Русский
Evaluation of the efficacy and safety of combination therapy and prevention of exacerbations of atopic dermatitis in children with moderate and severe forms of the disease
DOI: https://dx.doi.org/10.18565/pharmateca.2024.10.90-96
Rusakova L.L., Murashkin N.N.
1) National Medical Research Center for Children’s Health, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3) Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Moscow, Russia
Methods. To assess the severity of atopic dermatitis, and subsequently the effectiveness of the therapy, patients were divided into three groups of 40 patients, in whom the EASI, SCORAD, DLQI, IGA, NRS, POEM indices were studied, laboratory tests were carried out (clinical urine analysis, clinical blood test, biochemical blood test, total IgE level) at 16, 28, 52, 64, 104 weeks of follow-up. During this follow-up period, adverse events were also assessed.
Results. As a result of the assessment of the EASI and SCORAD indices, their complex indicators indicate positive statistically significant (p<0.001) dynamics of the pathological process by 16 and 28 weeks with further stabilization of the indicators in the subsequent follow-up period. Moreover, starting from the 52nd week of follow-up, the program DUP + TGCS + TCI + EMOL (Group 2) demonstrated the greatest efficiency, the program DUP + TGCS + EMOL (Group 1) was in second place in terms of efficiency, and the program DUP + EMOL (Group 3) showed the least efficiency. Conclusion. According to comparative assessment of the safety and clinical efficiency of various complex algorithms for the treatment of children with moderate and severe AD who received an IL-4, IL-13 inhibitor (dupilumab), depending on the method of topical therapy, in the aspect of a 2-year follow-up based on the data of the EASI and SCORAD indices, it is possible to present the algorithm «TGCS 1 time per day – 2 weeks, then TCI 2 times per day up to 16 weeks, then TCI 2 times per week + emollients up to 104 weeks» as the most effective method of safe proactive therapy and prevention of exacerbations of AD in childhood, with a recommendation for its further implementation in the practice of dermatovenereological and pediatric departments, hospitals and clinics.
About the Autors
Corresponding author: Nikolay N. Murashkin, Dr. Sci. (Med.), Professor, Head of the Research Institute of Pediatric Dermatology, Head of the Department of Dermatology and Allergology, Head of the Laboratory of Skin Pathology in Children, Department of Scientific Research in Pediatrics, National Medical Research Center for Children’s Health; Professor, Department of Dermatovenereology and Cosmetology, Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation, Professor, Department of Pediatrics and Pediatric Rheumatology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; m_nn2001@mail.ru
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