The Journal of dermatological treatment · 2018
Human recombinant epidermal growth factor in skin lesions: 77 cases in EPItelizando project.
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Esquirol-Caussa Jordi, Herrero-Vila Elisabeth
Аннотация
OBJECTIVE: To analyze compounded recombinant human epidermal growth factor (rhEGF) effectiveness on skin lesions through a case series.
DESIGN: Multicentric series of skin lesions treated with topical rhEGF. Site: Patients from 56 different health professionals, three different countries, and two recruitment years.
PARTICIPANTS: Seventy-seven patients with skin lesions, mean age of 63.15 years (min = 18, max = 95); 53.2% of patients were men and 46.8% were women; 47 of the lesions were ulcers (venous, arterial, and diabetic foot), others were surgical and traumatic wounds, burns, and scars. Most common pathologies were type 2 diabetes mellitus and chronic venous insufficiency. Mean previous evolution time before inclusion was 29.59 months.
INTERVENTIONS: Cures using compounded topical rhEGF most commonly used rhEGF concentration: 30 μg/g; most used excipient: gel; average time between cures: 36 h (24-48); and mean follow-up: 6.6 weeks (max = 20).
MAIN MEASUREMENTS: Lesions appearance, margins and bed, lesional size evolution, treatment subjective effectiveness, tolerability and comfort through professional oppinion.
RESULTS: Qualitative assessment: effectiveness 8.65, tolerability 9.53, and comfort 8.86 (max = 10). Perilesional skin showed improvement in 93.5% of the cases, lesions margins and wound bed appearance improved in 92.2% of the cases, respectively. Wound area decreased a mean average of 66.7%. About 43.3% of included venous ulcers had a greater than 40% cure rate in 4 weeks.
LIMITATIONS: Heterogeneity of the included pathologies, limited time follow-up in some cases.
CONCLUSIONS: Topical rhEGF in individualized formulation (compounding) seems to exhibit effectiveness, comfort, and tolerability. Further larger-size studies with experimental design will allow to establish more precise concentrations, indications, and clinical guidelines.
DESIGN: Multicentric series of skin lesions treated with topical rhEGF. Site: Patients from 56 different health professionals, three different countries, and two recruitment years.
PARTICIPANTS: Seventy-seven patients with skin lesions, mean age of 63.15 years (min = 18, max = 95); 53.2% of patients were men and 46.8% were women; 47 of the lesions were ulcers (venous, arterial, and diabetic foot), others were surgical and traumatic wounds, burns, and scars. Most common pathologies were type 2 diabetes mellitus and chronic venous insufficiency. Mean previous evolution time before inclusion was 29.59 months.
INTERVENTIONS: Cures using compounded topical rhEGF most commonly used rhEGF concentration: 30 μg/g; most used excipient: gel; average time between cures: 36 h (24-48); and mean follow-up: 6.6 weeks (max = 20).
MAIN MEASUREMENTS: Lesions appearance, margins and bed, lesional size evolution, treatment subjective effectiveness, tolerability and comfort through professional oppinion.
RESULTS: Qualitative assessment: effectiveness 8.65, tolerability 9.53, and comfort 8.86 (max = 10). Perilesional skin showed improvement in 93.5% of the cases, lesions margins and wound bed appearance improved in 92.2% of the cases, respectively. Wound area decreased a mean average of 66.7%. About 43.3% of included venous ulcers had a greater than 40% cure rate in 4 weeks.
LIMITATIONS: Heterogeneity of the included pathologies, limited time follow-up in some cases.
CONCLUSIONS: Topical rhEGF in individualized formulation (compounding) seems to exhibit effectiveness, comfort, and tolerability. Further larger-size studies with experimental design will allow to establish more precise concentrations, indications, and clinical guidelines.