托法替布治疗斑秃的短期疗效与安全性OA
Short-term efficacy and safety of tofacitinib in the treatment of alopecia areata
目的 了解托法替布治疗斑秃的短期疗效及安全性.方法 收集2020年1月至2022年12月开封市人民医院经治的斑秃患者80例,采用抽签法均分为观察组(40例)与对照组(40例).对照组给予口服醋酸泼尼松片[0.3 mg/(kg·d)]及外用米诺地尔酊(每天2次)治疗,观察组给予口服托法替布(5 mg/d)及外用米诺地尔酊(每天2次,外用)治疗,2组均连续治疗8周.比较两组治疗4周、8周的临床疗效,并比较不同性别、病程、临床分型、脱发面积、拉发试验结果及有无家族史的斑秃患者的临床疗效.记录2组治疗期间各类不良事件发生情况并行对比分析.结果 治疗8周后,观察组痊愈率高于对照组(60.00%比32.50%,P=0.014).观察组中,病程≤7月组痊愈率高于>7月组(85.00%比35.00%,P=0.001);拉发试验阳性组痊愈率高于拉发试验阴性组(74.07%比30.77%,P=0.009),而不同性别、临床分型、脱发面积及有无家族史的斑秃患者痊愈率的差异无统计学意义(均P>0.05).两组患者头皮接触性皮炎、轻度头痛、肝酶升高及口角单纯疱疹的发生率间差异均无统计学意义(均P>0.05).结论 托法替布治疗斑秃短期疗效优于激素,且未增加不良反应.病程较短、拉发实验阳性者疗效更好.
Objective To investigate the short-term efficacy and safety of tofacitinib in the treatment of alopecia areata.Methods A total of 80 cases of alopecia areata,who visited our hos-pital from January 2020 to December 2022,were divided into the control and the observational groups according to the lottery method.The controls were given oral prednisone acetate tablet[0.3 mg/(kg·d)]and topical minoxidil tincture twice daily for 8 weeks,while the patients in the observation group were treated with oral tofacitinib(5 mg/d)and topical minoxidil tincture twice daily.The association of therapeutic efficacy with demographic characteristics,disease dura-tion,clinical classification,hair loss area,hair pulling test results,and family history were also determined.In addition,the clinical efficacy and adverse reactions were compared between the two groups following 4 and 8 weeks of treatment.Results After 8-week treatment,the cure rate in the observation group was higher than that in the controls(60.0%vs.32.50%,P=0.014).In the observation group,the cure rate was higher in patients with disease duration of ≤7 months than in that with disease duration of>7 months(85.00%vs.35.00%,P=0.001).Moreover,the cure rate was higher in patients with positive hair pulling test than in that with negative hair pulling test(74.07%vs.30.77%,P=0.009).However,the cure rate was not influenced by gender,clinical subtype,area of hair loss and family history.There were no significant differences in the incidence of adverse reactions,including scalp contact dermatitis,mild headache,elevated liver enzymes,and oral herpes simplex between the two groups.Conclusions Tofacitinib is safe for the treatment of alopecia areata,and its efficacy is superior to that of glucocorticoids,especial-ly for those with short disease duration and positive hair pulling test.
王祖艳;轩俊丽;王哲新
开封市人民医院,河南 开封 475000开封市人民医院,河南 开封 475000开封市人民医院,河南 开封 475000
托法替布斑秃疗效安全性
tofacitinibalopecia areataefficacysafety
《皮肤性病诊疗学杂志》 2024 (2)
95-101,7
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