School of Pharmacy, Virginia Commonwealth University, 410 N 12th Street, Richmond, VA, 23298, USA.
Otsuka Pharmaceutical, 508 Carnegie Center Dr, Princeton, NJ, 08540, USA.
Clin Drug Investig. 2024 Oct;44(10):733-737. doi: 10.1007/s40261-024-01392-w. Epub 2024 Sep 28.
This review examines the pharmacology, efficacy and safety, dosage and administration, and place in therapy of the combination of 5-fluorouracil (5-FU) and calcipotriol for the treatment of actinic keratosis. Currently, 5% 5-FU topical cream is approved for actinic keratosis treatment, while calcipotriol is indicated for plaque psoriasis in adults. The typical administration of 5-FU involves topical application twice daily for up to 4 weeks, whereas calcipotriol is applied in a thin layer once or twice daily as directed by a physician. Adverse effects of 5-FU are primarily localized, including skin irritation, ulceration, pruritus, erythema, crusting, and eczematous reactions due to minimal systemic absorption. Calcipotriol may cause burning, itching, and skin irritation. This review details clinical trials that investigate the innovative approach of combining topical 5-FU with calcipotriol for actinic keratosis treatment, highlighting the significant outcomes. Notably, the clinical trials indicate that all participants experienced either a reduction in lesion size or complete lesion clearance, with minimal adverse effects impacting treatment success. The combination of 5-FU and calcipotriol effectively treats actinic keratosis by enhancing the immune response and targeting cell overgrowth, while reducing local site reactions and the lengthy treatment time often associated with existing therapies.
这篇综述考察了 5-氟尿嘧啶(5-FU)和卡泊三醇联合用于治疗光化性角化病的药理学、疗效和安全性、剂量和给药以及治疗中的地位。目前,5%的 5-FU 乳膏被批准用于治疗光化性角化病,而卡泊三醇则适用于成人斑块状银屑病。5-FU 的典型给药方案为每日两次局部涂抹,持续 4 周,而卡泊三醇则根据医生的指示,每日一次或两次涂抹薄薄一层。5-FU 的不良反应主要为局部反应,包括皮肤刺激、溃疡、瘙痒、红斑、结痂和湿疹样反应,这是由于其系统吸收很少。卡泊三醇可能引起烧灼感、瘙痒和皮肤刺激。这篇综述详细介绍了联合应用局部 5-FU 和卡泊三醇治疗光化性角化病的临床试验,突出了显著的结果。值得注意的是,临床试验表明,所有参与者的病变大小均有缩小或完全清除,且不良反应轻微,不影响治疗效果。5-FU 和卡泊三醇的联合应用通过增强免疫反应和靶向细胞过度生长,同时减少局部反应和现有治疗方法中常见的漫长治疗时间,有效地治疗了光化性角化病。