Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials

医学 丙酸氟替卡松 耐受性 荟萃分析 随机对照试验 特应性皮炎 他克莫司 钙调神经磷酸酶 内科学 不利影响 氟替卡松 科克伦图书馆 皮密莫司 皮肤病科 皮质类固醇 移植
作者
Jochen Schmitt,Laura von Kobyletzki,Åke Svensson,Christian Apfelbacher
出处
期刊:British Journal of Dermatology [Oxford University Press]
卷期号:164 (2): 415-428 被引量:237
标识
DOI:10.1111/j.1365-2133.2010.10030.x
摘要

Long-term low-level topical anti-inflammatory therapy has been suggested as a new paradigm in the treatment of atopic eczema (AE).To determine the efficacy and tolerability of topical corticosteroids and calcineurin inhibitors for flare prevention in AE.Systematic review of randomized controlled trials reporting efficacy of topical corticosteroids and/or topical calcineurin inhibitors for flare prevention in AE. Identification of relevant articles by systematic electronic searches (Cochrane Library, Medline) supplemented by hand search. Primary efficacy endpoint: proportion of participants experiencing at least one flare during proactive anti-inflammatory treatment. Relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated and pooled by pharmaceutical agent using random-effects meta-analysis. Sensitivity analysis included meta-regression to explore the influence of study-specific covariates.Nine articles reporting on eight vehicle-controlled trials were included. Three, four and one trial(s) evaluated proactive therapy with topical tacrolimus, fluticasone propionate and methylprednisolone aceponate, respectively. Each agent under study was more efficacious to prevent flares than vehicle. Meta-analysis suggested that topical fluticasone propionate (RR 0·46, 95% CI 0·38-0·55) may be more efficacious to prevent disease flares than topical tacrolimus (RR 0·78, 95% CI 0·60-1·00). Meta-regression indicated robustness of these findings. Proactive anti-inflammatory therapy was generally well tolerated. The trials identified, however, do not allow firm conclusions about long-term safety.Vehicle-controlled trials indicate efficacy of proactive treatment with tacrolimus, fluticasone propionate and methylprednisolone aceponate to prevent AE flares. Indirect evidence from vehicle-controlled trials suggests that twice weekly application of the potent topical corticosteroid fluticasone propionate may be more efficacious to prevent AE flares than tacrolimus ointment. Head to head trials should be conducted to confirm these results. Future studies are also needed to evaluate the long-term safety of proactive treatment of AE.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
hao完成签到,获得积分10
刚刚
不安的白昼完成签到 ,获得积分10
1秒前
不知道完成签到,获得积分10
3秒前
3秒前
chebo发布了新的文献求助10
4秒前
一一一应助滕皓轩采纳,获得10
4秒前
一一一应助滕皓轩采纳,获得10
4秒前
科研通AI2S应助滕皓轩采纳,获得10
4秒前
大个应助十曰采纳,获得10
5秒前
li完成签到 ,获得积分10
6秒前
尘埃之影完成签到,获得积分10
8秒前
陶醉的钢笔完成签到 ,获得积分10
9秒前
飞行的子弹完成签到,获得积分20
10秒前
泥花完成签到,获得积分10
10秒前
10秒前
mr_beard完成签到 ,获得积分10
11秒前
岑晓冰完成签到 ,获得积分10
13秒前
啦啦啦完成签到,获得积分10
13秒前
感动的小鸽子完成签到 ,获得积分10
14秒前
lxj完成签到 ,获得积分10
14秒前
无辜的蜗牛完成签到 ,获得积分10
14秒前
xiaojin完成签到,获得积分10
15秒前
程程完成签到,获得积分10
15秒前
duckspy发布了新的文献求助30
15秒前
15秒前
sunyanghu369发布了新的文献求助30
20秒前
hdc12138完成签到,获得积分10
21秒前
飞龙在天完成签到,获得积分0
21秒前
狄淇儿完成签到 ,获得积分10
21秒前
吨吨完成签到,获得积分10
22秒前
小芒果完成签到,获得积分0
26秒前
27秒前
杰克李李完成签到,获得积分10
28秒前
pakiorder完成签到,获得积分20
30秒前
无心的雅霜完成签到,获得积分10
30秒前
1122完成签到,获得积分10
31秒前
王磊完成签到,获得积分10
31秒前
顺心醉蝶完成签到 ,获得积分10
31秒前
量子星尘发布了新的文献求助10
31秒前
zhao完成签到 ,获得积分10
32秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038235
求助须知:如何正确求助?哪些是违规求助? 3575992
关于积分的说明 11374009
捐赠科研通 3305760
什么是DOI,文献DOI怎么找? 1819276
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022