局部皮质类固醇在亚托邦性皮炎的长期安全性:系统性审查
Jane Harvey1, Stephanie J Lax1, Alison Lowe2
1Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UK.
Skin health and disease
|October 6, 2023
概括
长期用于湿疹的局部皮质类固醇 (TCS) 显示出关于生长和皮肤变薄的安慰性安全性,间歇性使用可能会带来最小的风险. 然而,关于其他潜在的不良影响,仍然存在重大知识差距.
科学领域:
- 皮肤病学 皮肤病学
- 药理学 药理学是指药理学的学科.
- 基于证据的医学 基于证据的医学
背景情况:
- 局部皮质类固醇 (TCS) 是治疗湿疹的主要治疗方法.
- 有关TCS的长期安全概况存在担忧.
研究的目的:
- 系统地审查与长期局部皮质类固醇在湿疹患者的使用相关的不良影响.
主要方法:
- 随机对照试验 (RCT),队列和病例控制研究的系统审查.
- 纳入标准: >1年的随访,最低参与者数量.
- 证据质量的等级评估.
主要成果:
- 两个RCT (n=2570) 发现间歇性TCS使用与局部氨酸抑制剂相比,可能对生长,感染,疫苗反应或恶性瘤的影响很小.
- 一个RCT (n=1213) 报告了在5年内间歇性轻度/中度TCS使用的最小皮肤缩.
- 在病例控制研究中,在TCS和2型糖尿病/淋巴瘤之间发现了非常不确定的关联;没有关于局部类固醇戒断或眼睛问题的数据.
结论:
- 间歇性TCS在湿疹中使用长达五年的时间似乎对生长和皮肤变薄是安全的.
- 关于局部皮质类固醇的其他长期不良影响,仍然存在重大知识差距.
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