◇◆◇完膚なきまでに議論してくれ皆さん◇◆◇
ここらへんをRON氏の定義のリバウンドをあてはめて読むとわからなくなるのです。
Suplatast tosilate
It has been suggested that a rebound phenomenon occurs in people with atopic eczema who have
been treated for prolonged periods with strong topical corticosteroids. We found one small RCT328
that evaluated the role of an anti-allergic medication called suplatast tosilate (which down-regulates
production of IgE and related cytokines) versus bufexamace ointment to prevent rebound from topical steroids in atopic eczema.
Benefits
Thirty-two patients who had been treated with strong steroid ointment for several years
were randomised to either bufexamace ointment (a non-steroidal antiinflammatory ointment) or bufexamace ointment
and oral suplatast tosilate (400 mg/day). In the control group, 15 patients experienced the rebound
phenomenon after 2 weeks compared with only two of 17 patients in the active group (rebound
was undefined). Several cytokines increased in the control group but not in the active group.
Harms
No adverse effects were reported in this small study.
Comment
The issue of rebound from regular use of topical steroids is a serious and important one as it is
possible that the regular use of corticosteroids
increases the chronicity of disease while benefiting the short-term control of flare-ups. This small study
was unblinded (the control group did not have an oral placebo) and the ‘rebound’ was completely
undefined and therefore highly prone to investigator bias. The study should be followed by a
randomised, controlled double-blind trial over a long period with clinical outcomes and a vehicle-only comparison group.
Suplatast tosilate
It has been suggested that a rebound phenomenon occurs in people with atopic eczema who have
been treated for prolonged periods with strong topical corticosteroids. We found one small RCT328
that evaluated the role of an anti-allergic medication called suplatast tosilate (which down-regulates
production of IgE and related cytokines) versus bufexamace ointment to prevent rebound from topical steroids in atopic eczema.
Benefits
Thirty-two patients who had been treated with strong steroid ointment for several years
were randomised to either bufexamace ointment (a non-steroidal antiinflammatory ointment) or bufexamace ointment
and oral suplatast tosilate (400 mg/day). In the control group, 15 patients experienced the rebound
phenomenon after 2 weeks compared with only two of 17 patients in the active group (rebound
was undefined). Several cytokines increased in the control group but not in the active group.
Harms
No adverse effects were reported in this small study.
Comment
The issue of rebound from regular use of topical steroids is a serious and important one as it is
possible that the regular use of corticosteroids
increases the chronicity of disease while benefiting the short-term control of flare-ups. This small study
was unblinded (the control group did not have an oral placebo) and the ‘rebound’ was completely
undefined and therefore highly prone to investigator bias. The study should be followed by a
randomised, controlled double-blind trial over a long period with clinical outcomes and a vehicle-only comparison group.
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