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1%替拉替尼软膏显著降低光化性角化病患者的光化性角化病面积和严重程度指数:一项真实世界研究的结果

Tirbanibulin 1% Ointment Significantly Reduces the Actinic Keratosis Area and Severity Index in Patients with Actinic Keratosis: Results from a Real-World Study.

作者信息

Kirchberger Michael Constantin, Gfesser Michael, Erdmann Michael, Schliep Stefan, Berking Carola, Heppt Markus Vincent

机构信息

Hautarztzentrum Ingolstadt, Schlüterstr. 3a, 85057 Ingolstadt, Germany.

Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany.

出版信息

J Clin Med. 2023 Jul 22;12(14):4837. doi: 10.3390/jcm12144837.

Abstract

BACKGROUND

Actinic keratosis (AK) is a cutaneous lesion resulting from the proliferation of atypical epidermal keratinocytes caused by long-term exposure to ultraviolet radiation. AK may progress to cutaneous squamous cell carcinoma (cSCC) and therefore is often treated with topical agents such as 5-fluorouracil, diclofenac, imiquimod, and photodynamic therapy. Tirbanibulin has been approved based on two phase III trials in the USA. However, real-world evidence for tirbanibulin is absent.

METHODS

This was a single-centre study of adult patients with clinically typical, visible AK on the face or scalp treated with tirbanibulin 1% ointment. Treatment was administered as per label once daily for 5 consecutive days on the same lesions or field. Treatment outcomes were assessed 4 weeks after treatment, with additional optional assessments conducted at later time points. Efficacy was measured using the actinic keratosis area and severity index (AKASI) and digital dermoscopy.

RESULTS

A total of 33 patients were treated of whom 30 were analysed. The median AKASI score was 5.6 (1.4-11) pre-treatment and 1.2 (0-7.4) post-treatment ( < 0.0001). Complete clearance as defined by AKASI scores less than 1 was achieved in 47% ( = 14) and 57% ( = 13) at the first and second follow-up, respectively. All local reactions resolved spontaneously and without sequelae. The most common local reactions were erythema (80%, = 26) and flaking or scaling (43%, = 13).

CONCLUSIONS

Tirbanibulin 1% ointment significantly and rapidly reduced the AKASI score in a real-world setting. The complete clearance rates were in line with those observed in the two pivotal trials.

摘要

背景

光化性角化病(AK)是一种皮肤病变,由长期暴露于紫外线辐射导致非典型表皮角质形成细胞增殖引起。AK可能进展为皮肤鳞状细胞癌(cSCC),因此常采用5-氟尿嘧啶、双氯芬酸、咪喹莫特等局部用药及光动力疗法进行治疗。在美国,替巴替尼已基于两项III期试验获得批准。然而,替巴替尼的真实世界证据尚不存在。

方法

这是一项针对面部或头皮患有临床典型、可见AK的成年患者的单中心研究,患者接受1%替巴替尼软膏治疗。按照标签说明,在相同皮损或区域连续5天每天给药一次。治疗4周后评估治疗结果,并在后续时间点进行额外的可选评估。使用光化性角化病面积和严重程度指数(AKASI)及数字皮肤镜检查来衡量疗效。

结果

共治疗33例患者,其中30例进行分析。治疗前AKASI评分中位数为5.6(1.4 - 11),治疗后为1.2(0 - 7.4)(<0.0001)。在首次和第二次随访时,AKASI评分小于1所定义的完全清除率分别为47%(n = 14)和57%(n = 13)。所有局部反应均自发消退且无后遗症。最常见的局部反应为红斑(80%,n = 26)和脱屑或鳞屑(43%,n = 13)。

结论

在真实世界环境中,1%替巴替尼软膏能显著且迅速降低AKASI评分。完全清除率与两项关键试验中观察到的结果一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4920/10381110/ac93716600cc/jcm-12-04837-g001.jpg

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