背景:白癜风的治疗在皮肤科是一个持续的挑战。对于那些对经典疗法有抗性或不耐受的人,正在该领域提供和研究新的治疗方法。
目的:在本系统综述中,我们研究使用前列腺素类似物(PGAs)和磷酸二酯酶抑制剂(PDEIs)治疗白癜风,因为它们以其通过激活黑素细胞的色素沉着诱导作用而闻名。
方法:我们搜索了四个主要的在线数据库,关键字为“白癜风”,“前列腺素类似物”和“磷酸二酯酶抑制剂”。
结果:共纳入42篇文章,1027例,研究比马前列素这样的药物,拉坦前列素,曲伏前列素,地诺前列酮,apremilast,crisaborole,等。在纳入的研究中,治疗方案通常是每天一次或两次,持续12-48周,平均20.61周,给药途径主要是外用凝胶剂或眼用溶液和口服片剂。副作用温和可忍受,即红斑,局部用药应用部位的瘙痒或灼烧感,或者apremilast的胃肠道问题。在成人和儿童患者以及进行性或稳定型白癜风中,色素恢复结果都很重要。PGAs和PDEIs优于许多经典疗法,例如,窄带紫外线B光疗(NB-UVB),他克莫司,莫米松或甲基强的松龙小脉冲。PGA或PDEIs通常用于联合治疗,以引起协同作用或增加药物递送。几乎总是增强色素沉着,例如,NB-UVB,分数CO2激光,微针,和莫米松.
结论:单药治疗或添加PGA和PDEIs可被认为是白癜风的有效治疗方法,也是对其他疗法耐药的患者有希望的最后手段。
BACKGROUND: The treatment of vitiligo is a persistent challenge in dermatology. New treatments are being offered and studied in this field for those resistant to or intolerant of classical therapies.
OBJECTIVE: In this systematic review, we study the use of prostaglandin analogues (PGAs) and phosphodiesterase inhibitors (PDEIs) in the treatment of vitiligo, as they are known for their pigmentation inducing effects through activating melanocytes.
METHODS: We searched four main online databases with the keywords \"Vitiligo\", \"Prostaglandin analogue\" and \"Phosphodiesterase inhibitor\".
RESULTS: A total of 42 articles were included, with 1027 cases, studying drugs like bimatoprost, latanoprost, travoprost, dinoprostone, apremilast, crisaborole, etc. Among the included studies, the treatment regimens are commonly once or twice daily for 12-48 weeks, with a mean of 20.61 weeks, and the routes of administration are mainly topical gels or ophthalmic solutions and oral tablets. Side effects are mild and tolerable, namely erythema, itching or burning sensations at application site for topicals, or gastrointestinal problems with apremilast. Repigmentation results are significant in both adult and pediatric patients and progressive or stable vitiligo. PGAs and PDEIs outperform many classical therapies, for example, narrowband ultraviolet B phototherapy (NB-UVB), tacrolimus, mometasone or methylprednisolone mini-pulse. PGAs or PDEIs are usually used in combination therapies to either cause synergism or increase drug delivery, and almost always enhance repigmentation, for example, with NB-UVB, fractional CO2 laser, microneedling, and mometasone.
CONCLUSIONS: Monotherapy or add-on PGAs and PDEIs can be considered effective treatments for vitiligo and promising last resorts for those resistant to other therapies.