Фармакоэкономический анализ различных методов лечения акне у детей и подростков

Abstract

Acne is a widespread dermatological disease affecting children and adolescents that requires the use of innovative approaches to its treatment with the purpose of not only improving the patient's condition but also to minimize the treatment costs. The purpose of this research was to analyze the clinical efficacy, safety and economic feasibility of the use of the cold atmospheric plasma (CAP) in the acne therapy. Materials and methods used: the study included 176 pediatric patients aged 10 to 18 y/o (ME 16 y/o, M:F gender ratio 1:1.2) who were divided into groups depending on the severity of acne as follows: G1 with mild acne, G2 with moderate acne, and randomized into subgroups depending on the treatment methods (TM) as follows: TM1 for monotherapy with a combined external drug containing 0.1% adapalene with 2.5% benzoyl peroxide in the form of a gel, TM2 for CAP monotherapy and TM3 for combined therapy consisting of external therapy with a gel containing 0.1% adapalene with 2.5% benzoyl peroxide and the CAP treatment. The severity of acne was assessed using the acne dermatological index (ADI) and the clinical efficacy was assessed by achieving ADI0, ADI75, and ADI50. Skin moisture and pH were measured in all patients both prior to and immediately after the treatment using the PH98110 pH meter (by Kelilong, China). Adverse events (AE) were assessed during the study. The incremental cost-effectiveness ratio (ICER) was used in the pharmacoeconomic analysis. Results: during treatment in the TM1 subgroups, the full clinical effect (DIA0) was achieved in 88.89% of cases with mild acne and in 61.76% of cases with moderate acne, in the TM2 s/g, the full clinical effect was achieved in 95.24% and 68.57% of cases and in the TM3 s/g in 100% and 88.24% of cases, respectively. After the treatment, the skin pH values in patients of the TM1 s/g, G1 and G2 became lower than the reference values, TM2 and TM3 s/gs of both groups returned to normal. Skin moisture after treatment decreased in the TM1 s/g of both groups, remained the same in the TM2 s/g and the TM3 s/g of G1 and approached to normal in the TM2, TM3 s/gs of G2. AEs (lichenification, erythema and/or burning sensation of the skin) were observed in patients of s/gs TM1 and TM3 and were mild (n=24) or moderate (n=25) in severity. The ICER coefficient for the TM1 v TM3 pairwise comparison was 324,254.55 Russian rubles for G1, 184,060.00 Russian rubles for G2, and for the TM2 v TM3 comparison 25,333.33 Russian rubles for G1, 12,800.00 Russian rubles for G2, which is statistically significant (p=0.001 and p=0.04, respectively) and indicates high economic feasibility of using the TM3. Conclusion: the use of CAP in the treatment of mild to moderate acne is effective, safe and cost-effective as well.