Sowlati Mehdi, Morariu Silviu-Horia, Orzan Olguta, Veraldi Stefano, Dodiuk-Gad Roni P, Orasan Remus I, Gainaru Cristian
County Emergency Clinica Hospital "Sf. Apostol Andrei", Tomis Boulevard 145, 900591, Constanţa, Romania.
Mures County Clinical Hospital, Târgu Mureş, Romania.
Dermatol Ther (Heidelb). 2023 Nov;13(11):2669-2679. doi: 10.1007/s13555-023-01035-6. Epub 2023 Sep 23.
Atopic dermatitis (AD) is a chronic disease that occurs mainly in children. Topical corticosteroids are the main treatment for mild to moderate AD, although they can induce side effects. The efficacy and tolerability of xyloglucan and pea protein (XG-PP) was compared with hydrocortisone in pediatric patients with AD as a steroid-sparing solution.
A prospective, multicenter, comparative study enrolled 42 patients (age 0.5-12 years) with mild-to-moderate AD, assigned 1:1 to XG-PP or hydrocortisone ointment. Treatments were applied twice daily for 14 consecutive days and assessed at baseline, day 8, and day 15. Efficacy endpoints were AD Severity Index (ADSI) score, Scoring Atopic Dermatitis (SCORAD) index, and Patient-Oriented Eczema Measure (POEM). Tolerability was assessed by the occurrence of adverse events (AEs).
Both treatments significantly improved ADSI mean score from baseline to day 15; in the XG-PP arm, ADSI score decreased from 10.55 to 4.15 (p = 0.00001), and in the hydrocortisone arm, from 10.65 to 4.30 (p = 0.0001). In the XG-PP arm, the mean SCORAD score decreased from 65.86 to 30.26 (p = 0.00001) and in the hydrocortisone arm from 68.84 to 31.19 (p = 0.0001) at day 15. An overall decrease from moderate to mild AD for both arms (p = 0.0001) was observed with POEM. For all the three indexes evaluated, no statistical significant differences between the study arms evolution from baseline to day 8 or to day 15 were found. No AEs were reported.
XG-PP provided a comparable efficacy to hydrocortisone ointment in managing AD, thus representing a safe and effective steroid-sparing alternative in pediatric patients with AD.
Retrospectively registered on 24 November 2021 in the ISRCTN registry: 11118799.
特应性皮炎(AD)是一种主要发生于儿童的慢性疾病。局部用皮质类固醇是治疗轻度至中度AD的主要方法,尽管它们可能会引起副作用。在患有AD的儿科患者中,比较了木葡聚糖和豌豆蛋白(XG-PP)与氢化可的松作为一种节省类固醇的解决方案的疗效和耐受性。
一项前瞻性、多中心、对照研究纳入了42例年龄在0.5至12岁之间的轻度至中度AD患者,将其按1:1随机分配至XG-PP组或氢化可的松软膏组。治疗每天应用两次,连续应用14天,并在基线、第8天和第15天进行评估。疗效终点为AD严重程度指数(ADSI)评分、特应性皮炎评分(SCORAD)指数和患者导向性湿疹评估(POEM)。通过不良事件(AE)的发生情况评估耐受性。
从基线到第15天,两种治疗方法均使ADSI平均评分显著改善;在XG-PP组中,ADSI评分从10.55降至4.15(p = 0.00001),在氢化可的松组中,从10.65降至4.30(p = 0.0001)。在XG-PP组中,第15天时平均SCORAD评分从65.86降至30.26(p = 0.00001),在氢化可的松组中从68.84降至31.19(p = 0.0001)。POEM评估显示,两组均从中度AD总体降至轻度AD(p = 0.0001)。对于所评估的所有三个指标,在研究组从基线到第8天或第15天的变化中未发现统计学显著差异。未报告不良事件。
XG-PP在治疗AD方面提供了与氢化可的松软膏相当的疗效,因此是患有AD的儿科患者一种安全有效的节省类固醇的替代方法。
于2021年11月24日在ISRCTN注册中心进行回顾性注册:11118799。