局部曲安奈德治疗斑状斑秃的最佳浓度:一项系统回顾和荟萃分析

IF 2.3 4区 医学 Q2 DERMATOLOGY
Hsuan-An Su, Yu-Tsung Chen, Yu-Chia Chen
{"title":"局部曲安奈德治疗斑状斑秃的最佳浓度:一项系统回顾和荟萃分析","authors":"Hsuan-An Su, Yu-Tsung Chen, Yu-Chia Chen","doi":"10.4103/ds.ds_15_22","DOIUrl":null,"url":null,"abstract":"Background: Intralesional steroid treatment for alopecia areata (AA) has been developed for decades, yet the optimal concentration of triamcinolone acetonide (TrA) is not well-established. Objectives: This review aims to determine the optimal concentration of intralesional TrA in treating patchy AA. Methods: We conducted a systematic review and meta-analysis, and searched the Cochrane Library, Embase, and PubMed databases on July 4, 2021, to identify randomized or nonrandomized comparative studies reporting the response rates and/or adverse events among AA patients treated with various concentrations of TrA. The meta-analysis of proportions and odds ratios was analyzed using random-effects modeling. Results: Nineteen studies and a total of 783 participants were included. The estimated response rate of 5 mg/dl (74.82%, 95% confidence interval [CI] 64.99%–83.50%) was shown to be more efficacious than 2.5/3.33 mg/dl (38.64%, 95% CI 16.98%–62.99%) but similar to 10 mg/dl (71.06%, 95% CI 59.72%–81.20%), while pooled estimate of odds ratios revealed higher efficacy with 10 mg/dl than 5 mg/dl (odds ratio = 1.64, 95% CI 1.05–2.58, P = 0.031). The rates of skin atrophy were 18.05% (95% CI, 10.32%–27.38%), 11.49% (95% CI, 2.86%–24.84%), and 3.85% (95% CI, 1.27%–14.01%) in groups 10, 5, and 2.5/3.33 mg/dl, respectively. Higher concentration is associated with more skin atrophy in a dose-dependent fashion (P = 0.012). Heterogeneity among studies in the meta-analyses was high. Conclusion: The optimal intralesional concentration of TrA for patchy AA is probably 10 mg/dl with acceptable adverse events.","PeriodicalId":11107,"journal":{"name":"Dermatologica Sinica","volume":"198 1","pages":"85 - 93"},"PeriodicalIF":2.3000,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The optimal concentration of intralesional triamcinolone acetonide for patchy alopecia areata: A systematic review and meta-analysis\",\"authors\":\"Hsuan-An Su, Yu-Tsung Chen, Yu-Chia Chen\",\"doi\":\"10.4103/ds.ds_15_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Intralesional steroid treatment for alopecia areata (AA) has been developed for decades, yet the optimal concentration of triamcinolone acetonide (TrA) is not well-established. Objectives: This review aims to determine the optimal concentration of intralesional TrA in treating patchy AA. Methods: We conducted a systematic review and meta-analysis, and searched the Cochrane Library, Embase, and PubMed databases on July 4, 2021, to identify randomized or nonrandomized comparative studies reporting the response rates and/or adverse events among AA patients treated with various concentrations of TrA. The meta-analysis of proportions and odds ratios was analyzed using random-effects modeling. Results: Nineteen studies and a total of 783 participants were included. The estimated response rate of 5 mg/dl (74.82%, 95% confidence interval [CI] 64.99%–83.50%) was shown to be more efficacious than 2.5/3.33 mg/dl (38.64%, 95% CI 16.98%–62.99%) but similar to 10 mg/dl (71.06%, 95% CI 59.72%–81.20%), while pooled estimate of odds ratios revealed higher efficacy with 10 mg/dl than 5 mg/dl (odds ratio = 1.64, 95% CI 1.05–2.58, P = 0.031). The rates of skin atrophy were 18.05% (95% CI, 10.32%–27.38%), 11.49% (95% CI, 2.86%–24.84%), and 3.85% (95% CI, 1.27%–14.01%) in groups 10, 5, and 2.5/3.33 mg/dl, respectively. Higher concentration is associated with more skin atrophy in a dose-dependent fashion (P = 0.012). Heterogeneity among studies in the meta-analyses was high. Conclusion: The optimal intralesional concentration of TrA for patchy AA is probably 10 mg/dl with acceptable adverse events.\",\"PeriodicalId\":11107,\"journal\":{\"name\":\"Dermatologica Sinica\",\"volume\":\"198 1\",\"pages\":\"85 - 93\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2022-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Dermatologica Sinica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/ds.ds_15_22\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatologica Sinica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/ds.ds_15_22","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 1

