治疗中重度银屑病患者的脉冲硫唑嘌呤(AZA)和小剂量甲氨蝶呤(MTX)与标准剂量MTX的随机对照试验。

IF 3.7 4区 医学 Q1 DERMATOLOGY
Mohamed Hussein Medhat El-Komy, Khadiga S Sayed, Gehad Gawish, Menatallah Mohamed Elaguizy, Yousra Azzazi
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引用次数: 0

摘要

背景:银屑病是一种常见的免疫介导的慢性炎症性皮肤病。目的:我们旨在比较联合脉冲硫唑嘌呤(AZA)和小剂量甲氨蝶呤与常规剂量甲氨蝶呤(MTX)对慢性斑块状银屑病患者的疗效和安全性:在这项随机对照试验中,67名中度至重度斑块状银屑病患者被随机分为两组,分别接受脉冲AZA(每周300毫克)和小剂量MTX(每周10毫克)联合治疗或常规剂量MTX(0.3毫克/千克/周)治疗,为期16周。使用PASI评分评估患者的治疗反应,并在第12周和第16周以及停止治疗后的3个月内评估患者是否出现任何不良反应:与接受常规剂量MTX单药治疗的患者相比,接受脉冲AZA和小剂量MTX联合治疗的患者在第12周达到PASI 90和PASI 100,在第16周达到PASI 100的比例明显更高。在整个研究期间,两组患者均未出现严重不良反应:结论:使用脉冲AZA和小剂量MTX联合治疗中重度斑块状银屑病疗效显著,安全性相对较好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pulse azathioprine and low-dose methotrexate vs. standard-dose methotrexate in treatment of patients with moderate-to-severe psoriasis: a randomized controlled trial.

Background: Psoriasis is a common chronic, immune-mediated inflammatory skin disease. Despite the availability of several systemic therapeutic agents, treatment of psoriasis remains a challenge because of the associated adverse effects and/or the financial burden of these medications, given the chronicity of the disease.

Objectives: We aimed to compare the efficacy and safety of combined pulse azathioprine (AZA) and low-dose methotrexate (MTX) vs. a conventional dose of MTX in patients with chronic plaque psoriasis.

Methods: In this randomized controlled trial, 67 patients with moderate-to-severe plaque psoriasis were randomized into two groups, receiving either combined pulse AZA (300 mg weekly dose) and low-dose MTX (10 mg weekly) or conventional-dose MTX (0.3 mg kg-1 per week) for 16 weeks. Patients were assessed for treatment response using the Psoriasis Area and Severity Index (PASI) score and for the development of any adverse effects at weeks 12 and 16, and for a further 3 months after stopping treatment.

Results: A statistically significantly higher proportion of the patients receiving combined pulse AZA and low-dose MTX achieved ≥ 90% improvement in PASI and 100% improvement (PASI 100) at week 12, and PASI 100 at week 16, compared with those receiving the conventional dose of MTX as monotherapy. No serious adverse events were reported during the entire study period in the two groups.

Conclusions: Combination therapy using pulse AZA and low-dose MTX can be an efficacious treatment for moderate-to-severe plaque psoriasis, with a relatively good safety profile.

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来源期刊
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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