针对湿疹的局部抗炎治疗方法:科克兰系统性审查和网络元分析
Stephanie J Lax1, Eleanor Van Vogt2, Bridget Candy3
1Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK.
概括
有效的局部类固醇,Janus激酶抑制剂和0.1%的塔克罗利是治疗湿疹的最有效的局部抗炎疗法. 这个网络元分析根据患者报告的症状和临床医生报告的症状对这些治疗进行了排名.
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:
- 湿疹是全球普遍存在的皮肤疾病,造成重大负担.
- 局部抗炎治疗是治疗湿疹症状的标准.
- 关于这些治疗方法的相对有效性和安全性存在不确定性.
研究的目的:
- 进行网络元分析,比较当前抗炎治疗湿疹的疗效和安全性.
- 根据现有证据,对这些治疗方法进行统计排名.
主要方法:
- 一个Cochrane系统审查,包括网络元分析.
- 搜索了多个数据库 (Cochrane Skin,CENTRAL,MEDLINE,Embase) 和临床试验登记册,截至2023年6月.
- 包括局部抗炎治疗湿疹的随机对照试验 (RCT),但不包括特定类型和治疗方法.
主要成果:
- 分析了291项试验 (45,846名参与者),其中89%的试验具有高偏差风险.
- 强效局部类固醇,塔克罗利斯0.1%和鲁克索利提尼布1.5%在改善患者报告的症状 (低信心) 和临床医生报告的症状 (中等信心) 方面排名很高.
- 雅努斯激酶抑制剂 (鲁克索利提尼布,德尔戈西提尼布),强效局部类固醇和塔克罗利斯0.1%的有效性显示为研究人员的全球评估 (中等信心).
- 局部部位反应最常见的是tacrolimus 0.1%和crisaborole 2%;在短期使用类固醇时没有观察到皮肤变薄,但在长期使用时报告.
结论:
- 有效的局部类固醇,Janus激酶抑制剂和0.1%的塔克罗利总是被列为治疗湿疹最有效的局部抗炎药物.
- 这些发现为治疗湿疹的临床决策提供了有价值的比较数据.
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