治疗急性疹:一个系统的审查
Fariza M S Badloe1,2, Martine Grosber1, Johannes Ring3
1SKIN Research Group, Vrije Univeristeit Brussel (VUB), Brussels, Belgium.
Journal of the European Academy of Dermatology and Venereology : JEADV
|February 29, 2024
概括
在大多数试验中,添加抗组胺剂的全身皮质类固醇并没有显著改善严重急性疹 (AU) 症状. 对AU的基于证据的治疗指南仍然不清楚,需要进一步研究.
科学领域:
- 皮肤病学 皮肤病学
- 临床药理学 临床药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 治疗急性疹 (AU) 缺乏可靠的临床试验数据.
- 系统性皮质类固醇与抗组胺药物结合治疗严重AU的疗效尚未得到充分证实.
- 目前的治疗指南主要针对慢性疹,使得AU的管理不清楚.
研究的目的:
- 系统地审查有关急性疹治疗方法的现有证据.
- 评估系统性皮质类固醇在严重的AU中对抗胰岛素的附加益处.
- 为了确定急性疹的有效治疗策略.
主要方法:
- 对PubMed和Web of Science进行了系统的电子搜索.
- 纳入了10项随机对照试验 (RCT),涉及857名参与者.
- 数据综合遵循了PRISMA声明,使用Cochrane偏差风险工具进行质量评估.
主要成果:
- 在2/3的RCT中,与抗组胺单一治疗相比,添加莱沃西里辛的皮质类固醇并没有改善AU症状.
- 在2/5的研究中,静脉注射的二水胺与兰尼蒂丁或西米蒂丁相结合显示了最多的疹缓解.
- 镇静和昏昏欲睡是报告的最常见的不良反应.
结论:
- 由于有限的高质量证据,急性疹的最佳管理仍然不清楚.
- 将皮质类固醇添加到AU的抗组胺药物中需要进一步调查.
- 精心设计的临床试验对于建立基于证据的治疗指南至关重要.
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