摘要

背景:斑秃(AA)的病灶内类固醇治疗已经发展了几十年,但曲安奈德(TrA)的最佳浓度尚未确定。目的:本综述旨在确定局斑性AA治疗的最佳局斑内TrA浓度。方法:我们于2021年7月4日进行了系统回顾和荟萃分析,并检索了Cochrane图书馆、Embase和PubMed数据库,以确定报告不同浓度TrA治疗AA患者的缓解率和/或不良事件的随机或非随机比较研究。采用随机效应模型对比例和优势比进行meta分析。结果:19项研究共纳入783名受试者。5 mg/dl的估计有效率(74.82%,95%可信区间[CI] 64.99%-83.50%)比2.5/3.33 mg/dl更有效(38.64%,95% CI 16.98%-62.99%),但与10 mg/dl相似(71.06%,95% CI 59.72%-81.20%),而合并估计的优势比显示10 mg/dl的疗效高于5 mg/dl(优势比= 1.64,95% CI 1.05-2.58, P = 0.031)。10、5和2.5/3.33 mg/dl组的皮肤萎缩率分别为18.05% (95% CI, 10.32% ~ 27.38%)、11.49% (95% CI, 2.86% ~ 24.84%)和3.85% (95% CI, 1.27% ~ 14.01%)。浓度越高,皮肤萎缩越严重,呈剂量依赖性(P = 0.012)。meta分析中各研究的异质性较高。结论:局部AA的最佳局灶内TrA浓度为10 mg/dl,不良反应可接受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The optimal concentration of intralesional triamcinolone acetonide for patchy alopecia areata: A systematic review and meta-analysis
Background: Intralesional steroid treatment for alopecia areata (AA) has been developed for decades, yet the optimal concentration of triamcinolone acetonide (TrA) is not well-established. Objectives: This review aims to determine the optimal concentration of intralesional TrA in treating patchy AA. Methods: We conducted a systematic review and meta-analysis, and searched the Cochrane Library, Embase, and PubMed databases on July 4, 2021, to identify randomized or nonrandomized comparative studies reporting the response rates and/or adverse events among AA patients treated with various concentrations of TrA. The meta-analysis of proportions and odds ratios was analyzed using random-effects modeling. Results: Nineteen studies and a total of 783 participants were included. The estimated response rate of 5 mg/dl (74.82%, 95% confidence interval [CI] 64.99%–83.50%) was shown to be more efficacious than 2.5/3.33 mg/dl (38.64%, 95% CI 16.98%–62.99%) but similar to 10 mg/dl (71.06%, 95% CI 59.72%–81.20%), while pooled estimate of odds ratios revealed higher efficacy with 10 mg/dl than 5 mg/dl (odds ratio = 1.64, 95% CI 1.05–2.58, P = 0.031). The rates of skin atrophy were 18.05% (95% CI, 10.32%–27.38%), 11.49% (95% CI, 2.86%–24.84%), and 3.85% (95% CI, 1.27%–14.01%) in groups 10, 5, and 2.5/3.33 mg/dl, respectively. Higher concentration is associated with more skin atrophy in a dose-dependent fashion (P = 0.012). Heterogeneity among studies in the meta-analyses was high. Conclusion: The optimal intralesional concentration of TrA for patchy AA is probably 10 mg/dl with acceptable adverse events.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Dermatologica Sinica
Dermatologica Sinica DERMATOLOGY-
CiteScore
2.80
自引率
20.00%
发文量
28
审稿时长
>12 weeks
期刊介绍: Dermatologica Sinica aims to publish high quality scientific research in the field of dermatology, with the goal of promoting and disseminating dermatological-related medical science knowledge to improve global health. Articles on clinical, laboratory, educational, and social research in dermatology and other related fields that are of interest to the medical profession are eligible for consideration. Review articles, original articles, brief reports, case reports and correspondence are accepted.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信