【 文献重点摘要 】

Background

Simvastatin belongs to the statin family, whose members have immunomodulatory activities. Ezetimibe have synergetic effects when co-administered with simvastatin. In several case reports, alopecia totalis and alopecia universalis were successfully treated with simvastatin/ezetimibe, suggesting that this combination could be a new efficient therapy for recalcitrant alopecia areata (AA).

Objective

To verify the efficacy of the simvastatin/ezetimibe combination therapy for recalcitrant AA and investigate the relationship between various treatment responses and prognostic factors.

Methods

This prospective open study was performed in patients with recalcitrant AA with the bald surface exceeding 75%. All patients took simvastatin (40 mg) and ezetimibe (10 mg) daily. The extent of hair regrowth expressed as percentage of the bald area was used to evaluate the effectiveness of the therapy.

Results

Of 14 enrolled patients, 4 patients (28.6%) were judged as responders showing regrowth of 30% to 80% after 3 months of treatment. The mean age of onset in non-responders was significantly lower than in responders. The total score of prognostic factors, calculated as a sum of factors related to poor prognosis, was much lower in responders than in non-responders.

Conclusion

The remission rate in this study was unsatisfactory. However, since the recruited patients had not responded to any other treatments for AA, simvastatin/ezetimibe can still be considered as an alternative treatment for recalcitrant AA. The total scores of the prognostic factors were statistically different between responders and non-responders. These results can be used to predict the outcome of treatment with simvastatin/ ezetimibe and anticipate prognosis.

Keywords

Alopecia areata, Ezetimibe, Prognostic factor, Simvastatin

背景

辛伐他汀属于他汀类药物家族，其成员具有免疫调节活性。依折麦布与辛伐他汀合用有协同作用。在几个病例报告中，辛伐他汀/依折麦布成功地治疗了全面性脱发和全面性脱发，提示这种联合疗法可能是治疗顽固性斑秃(AA)的一种新的有效疗法。

目的

验证辛伐他汀/依折麦布联合治疗难治性再障的疗效，探讨各种治疗反应与预后因素的关系。

方法

对秃顶面积超过75%的顽固性再障患者进行前瞻性开放研究。所有患者每日服用辛伐他汀(40 Mg)和依折麦布(10 Mg)。用脱发面积百分比表示的毛发再生程度来评价治疗效果。

结果

14例入选患者中，4例(28.6%)在治疗3个月后再生长30%~80%。无应答者的平均发病年龄明显低于应答者。有反应者的预后因素总分(由与预后不良相关的因素之和计算)比无反应者低得多。

结论

本研究的缓解率不尽人意。然而，由于招募的患者对任何其他治疗再生障碍性贫血没有反应，辛伐他汀/依折麦布仍然可以被认为是顽固性再生障碍性贫血的替代治疗。应答者和无应答者的预后因素总分差异有统计学意义。这些结果可用于预测辛伐他汀/依折麦布治疗的结果和预后。

关键词

斑秃，依折麦布，预后因子，辛伐他汀