Cyclosporine treatment of severe Hidradenitis suppurativa - A case series
Cyclosporine treatment of severe Hidradenitis suppurativa - A case series
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DOI：
10.3109/09546634.2015.1088128
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发表时间：
2016-05-03
影响因子：
2.9
通讯作者：
Jemec, Gregor B. E.
中科院分区：
文献类型：
--
作者：
Anderson, Marianne D.;Zauli, Stefania;Jemec, Gregor B. E.
背景：化脓性汗腺炎（HS）是一种被忽视但常见的疾病，严重影响男女。HS通常被认为是难以治疗的，尽管有许多治疗方法，但显然需要更有效的治疗。目的：环孢霉素A（CsA）已被建议作为一种有效的治疗在四个较小的病例系列。因此，决定审查更多病例系列，报告所有结局，以便为评价CsA用于HS的潜力提供偏倚较小的基础。研究方法：在三个皮肤科对病例记录进行了探索性回顾性审查，特别关注HS，其中HS在2009 - 2012年期间接受了CsA治疗。结果：总共确定并分析了18例接受CsA治疗的HS患者，50%的患者报告了一些获益。所有患者之前均接受过多种其他方式的治疗。局限性：这是一项探索性回顾性综述，患者数量有限。结论：本回顾性研究发现，CsA在所研究的难治性病例中有一定的疗效，主要报告为"轻微改善"。这可能是由于一些因素可能高估（例如，伴随治疗）或低估（例如，选择非依从性病例）了疗效，并表明需要对声明进行前瞻性评价。目前的数据提供了一个基础的权力计算在未来的研究调查的潜力，治疗HS与CsA的随机对照试验。
Background: Hidradenitis suppurativa (HS) is an overlooked but common disease severely affecting both genders. HS is generally perceived as difficult to treat and although a number of treatments are available, the need for more effective treatment is apparent. Objectives: Cyclosporine A (CsA) has been suggested as an effective treatment in four smaller case series. It was therefore decided to review a larger series of cases, reporting all outcomes in order to provide a less biased base for evaluating the potential of CsA for use in HS. Methods: An exploratory retrospective review of case notes was performed at three departments of dermatology with a special interest in HS, where HS had been treated with CsA in the period 2009-2012. Results: In total, 18 HS patients treated with CsA were identified and analysed and 50% reported some benefit. All patients had previously been treated with multiple various other modalities. Limitations: This is an exploratory retrospective review with a limited number of patients. Conclusions: This retrospective review found some effect of CsA in the recalcitrant cases studied, mainly reported as "slight improvement". This may be due to a number of factors which may have overestimated (e.g. concommitant therapy) or underestimated (e.g. case selection of recalcitrant cases) the effect, and indicates the need for prospective evaluation of the claims. The present data provide a basis for power calculations in future studies investigating the potential for treating HS with CsA in a randomised controlled trial.