Filtro solar versus filtro solar contendo fotoliase e antioxidantes tópicos no tratamento da queratose actínica e campo de cancerização cutâneo : um ensaio clínico randomizado e fatorial
Carregando...
Data
2020-07-04
Autores
Alvares, Bruno Augusto
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Diversos tratamentos são disponíveis para pele com fotodano avançado, caracterizada pela presença de queratoses actínicas (QAs), não havendo padrão ouro. Objetivo: Avaliar a eficácia e segurança da formulação de antioxidantes tópicos (L- ácido ascórbico 15%, alfa-tocoferol 1%, ácido ferúlico 0,5%) associado ao filtro solar comum ou filtro solar com fotoliase no tratamento do fotodano avançado. Método: Ensaio clínico randomizado, duplo-cego e fatorial. Foram randomizados participantes com QAs nos antebraços para aplicar durante o dia filtro solar (FPS) ou filtro solar com fotoliase (EryF) em ambos antebraços. Um dos antebraços de cada grupo foi randomizado novamente para receber antioxidantes tópicos (AOx) e o outro antebraço creme placebo (ambos de aplicação noturna). Os quatro grupos foram EryF + AOx, EryF + placebo, FPS + AOx, FPS + placebo. A duração dos tratamentos foi de 8 semanas. Os desfechos primários foram clearance total de QA, escala de fotoenvelhecimento e escore de gravidade de QA e os secundários foram a redução na contagem de QAs, taxa de clearence parcial e segurança. Resultados: Houve a inclusão de 40 participantes. Todos os grupos apresentaram melhora significativa dos desfechos ao longo do tempo. Não houve diferença significativa entre FPS e EryF, entretanto AOx levou a redução significativa da contagem das QAs. Clearance parcial foi obtido em 18 (47,4%) antebraços tratados com AOx e em nove (23,7%) tratados com placebo (p < 0,05). Conclusões: Filtro solar e filtro solar contendo fotoliase não apresentaram diferença significativa. AOx promoveu melhora do fotodano com redução da contagem de QA dos antebraços.
Introduction: Several treatments are available for skin with advanced photodamage, which is characterized by the presence of actinic keratoses (AK), with no gold standard. Objective: To evaluate the effectiveness and safety of topical antioxidant formulation (L- ascorbic acid 15%, alpha-tocopherol 1%, ferulic acid 0.5%) associated with common sunscreen or sunscreen with photolyase in treating advanced photodamage. Method: Randomized, double-blind and factorial clinical trial. Participants with AKs on their forearms were randomized to apply sunscreen (FPS) or sunscreen with photolyase (EryF) on both forearms during the day. One of the forearms in each group was randomized again to receive topical antioxidants (AOx) and the other forearm was a placebo cream (both for night application). The four groups were EryF + AOx, EryF + placebo, FPS + AOx, FPS + placebo. The duration of treatments was 8 weeks. The primary outcomes were total AK clearance, photoaging scale and AK severity score, and the secondary outcomes were a reduction in AK count, partial clearance rate and safety. Results: There were 40 participants included. All groups showed a significant improvement in outcomes over time. There was no significant difference between FPS and EryF, however AOx led to a significant reduction in the QA count. Partial clearance was obtained in 18 (47.4%) forearms treated with AOx and in nine (23.7%) treated with placebo (p <0.05). Conclusions: Sunscreen and sunscreen containing photolyase showed no significant difference. AOx improved photodamage by reducing the AK count in the forearms.
Introduction: Several treatments are available for skin with advanced photodamage, which is characterized by the presence of actinic keratoses (AK), with no gold standard. Objective: To evaluate the effectiveness and safety of topical antioxidant formulation (L- ascorbic acid 15%, alpha-tocopherol 1%, ferulic acid 0.5%) associated with common sunscreen or sunscreen with photolyase in treating advanced photodamage. Method: Randomized, double-blind and factorial clinical trial. Participants with AKs on their forearms were randomized to apply sunscreen (FPS) or sunscreen with photolyase (EryF) on both forearms during the day. One of the forearms in each group was randomized again to receive topical antioxidants (AOx) and the other forearm was a placebo cream (both for night application). The four groups were EryF + AOx, EryF + placebo, FPS + AOx, FPS + placebo. The duration of treatments was 8 weeks. The primary outcomes were total AK clearance, photoaging scale and AK severity score, and the secondary outcomes were a reduction in AK count, partial clearance rate and safety. Results: There were 40 participants included. All groups showed a significant improvement in outcomes over time. There was no significant difference between FPS and EryF, however AOx led to a significant reduction in the QA count. Partial clearance was obtained in 18 (47.4%) forearms treated with AOx and in nine (23.7%) treated with placebo (p <0.05). Conclusions: Sunscreen and sunscreen containing photolyase showed no significant difference. AOx improved photodamage by reducing the AK count in the forearms.
Descrição
Palavras-chave
Dermatologia, Fotodano, Queratose actínica, Campo de cancerização, Carcinoma espinocelular, Oncologia, Filtro solar, Fotoliase, L-ácido ascórbico, Alfa-tocoferol, Ácido ferúlico