Effect of prednisone plus either adalimumab or cyclosporine on dermatological symptoms in Vogt-Koyanagi-Harada disease: Systemic outcomes from a randomized trial.
Zhenyu Zhong, Jiayi Wang, Weiting Liao, Junjie Xiang, Tao Cai, Peizeng Yang
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Abstract
Background: Vogt-Koyanagi-Harada (VKH) disease causes vitiligo, poliosis, and alopecia.
Objective: To investigate the effect of prednisone plus either adalimumab or cyclosporine-based immunosuppression on VKH dermatologic disorders using ancillary data from a VKH eye disease trial.
Methods: Patients with VKH disease treated with individualized prednisone tapering (maximum daily dose, 40 mg; maximum duration, 6 months) were randomized to adjunctive adalimumab (N = 54) or cyclosporine (N = 56). Outcomes included changes in vitiligo, poliosis, and alopecia at the sixth month.
Results: Overall, there was a decrease in the percentage of alopecia but no change in the presence of vitiligo or poliosis at the sixth month. The adalimumab group showed no nominally significant differences in the percentage changes of each dermatologic manifestation but a greater reduction in the number of affected dermatologic categories compared with the cyclosporine group.
Limitations: This is a secondary analysis of a VKH eye disease trial. Six-month follow-up may not fully assess effects on vitiligo and poliosis.
Conclusions: In conjunction with prednisone tapering, both adalimumab and cyclosporine similarily improved alopecia but had no obvious effect on the presence of vitiligo or poliosis at 6 months. Adalimumab was associated with a greater decrease in the number of affected dermatologic conditions compared with cyclosporine.
期刊介绍：
The Journal of the American Academy of Dermatology (JAAD) is the official scientific publication of the American Academy of Dermatology (AAD). Its primary goal is to cater to the educational requirements of the dermatology community. Being the top journal in the field, JAAD publishes original articles that have undergone peer review. These articles primarily focus on clinical, investigative, and population-based studies related to dermatology. Another key area of emphasis is research on healthcare delivery and quality of care. JAAD also highlights high-quality, cost-effective, and innovative treatments within the field. In addition to this, the journal covers new diagnostic techniques and various other topics relevant to the prevention, diagnosis, and treatment of skin, hair, and nail disorders.
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