Lebwohl M, Yoles A, Lombardi K, Lou W
Mount Sinai Medical Center, New York, New York 10029, USA.
J Am Acad Dermatol. 1998 Sep;39(3):447-50. doi: 10.1016/s0190-9622(98)70323-8.
Weekend therapy with superpotent topical corticosteroids has been used for the long-term treatment of psoriasis. Recently, calcipotriene ointment has been added to this regimen for use on weekdays, but there are no long-term studies of that combination.
The purpose of this study was to determine whether the addition of weekday calcipotriene to a pulse therapy regimen of weekend superpotent corticosteroids results in a longer duration of remission of plaque psoriasis.
This was a double-blind, placebo-controlled, parallel-group study. Forty-four patients with mild to moderate psoriasis were treated with calcipotriene ointment in the morning and halobetasol ointment in the evening for 2 weeks. Thereafter, 40 patients who were at least moderately (50% or greater) improved were randomized to 2 treatment groups. After 2 weeks of treatment with calcipotriene ointment in the morning and halobetasol ointment in the evening, 20 patients were randomized to receive halobetasol ointment twice daily on weekends and calcipotriene ointment twice daily on weekdays, and 20 patients were randomized to receive halobetasol ointment twice daily on weekends and placebo ointment twice daily on weekdays.
Seventy-six percent of patients applying halobetasol ointments on weekends and calcipotriene ointment on weekdays were able to maintain remission for 6 months compared with 40% of patients applying halobetasol ointment on weekends only with the vehicle on weekdays.
The addition of calcipotriene ointment applied on weekdays to a weekend pulse therapy regimen of superpotent corticosteroids can increase the duration of remission of psoriasis.
强效外用糖皮质激素的周末疗法已用于银屑病的长期治疗。最近，卡泊三醇软膏已被添加到该方案中用于平日治疗，但尚无关于该联合用药的长期研究。
本研究的目的是确定在周末强效糖皮质激素脉冲疗法方案中添加平日使用的卡泊三醇是否能延长斑块状银屑病的缓解期。
这是一项双盲、安慰剂对照、平行组研究。44例轻至中度银屑病患者接受早上使用卡泊三醇软膏和晚上使用卤米松软膏治疗2周。此后，40例至少有中度（50%或更高）改善的患者被随机分为2个治疗组。在早上使用卡泊三醇软膏和晚上使用卤米松软膏治疗2周后，20例患者被随机分配在周末每天使用两次卤米松软膏，平日每天使用两次卡泊三醇软膏，另外20例患者被随机分配在周末每天使用两次卤米松软膏，平日每天使用两次安慰剂软膏。
周末使用卤米松软膏且平日使用卡泊三醇软膏的患者中有76%能够维持缓解6个月，而仅在周末使用卤米松软膏且平日使用赋形剂的患者中这一比例为40%。
在强效糖皮质激素的周末脉冲疗法方案中添加平日使用的卡泊三醇软膏可延长银屑病的缓解期。
