NICOTINAMIDE AND TETRACYCLINE THERAPY OF BULLOUS PEMPHIGOID
NICOTINAMIDE AND TETRACYCLINE THERAPY OF BULLOUS PEMPHIGOID
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DOI：
10.1001/archderm.130.6.753
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发表时间：
1994-06-01
影响因子：
--
通讯作者：
MUTASIM, D
中科院分区：
文献类型：
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作者：
FIVENSON, DP;BRENEMAN, DL;MUTASIM, D
背景与设计：据报道，烟酰胺和四环素联合治疗大疱性类天疱疮有效。我们进行了一项随机、开放性试验，比较了500 mg烟酰胺（每日3次）和500 mg四环素（每日4次）联合泼尼松治疗20例大疱性类天疱疮患者。这项研究分为8周的急性期与固定的药物剂量和10个月的随访期，其中研究药物逐渐减少的基础上，患者responsibility.Results：十八入组的20例患者进行了治疗，两名患者无法随访。12例患者接受烟酰胺和四环素联合治疗，6例患者接受泼尼松治疗。烟酰胺和四环素组有5例完全缓解，5例部分缓解，1例无缓解，1例疾病进展，而泼尼松组有1例完全缓解和5例部分缓解。两组之间的反应参数无统计学显著差异。接受长期随访的烟酰胺和四环素组的所有5名患者在药物逐渐减少期间保持无病，而泼尼松组的3名患者在类固醇逐渐减少的情况下反复发生疾病发作。烟酰胺和四环素组的不良反应包括胃肠道不适（2例患者）和一过性肾衰竭（1例患者）。在泼尼松组中，高血压、糜烂性胃炎、多发性褥疮、骨髓炎、深静脉血栓形成和败血症相关死亡各发生1例。两名患者需要胰岛素治疗高血糖症。结论：烟酰胺和四环素的组合似乎是一个有用的替代全身类固醇治疗大疱性类天疱疮。
Background and Design: The combination of nicotinamide and tetracycline has been anecdotally reported to be effective in the treatment of bullous pemphigoid. We conducted a randomized, open-labeled trial comparing the combination of 500 mg of nicotinamide, three times daily, and 500 mg of tetracycline four times daily, with prednisone therapy in 20 patients with bullous pemphigoid. The study was divided between an 8-week acute phase with fixed drug dosages and a 10-month follow-up phase in which study medications were tapered based on patient response.Results: Eighteen of 20 patients enrolled in the study were treated,two patients were unavailable for followup. Twelve patients were treated with the combination of nicotinamide and tetracycline and six patients were treated with prednisone. There were five complete responses, five partial responses, one nonresponder, and one patient with disease progression in the nicotinamide and tetracycline group compared with one complete response and five partial responses in the prednisone group. There were no statistically significant differences in response parameters between the two groups. All five patients in the nicotinamide and tetracycline group receiving long-term follow-up remained disease free during medication tapering, while three patients in the prednisone group had repeated disease flare-ups with steroid tapering. Adverse effects in the nicotinamide and tetracycline group included gastrointestinal upset (two patients) and transient renal failure (one patient). In the prednisone group, there was one occurrence each of hypertension, erosive gastritis, multiple decubitus ulcers, osteomyelitis, deep venous thrombosis, and death related to sepsis. Two patients required insulin therapy for hyperglycemia.Conclusions: The combination of nicotinamide and tetracycline appears to be a useful alternative to systemic steroids in the treatment of bullous pemphigoid.