L) between baseline and week 8, with no significant differences between patch sizes. There was a shift in overall vitamin D status between baseline and week 8 (23% deficient (<30 nmol/L) decreasing to 0%, and normal (>50 nmol/L) increasing from 37% to 70% at week 8).

CONCLUSION

Based on these results, long-term (8 weeks) application of patented transdermal vitamin D patches was found to be safe. There may be minor skin tolerance issues with big patches for some, which appears to relate to patch size. Larger trials are warranted to explore the increase in vitamin D levels beyond 8 weeks.

TRIAL REGISTRATION NUMBER

NCT04851990.

摘要

背景

经皮递送的维生素D可能会抑制伤害性疼痛感受器的过度活跃并改变疼痛强度,这为不同临床环境下的局部疼痛管理提供了一种有用的补充方法。目前,关于持续释放维生素D贴片的长期使用情况知之甚少。

方法

我们进行了一项随机平行试点试验,以评估专利(US8821921B2)的经皮维生素D贴片每日应用8周的安全性和耐受性,并评估血清维生素D的时间-水平曲线。每天监测依从性、耐受性和阳光暴露情况,每2周测量一次血清25(OH)D,每4周测量一次饮食摄入量和安全指标。

结果

30名健康成年人被随机分为两个治疗组:大贴片组和小贴片组。平均年龄为36岁(20 - 68岁),女性占63%,男性占37%。贴片大小不同,但含有相同成分,包括30000 IU胆钙化醇。身体和血液安全指标保持稳定,在正常临床参数范围内,且在整个过程中无临床意义上的变化。5名大贴片组参与者出现皮肤刺激,其中3人症状轻微且偶尔出现,2人持续出现,导致贴片停用。小贴片组未出现皮肤反应。在基线至第8周期间,血清25(OH)D水平平均升高了+14 nmol/L(标准差11.63,范围为-4至40 nmol/L),贴片大小之间无显著差异。在基线至第8周期间,总体维生素D状态发生了变化(维生素D缺乏(<30 nmol/L)从23%降至0%,正常(>50 nmol/L)从37%增至第8周时的70%)。

结论

基于这些结果,发现专利经皮维生素D贴片的长期(8周)应用是安全的。对于一些人来说,大贴片可能存在轻微的皮肤耐受性问题,这似乎与贴片大小有关。有必要进行更大规模的试验来探索维生素D水平在8周以上的升高情况。

试验注册号

NCT04851990。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c876/9813629/230a3650a8e7/bmjnph-2022-000471f01.jpg

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