Camp R D, Reitamo S, Friedmann P S, Ho V, Heule F
Section of Dermatology, University of Leicester, U.K.
Br J Dermatol. 1993 Aug;129(2):217-20. doi: 10.1111/j.1365-2133.1993.tb03532.x.
Data on the use of oral cyclosporin A (CyA; Sandimmun) therapy for severe adult atopic dermatitis have accumulated since 1987. Details of over 200 adult patients who have received short-term CyA were presented at an international workshop in April 1993. Eighty-six of these patients had participated in three randomized, double-blind, placebo-controlled studies in which CyA was given for 6-8 weeks. The efficacy and safety of short-term CyA treatment in atopic dermatitis is established, provided that appropriate guidelines are observed. Evidence to date suggests that atopic dermatitis patients are no more prone to toxicity than patients with psoriasis, in whom more detailed and longer-term data are available. Early data also suggest that long-term CyA may be effective in atopic dermatitis, but there is concern regarding long-term safety, as experience is still limited. Careful monitoring of all CyA-treated patients is therefore mandatory. CyA should only be used under the direct and regular supervision of a hospital-based dermatologist who is knowledgeable in the use of cyclosporin A, and experienced in the management of severe skin disease and in the use of potentially toxic drugs.
自1987年以来，有关口服环孢素A（CyA；山地明）治疗重度成人特应性皮炎的数据不断积累。1993年4月在一次国际研讨会上介绍了200多名接受短期CyA治疗的成年患者的详细情况。其中86名患者参与了三项随机、双盲、安慰剂对照研究，在这些研究中，CyA给药6 - 8周。只要遵循适当的指导原则，短期CyA治疗特应性皮炎的疗效和安全性是有依据的。迄今为止的证据表明，特应性皮炎患者并不比银屑病患者更易出现毒性反应，后者有更详细和长期的数据。早期数据还表明，长期使用CyA可能对特应性皮炎有效，但由于经验仍然有限，人们对其长期安全性存在担忧。因此，对所有接受CyA治疗的患者进行仔细监测是必不可少的。CyA仅应在具备环孢素A使用知识、有重度皮肤病管理经验以及有潜在毒性药物使用经验的医院皮肤科医生的直接和定期监督下使用。
