目的:比较非皮质类固醇局部治疗斑块状银屑病的安全性和有效性。数据来源:使用关键词斑块状银屑病对PubMed数据库进行了文献检索(1978年1月至2023年5月),tapinarof,benvitimod,Vtama,罗氟米拉斯特,Zoryve,吡美莫司,他克莫司,他扎罗汀,他卡西醇,骨化三醇,Vectical,钙三烯,Dovonex,他卡西醇,维生素D类似物,水杨酸,非皮质类固醇外用,调查员全球评估,和医生的全球评估。研究选择和数据提取:考虑了相关的英语文章和临床试验数据。数据综合:选择用于治疗斑块状银屑病的六种非皮质类固醇局部类别。使用他卡西醇治疗8周后,获得研究者全球评估(IGA)成功的斑块型银屑病患者的百分比,钙三烯/二丙酸倍他米松复方,他扎罗汀/丙酸卤倍他罗汀,罗氟司特为17.9%,39.9%,40.7%,和42.4%,分别。对于tapinarof和煤焦油的12周试验,37.4%和58.2%的患者获得了IGA成功,分别。水杨酸(12周)和吡美莫司(4周)的IGA评分分别降低了48%和71.4%,分别。最后,66.7%的患者在8周的他克莫司治疗中取得了医师全球评估的成功。非皮质类固醇局部用药没有发生严重不良事件。结论:对于希望避免局部使用皮质类固醇或因长期使用皮质类固醇而产生不良反应的斑块状银屑病患者,非皮质类固醇局部用药是合适的选择。由于治疗持续时间的差异和不同的结果指标,目前尚不清楚哪一种非皮质类固醇局部用药最有效;然而,钙调神经磷酸酶抑制剂似乎表现出最大的功效。每种局部治疗都能有效治疗斑块状银屑病,并具有足够的安全性。尽管斑块状牛皮癣有几种治疗选择,服药依从性是一个限制因素。
Objective: The objective was to compare the safety and efficacy of noncorticosteroid topical treatments for plaque psoriasis. Data Sources: A literature search of the PubMed database was performed (January 1978 to May 2023) using the keywords plaque psoriasis, tapinarof, benvitimod, Vtama, roflumilast, Zoryve, pimecrolimus, tacrolimus, tazarotene, tacalcitol, calcitriol, Vectical, calcipotriene, Dovonex, tacalcitol, vitamin D analogs, salicylic acid, non-corticosteroid topical, Investigator\'s Global Assessment, and Physician\'s Global Assessment. Study Selection and Data Extraction: Relevant English-language articles and clinical trial data were considered. Data Synthesis: Six noncorticosteroid topical classes for the treatment of plaque psoriasis were selected. The percentage of patients with plaque psoriasis who achieved Investigator\'s Global Assessment (IGA) success after 8 weeks of treatment with tacalcitol, calcipotriene/betamethasone dipropionate compound, tazarotene/halobetasol propionate, and roflumilast was 17.9%, 39.9%, 40.7%, and 42.4%, respectively. For 12-week trials of tapinarof and coal tar, 37.4% and 58.2% of patients achieved IGA success, respectively. There were 48% and 71.4% reductions in IGA scores with salicylic acid (12 weeks) and pimecrolimus (4 weeks), respectively. Finally, 66.7% of patients achieved Physician\'s Global Assessment success with 8 weeks of tacrolimus. There were no serious adverse events for the noncorticosteroid topicals. Conclusion: Noncorticosteroid topicals are suitable options for patients with plaque psoriasis who would like to avoid topical corticosteroids or have experienced adverse effects from chronic corticosteroid use. Due to treatment duration differences and varied outcome measures, it is unclear which noncorticosteroid topical is most efficacious; however, calcineurin inhibitors appear to exhibit the greatest efficacy. Each topical was efficacious in treating plaque psoriasis and had an adequate safety profile. Despite several treatment options for plaque psoriasis, medication adherence is a limiting factor.