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2%克立硼罗软膏主动治疗轻至中度特应性皮炎患儿的疗效与安全性:一项随机对照研究

Efficacy and Safety of Proactive Therapy with 2% Crisaborole Ointment in Children with Mild-to-Moderate Atopic Dermatitis: A Randomized Controlled Study.

作者信息

Yang Huan, Li Ping, Shu Hong, Qian Hua, Chen Jing-Ping, Wang Shan, Miao Li-Min, Li Xiao-Li, Meng Yuan, Cao Rong, Luo Xiao-Yan, Ma Lin, Wang Hua

机构信息

Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.

Department of Dermatology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.

出版信息

Paediatr Drugs. 2025 May;27(3):367-376. doi: 10.1007/s40272-025-00682-w. Epub 2025 Jan 28.

Abstract

BACKGROUND

The effectiveness of crisaborole for proactive treatment of atopic dermatitis (AD) is not well established.

OBJECTIVES

This study aims to investigate the efficacy and safety of a proactive treatment strategy with 2% crisaborole ointment for managing mild-to-moderate AD in children.

PATIENTS AND METHODS

In this 16-week randomized-controlled trial, children aged 2-17 years with mild-to-moderate AD were enrolled. All participants received treatment with 0.1% mometasone furoate cream for 2 weeks. Those with an IGA score of ≤ 1 were randomly assigned in a 1:1 ratio to either the proactive treatment group, which received crisaborole combined with emollient twice daily, or the reactive treatment group, which received emollients alone, and in the event of disease relapse, both groups received 0.1% mometasone furoate cream as rescue treatment.

RESULTS

Of the 153 patients screened, 142 were randomized; 73 to the proactive treatment group and 69 to the reactive treatment group. At the end of the 16-week trial, the proactive treatment group had a relapse rate of 43.84%, significantly lower than the 71.01% relapse rate in the reactive group (P = 0.001). Additionally, the proactive treatment group demonstrated a significant reduction in the need for mometasone furoate prescriptions at weeks 4, 8, 12, and 16 (P < 0.05). Improvements were also observed in IGA, EASI, PP-NRS, and POEM scores at 12 weeks (P < 0.05). No significant differences in adverse events were found between the groups (χ = 2.237, P = 0.135).

CONCLUSIONS

Proactive treatment with crisaborole ointment for children older than 2 years with mild-to-moderate AD effectively reduces flare-ups and reliance on topical corticosteroids, demonstrating good tolerability and safety.

CHINESE CLINICAL TRIAL REGISTRY

ChiCTR2100054340 (Date of Trial Registration: 14 December 2021).

摘要

背景

克立硼罗用于特应性皮炎(AD)的预防性治疗效果尚未明确。

目的

本研究旨在探讨采用2%克立硼罗软膏的预防性治疗策略用于治疗儿童轻至中度AD的疗效和安全性。

患者和方法

在这项为期16周的随机对照试验中,纳入了2至17岁的轻至中度AD儿童。所有参与者均接受0.1%糠酸莫米松乳膏治疗2周。那些伊氏评分(IGA)≤1的患者按1:1比例随机分为预防性治疗组(每天两次接受克立硼罗联合润肤剂治疗)或反应性治疗组(仅接受润肤剂治疗),若疾病复发,两组均接受0.1%糠酸莫米松乳膏作为挽救治疗。

结果

在153名筛查的患者中,142名被随机分组;73名进入预防性治疗组,69名进入反应性治疗组。在16周试验结束时,预防性治疗组的复发率为43.84%,显著低于反应性治疗组的71.01%(P = 0.001)。此外,预防性治疗组在第4、8、12和16周时糠酸莫米松处方需求显著减少(P < 0.05)。在第12周时,IGA、湿疹面积和严重程度指数(EASI)、患者总体评估数值评定量表(PP-NRS)和医师全面评估量表(POEM)评分也有改善(P < 0.05)。两组之间不良事件无显著差异(χ = 2.237,P = 0.135)。

结论

对于2岁以上轻至中度AD儿童,采用克立硼罗软膏进行预防性治疗可有效减少病情发作并降低对外用糖皮质激素的依赖,耐受性和安全性良好。

中国临床试验注册中心

ChiCTR2100054340(试验注册日期:2021年12月14日)

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