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白三烯受体拮抗剂治疗特应性皮炎的系统评价和荟萃分析

Leukotriene Receptor Antagonists for the Treatment of Atopic Dermatitis: A Systematic Review and Meta-analysis.

作者信息

Mahmood Safa Fawaza, Mahmood Wafa Nawafa, Abdalla Omnia Mohamed, Nazar Afra, Riaz Hadeeqah Zayaan, Elmorsy Soha

机构信息

David Tvildiani Medical University, Tbilisi, Georgia.

Kasr Al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt.

出版信息

Acta Derm Venereol. 2025 May 19;105:adv43140. doi: 10.2340/actadv.v105.43140.

Abstract

Atopic dermatitis is a chronic skin condition with no cure. Current conventional treatments can have many side effects or are expensive. Emerging evidence suggests leukotriene receptor antagonists could serve as a corticosteroid-sparing option. This meta-analysis examined 26 studies on the efficacy of leukotriene receptor antagonists for treating atopic dermatitis across 742 participants. There were non-significant reductions in atopic dermatitis severity overall. However, in subgroup analyses montelukast significantly reduced Severity Scoring of Atopic Dermatitis scores in adult populations (SMD = -0.94, 95% CI -1.35 to -0.54, p < 0.0001) and also when compared with conventional treatment rather than placebo (SMD = -0.84, 95% CI -1.21 to -0.47, p < 0.0001). Studies excluded from the statistical analysis generally showed a positive trend favouring montelukast, even if results were not statistically significant. Montelukast shows potential as an adjunct therapy in atopic dermatitis, particularly in adults, but its efficacy is inconsistent. While it may help with pruritus, it should not replace standard treatments. Future research should focus on standardized assessments and personalized approaches to clarify its role in atopic dermatitis management.

摘要

特应性皮炎是一种无法治愈的慢性皮肤病。目前的传统治疗方法可能有许多副作用或费用昂贵。新出现的证据表明,白三烯受体拮抗剂可作为一种节省皮质类固醇的选择。这项荟萃分析研究了26项关于白三烯受体拮抗剂治疗特应性皮炎疗效的研究,涉及742名参与者。总体上特应性皮炎严重程度的降低不显著。然而,在亚组分析中,孟鲁司特显著降低了成人人群的特应性皮炎严重程度评分(标准化均数差 = -0.94,95%置信区间-1.35至-0.54,p < 0.0001),与传统治疗相比而非安慰剂时也有显著降低(标准化均数差 = -0.84,95%置信区间-1.21至-0.47,p < 0.0001)。被排除在统计分析之外的研究通常显示出有利于孟鲁司特的积极趋势,即使结果没有统计学意义。孟鲁司特在特应性皮炎中显示出作为辅助治疗的潜力,尤其是在成人中,但其疗效并不一致。虽然它可能有助于缓解瘙痒,但不应取代标准治疗。未来的研究应集中在标准化评估和个性化方法上以阐明其在特应性皮炎管理中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a561/12105541/ae0f28ee833e/ActaDV-105-43140-g001.jpg

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