RESUMO
Atopic dermatitis is a chronic relapsing inflammatory skin disease affecting 15-20% children and 2-10% adults worldwide. Topical treatments include corticosteroids and calcineurin inhibitors, despite frequently observed adverse events such as skin atrophy, itching and burning sensations. Good alternatives that can prolong disease relief in between flare-ups are therefore needed. We conducted a randomized, single-blind, placebo-controlled, multicenter clinical trial in a Caucasian cohort of 90 children and 144 adults with mild-to-moderate atopic dermatitis that applied tested products twice daily for 60 days. A natural active from Ophiopogon japonicus, that improves atopic dermatitis symptoms in vivo, was successful in reducing the SCORing of Atopic Dermatitis (SCORAD), including erythema, pruritus and body surface area in both cohorts. The active also improved patient's quality of life and significantly reduced the number of patients relapsing compared to placebo. We conclude that this treatment could be an effective solution to help control the disease in between flare-ups.
Assuntos
Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/uso terapêutico , Frutanos/uso terapêutico , Ophiopogon , Extratos Vegetais/uso terapêutico , Adolescente , Adulto , Idoso , Pré-Escolar , Dermatite Atópica/diagnóstico , Dermatite Atópica/etnologia , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/isolamento & purificação , Feminino , França , Frutanos/efeitos adversos , Frutanos/isolamento & purificação , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Ophiopogon/química , Extratos Vegetais/efeitos adversos , Extratos Vegetais/isolamento & purificação , Polônia , Qualidade de Vida , Recidiva , Indução de Remissão , Índice de Gravidade de Doença , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , População Branca , Adulto JovemAssuntos
Fenômenos Biomecânicos/fisiologia , Desenvolvimento Infantil/fisiologia , Elasticidade/fisiologia , Envelhecimento da Pele/fisiologia , Adulto , Criança , Pré-Escolar , Colágeno/metabolismo , Feminino , Humanos , Lactente , Recém-Nascido , Microscopia Intravital , Masculino , Microscopia Confocal , Pele/diagnóstico por imagem , Pele/metabolismo , Adulto JovemAssuntos
Fármacos Dermatológicos/administração & dosagem , Glicosídeos/administração & dosagem , Menopausa , Envelhecimento da Pele/efeitos dos fármacos , Higiene da Pele/métodos , Creme para a Pele/administração & dosagem , Pele/efeitos dos fármacos , Administração Cutânea , Idoso , Fármacos Dermatológicos/efeitos adversos , Feminino , Glicosídeos/efeitos adversos , Humanos , Pessoa de Meia-Idade , Polônia , Estudos Prospectivos , Sebo/metabolismo , Pele/metabolismo , Pele/patologia , Higiene da Pele/efeitos adversos , Creme para a Pele/efeitos adversos , Espanha , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Atopic dermatitis (AD) requires permanent skin care. OBJECTIVE: A cream containing 2% SO (sunflower oleodistillate), with peroxisome proliferator-activated receptor-alpha (PPAR-α) agonist properties, has been compared to a topical steroid (hydrocortisone butyro-propionate 1 mg/g). METHODS: An open, randomized study included two groups of 40 children (aged 3 months to 4 years). Group A applied the steroid and group B applied the 2% SO cream, twice a day. SCORAD (SCORing Atopic Dermatitis) was determined at D0, D7 and D21 and quality of life (QoL) at D0 and D21. RESULTS: SCORAD was similar at D0 (37.2 versus 36.9), D7 (18.9 versus 19.2) (-49% and -48%) and D21 (11 versus 9.4) (-70% and -75%) (p < 0.01 versus D0). The Infant Dermatitis Quality of Life and Dermatitis Family Impact Questionnaire improved similarly by 65%/67% in group A and 72%/75% in group B at D21 (p < 0.01 versus D0). CONCLUSION: A 2% SO cream has demonstrated therapeutic properties, using clinical scores and QoL, comparable to those of a topical steroid.
Assuntos
Dermatite Atópica/diagnóstico , Dermatite Atópica/tratamento farmacológico , Hidrocortisona/uso terapêutico , PPAR alfa/antagonistas & inibidores , PPAR alfa/uso terapêutico , Administração Tópica , Pré-Escolar , Relação Dose-Resposta a Droga , Esquema de Medicação , Emolientes , Feminino , Seguimentos , Humanos , Lactente , Masculino , Qualidade de Vida , Valores de Referência , Fatores de Risco , Índice de Gravidade de Doença , Método Simples-Cego , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Emollients are commonly used for their effectiveness on atopic skin, supported by a few clinical studies suggesting their potential role as corticosteroid sparing agents. We investigated the effect of a new natural emollient on corticosteroid sparing and quality of life of young atopic children and their family. Eighty-six patients (4-48 mos) with moderate atopic dermatitis were randomized by 20 pediatricians to five groups for 21 days: corticosteroids (from twice daily to one application every other day) combined or not with the studied cream (twice daily), and evaluated by SCORAD and specific quality of life questionnaires. At the end of the study, all five groups were statistically improved in terms of SCORAD and quality of life index. Thus, application of a topical corticosteroid every other day in addition to the studied cream was as effective as a once or twice daily application of the steroid alone. The studied cream had a significant impact on lichenification, excoriation and quality of life. A twice daily application of a new natural emollient provided a major corticosteroid sparing, improved lichenification and excoriation and improved the quality of life in children and their parents.
