Case of bullous pemphigoid refractory to corticosteroids by antiepileptic drug-induced CYP3A4.
Case of bullous pemphigoid refractory to corticosteroids by antiepileptic drug-induced CYP3A4.
复制标题
抗癫痫药诱导的 CYP3A4 对皮质类固醇耐药的大疱性类天疱疮病例。
DOI：
10.1111/1346-8138.16624
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发表时间：
2023
期刊：
影响因子：
3.1
通讯作者：
Tatsuyoshi Kawamura
中科院分区：
文献类型：
--
作者：
Riko Asakawa;Youichi Ogawa;Eri Maejima;Akiko Honobe-Tabuchi;Takashi Okamoto;Hiroshi Mitsui;Yoshiyuki Kagawa;Shinji Shimada;Tatsuyoshi Kawamura
大疱性类天疱疮患者最常见的治疗选择是全身性皮质类固醇。CYP3A4是肝脏中的一种药物代谢酶，在不同程度上代谢合成类固醇。虽然有许多CYP3A4诱导药物，但一些抗癫痫药物，如苯妥英和苯巴比妥，强烈诱导CYP3A4，从而降低皮质类固醇的作用。在这里，我们报告一例难治性大疱性类天疱疮，在停用苯妥英钠和苯巴比妥后迅速改善。为了实现皮质类固醇的充分药理学作用，我们必须始终确保需要皮质类固醇治疗的患者不接受CYP3A4诱导剂治疗。
The most common treatment option for patients with bullous pemphigoid is systemic corticosteroids. CYP3A4, a drug‐metabolizing enzyme in the liver, metabolizes synthetic steroids to a varying degree. Although there are many CYP3A4‐inducing drugs, several antiepileptic drugs, such as phenytoin and phenobarbital, strongly induce CYP3A4, thereby reducing the effects of corticosteroids. Here, we report a case of refractory bullous pemphigoid that rapidly improved after the discontinuation of phenytoin and phenobarbital. To achieve adequate pharmacological effects of corticosteroids, we must always ensure that patients who require corticosteroids for treatment are not medicated with CYP3A4‐inducing agents.