中华皮肤科杂志 ›› 2015, Vol. 48 ›› Issue (2): 85-89.

• 论著 • 上一篇    下一篇

口服屈螺酮炔雌醇片治疗女性中度寻常痤疮的多中心、随机、安慰剂对照临床研究

张国毅1,林彤2,孙秋宁3,李恒进4,赖维5,顾军6,陆前进7,郭在培8,王宝玺9   

  1. 1. 中国医学科学院皮肤病研究所
    2. 南京 中国医学科学院北京协和医学院皮肤病研究所
    3. 北京协和医院皮肤科
    4. 北京解放军总医院皮肤科
    5. 广州中山大学附属第三医院皮肤科
    6. 上海第二军医大学附属长海医院皮肤科
    7. 长沙中南大学湘雅二医院皮肤科
    8. 成都四川大学华西医院皮肤科
    9. 中国医学科学院北京协和医学院皮肤病研究所
  • 收稿日期:2013-07-23 修回日期:2013-11-05 发布日期:2015-01-28
  • 通讯作者: 王宝玺 E-mail:wangbx@ncstdlc.org

An oral contraceptive containing ethinyl estradiol and drospirenone for the treatment of women with moderate acne vulgaris: a randomized, multicenter, placebo-controlled clinical trial

  • Received:2013-07-23 Revised:2013-11-05 Published:2015-01-28
  • Contact: WHANG Baoxi E-mail:wangbx@ncstdlc.org

摘要:

目的 评估口服避孕制剂屈螺酮炔雌醇片(YAZ)治疗女性中度寻常痤疮的疗效和安全性。 方法 采用多中心、随机、双盲、安慰剂对照研究。入选患者按照随机数字表分为YAZ组和安慰剂组,分别口服YAZ和安慰剂。两组患者在月经的第1天服药,每日1片,连续服用24 d,后服用4 d无活性药片,28 d为1个周期,共治疗6个周期。分别于治疗第1、3、6周期及治疗结束后8 ~ 15 d,对丘疹、脓疱、结节、开放性粉刺和闭合性粉刺进行计数,评估疗效和安全性。 结果 7个中心179 例女性中度寻常痤疮患者入组,173例入选全分析集,146例完成治疗研究,143例入选符合方案集。治疗6个周期后,全分析集YAZ组和安慰剂组皮损总数平均减少66.8%和37.7%;符合方案集YAZ组和安慰剂组皮损总数平均减少72.6%和55.6%。YAZ组和安慰剂组在第6 周期的炎性皮损数与基线期相比分别减少75.5%和60.9%,非炎性皮损数分别减少69.3%和50.2%。在YAZ组中,研究者评定:改善患者比例93.7%(74/79),安慰剂组78.1%(57/73)。本研究中未出现严重的不良事件。治疗期间YAZ组不良反应发生率为25.3%(22/87),安慰剂组为4.7%(4/86)。 结论 YAZ治疗女性中度寻常痤疮有效且安全。 临床试验注册 ClinicalTrials.gov Identifier: NCT00818519。

关键词: 避孕药, 女用

Abstract:

Zhang Guoyi *, Lin Tong, Sun Qiuning, Li Hengjin, Lai Wei, Gu Jun, Lu Qianjin, Guo Zaipei, Wang Baoxi. *Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding author: Wang Baoxi, Email: wangbx@ncstdlc.org 【Abstract】 Objective To evaluate the efficacy and safety of an oral contraceptive containing ethinyl estradiol and drospirenone (YAZ) in the treatment of women with moderate acne vulgaris. Methods A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted. Totally, 179 female patients with moderate acne vulgaris were enrolled into this study from 7 research institutions in China, and randomly divided into YAZ group and placebo group by a random number table to be treated by oral YAZ and placebo respectively. In one cycle of treatment, patients administrated YAZ or placebo (one tablet once daily) from the 1st to 24th day of the menstrual cycle followed by a 4-day treatment with inactive tablets. All the patients received six cycles of treatment without a treatment-free interval. Efficacy and safety were evaluated according to the number of papules, pustules, nodules, open and closed comedones after 1, 3 and 6 cycels of treatment and within 8 - 15 days after the end of treatment. Results Finally, 173 patients were eligible for the full analysis set (FAS), 146 completed the study, and 143 were eligible for the per protocol set (PPS). After 6 cycles of treatment, the total number of lesions was meanly reduced by 66.8% and 37.3% in the YAZ group and placebo group respectively in the FAS, 72.6% and 55.6% respectively in the PPS. The number of inflammatory and noninflammatory lesions decreased by 75.5% and 69.3% in the YAZ group respectively after 6 cycles of treatment when compared to baseline, and by 60.9% and 50.2% in the placebo group respectively. The proportion of subjects rated as "improved" by investigators was 93.7% (74/79) in the YAZ group and 78.1% (57/73) in the placebo group. There were no serious adverse events in this study. The incidence rate of adverse reactions was 25.3% (22/87) in the YAZ group, and 4.7% (4/86) in the placebo group. Conclusion Six cycles of treatment with oral YAZ are effective and safe for female patients with moderate acne vulgaris. Trial registration number ClinicalTrials.gov Ref. No: NCT00818519.

引用本文

张国毅 林彤 孙秋宁 李恒进 赖维 顾军 陆前进 郭在培 王宝玺. 口服屈螺酮炔雌醇片治疗女性中度寻常痤疮的多中心、随机、安慰剂对照临床研究[J]. 中华皮肤科杂志, 2015,48(2):85-89. doi: