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药品评价

地奈德乳膏治疗湿疹皮炎类皮肤病的临床综合评价

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  • 1.蚌埠医科大学研究生院,安徽 蚌埠 233000;
    2.中国科学技术大学附属第一医院 安徽省立医院, 安徽 合肥 230001
鲁文娜,女,硕士,研究方向:炎症性皮肤病

收稿日期: 2025-05-08

  修回日期: 2025-10-02

  录用日期: 2026-01-07

  网络出版日期: 2026-01-07

A Comprehensive Clinical Evaluation of Desonide Cream in the Treatment of Eczematous Dermatoses

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  • 1.Graduate School of Bengbu Medical University, Anhui Bengbu 233000, China;
    2.The First Affiliated Hospital of USTC Anhui Provincial Hospital, Anhui Hefei 230000, China

Received date: 2025-05-08

  Revised date: 2025-10-02

  Accepted date: 2026-01-07

  Online published: 2026-01-07

摘要

目的:构建地奈德乳膏治疗湿疹皮炎类皮肤病的临床综合评价体系,为药物政策制定和临床应用提供循证依据。方法:基于卫生技术评估(HTA)框架,从安全性、有效性、经济性、创新性、适宜性及可及性6个维度整合其上市前后证据。采用循证医学评价方法系统检索中英文数据库,应用R软件进行Meta分析;运用成本-效果分析法评估经济性;通过与丁酸氢化可的松等同类药物横向比较判定临床价值。结果:安全性:上市前动物实验及Ⅱ、Ⅲ期临床试验数据表明,地奈德乳膏对实验动物及试验人群无明显危害,上市后临床研究安全性结果表明地奈德乳膏与丁酸氢化可的松乳膏安全性及疗效均相当,Meta分析显示地奈德乳膏的不良反应发生率(3.26%)低于丁酸氢化可的松乳膏的不良反应发生率(4.78%),安全性好;有效性:上市前药效学实验结果表明地奈德的活性强于氢化可的松和强的松龙,Ⅱ、Ⅲ期临床试验表明地奈德乳膏疗效优异,上市后文献meta分析显示,地奈德治疗湿疹皮炎类皮肤病总有效率高于丁酸氢化可的松(RR=1.13 [1.05~1.22]),有效性好;经济性:基于随机对照试验(RCT)临床研究资料的药物经济学研究结果表明地奈德乳膏的增量成本效果比<人均GDP,地奈德乳膏治疗特应性皮炎增加的成本可接受,具有成本效果优势,日均费用0.7元(CNY),疗程费用占人均可支配收入比例≤0.1%,具有经济性;创新性:地奈德乳膏是一种弱效糖皮质激素,不含卤族元素,适用于儿童面部等敏感部位。与强效糖皮质激素相比,其引起皮肤萎缩、毛细血管扩张等不良反应的风险显著降低。此外,该乳膏采用创新乳化技术,以亲水-亲油性乳化基质为基础,不仅提升了药物的释放效率与渗透性,也优化了使用时的肤感。可及性:包装符合国家标准,剂型、运输管理、有效期、适应证、给药用药均具有适宜性;地奈德乳膏为医保乙类品种,按比例报销,患者支付压力小,覆盖31省,可及性好。结论:本研究表明地奈德乳膏在湿疹皮炎类皮肤病治疗中呈现“高有效性-低风险-经济合理”的三维优势特征,具有显著的临床应用价值。

本文引用格式

鲁文娜, 蔡明龙, 张弛 . 地奈德乳膏治疗湿疹皮炎类皮肤病的临床综合评价[J]. 中国药物评价, 2025 , 42(6) : 469 -469-476 . DOI: magtech-2025-05-08-00002

Abstract

Objective: To establish a comprehensive clinical evaluation system for desonide cream in the treatment of eczema and dermatitis-like skin diseases, providing evidence-based support for drug policy formulation and clinical application. Methods: Based on the Health Technology Assessment (HTA) framework, evidence from pre-marketing and post-marketing stages was integrated across six dimensions: safety, efficacy, economy, innovation, suitability, and accessibility. Systematic searches of Chinese and English databases were conducted using evidence-based medicine evaluation methods, with R software employed for Meta-analysis. Cost-effectiveness analysis was applied to assess economic value, and clinical value was determined through horizontal comparison with similar drugs such as hydrocortisone. Results: Safety: Pre-marketing animal studies and Phase Ⅱ/Ⅲ clinical trials indicated no significant adverse effects to animals or human subjects. Post-marketing clinical studies demonstrated comparable safety and efficacy between desonide cream and hydrocortisone butyrate cream. Meta-analysis showed a lower incidence of adverse reactions with desonides (3.26%) than hydrocortisone (4.78%), confirming its favorable safety profile. Efficacy: Pre-marketing pharmacodynamic studies revealed that desonide exhibits stronger activity than hydrocortisone and prednisolone. Phase Ⅱ/Ⅲ trials demonstrated considerable therapeutic effects, and post-marketing Meta-analysis indicated a higher total effective rate for desonide in treating eczema and dermatitis (RR=1.13 [1.05-1.22]) compared to hydrocortisone, confirming superior efficacy. Economy: Pharmacoeconomic analysis based on randomized controlled trials (RCT) showed that the incremental cost-effectiveness ratio (ICER) of desonide cream was below the per ca pita GDP. The additional cost for treating atopic dermatitis was fully justified, demonstrating cost-effectiveness advantages. The daily treatment cost was 0.7 CNY, with course expenses accounting for ≤0.1% of per ca pita disposable income, indicating high affordability. Innovation: Desonide cream is suitable for sensitive areas such as the facial skin of children, filling a clinical gap and exhibiting notable innovation value. Accessibility: The packaging complies with national standards, and the formulation, transportation, shelf life, indications, and administration are well-suited. Listed as a Class B medical insurance product with proportional reimbursement, desonide cream reducing patient financial burden. It is widely available across 31 provinces with sufficient supply, ensuring high accessibility. Conclusion: This study demonstrates that desonide cream exhibits a three-dimensional advantage of “high efficacy, low risk, and economic rationality” in treating eczema and dermatitis-like skin diseases, underscoring its significant clinical value.

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