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Efficacy and Safety of a Biodegradable Hyaluronic Acid Microneedle Patch for Dry Skin in Atopic Dermatitis : A Single-blinded, Split-body, Randomized Controlled Trial

아토피피부염 피부건조 증상 개선에 대한 용해성 마이크로니들 패치의 유효성 및 안전성 평가 임상연구

  • Ji-Hoon, Song (Department of Ophthalmology, Otolaryngology & Dermatology, College of Korean medicine, Dongshin University) ;
  • Gi-Hyun, Lee (College of Korean medicine, Dongshin University) ;
  • Min-Yeong, Jung (Department of Ophthalmology, Otolaryngology & Dermatology, College of Korean medicine, Dongshin University) ;
  • Jung-Hwa, Choi (Department of Ophthalmology, Otolaryngology & Dermatology, College of Korean medicine, Dongshin University) ;
  • Soo-Yeon, Park (Department of Ophthalmology, Otolaryngology & Dermatology, College of Korean medicine, Dongshin University)
  • 송지훈 (동신대학교 한의과대학 한방안이비인후피부과학교실) ;
  • 이기현 (동신대학교 한의과대학) ;
  • 정민영 (동신대학교 한의과대학 한방안이비인후피부과학교실) ;
  • 최정화 (동신대학교 한의과대학 한방안이비인후피부과학교실) ;
  • 박수연 (동신대학교 한의과대학 한방안이비인후피부과학교실)
  • Received : 2023.01.16
  • Accepted : 2023.02.10
  • Published : 2023.02.25

Abstract

목적 : 마이크로니들 패치는 피부장벽의 주요 구성성분인 각질층을 관통할 수 있어 일반적인 경피를 통한 약물 전달 수단보다 더 효율적으로 약물을 전달할 수 있다는 장점이 있어 다양한 분야에서 응용되고 있다. 본 임상연구는 아토피피부염 환자의 피부 건조 증상에 대하여 용해성 히알루론산 마이크로니들 패치와 외용제를 병행하여 용해성 마이크로니들 패치의 유효성과 안전성을 평가하였다. 방법 : 본 연구는 단일 기관, 연구자 주도, 평가자 눈가림, 인체 분할 연구로 설계된 무작위 배정 임상시험으로, 피부건조 증상이 있는 아토피피부염 환자 20명을 대상으로 임상연구를 수행하였다. 한 명의 피험자에서 2곳의 시험 병변을 선택한 후, 무작위 배정으로 각각 시험 병변과 대조 병변을 결정하여 2주 동안 매일 양측 병변에 모두 아로마 크림을 도포한 다음, 시험 병변에만 용해성 히알루론산 마이크로니들 패치를 추가로 부착하였다. 결과 : 1차 유효성 평가지표인 local scoring atopic dermatitis(L-SCORAD) index는 치료 후에 시험 병변이 대조 병변보다 유의성 있게 호전되었다. 2차 유효성 평가지표 중 피부 건조감 VAS와 피부 수분 함유량도 시험 병변이 대조 병변보다 유의성 있는 개선을 보였다. Investigator's Global Assessment scale, 소양감 VAS, 경피수분손실량에 있어서는 시험 병변과 대조 병변 모두 치료 후에 유의성 있게 호전되었으나, 두 병변 간의 차이에는 유의성이 없었다. 이상 반응은 나타나지 않았으므로 안전성도 확인되었다. 결론 : 용해성 히알루론산 마이크로니들 패치와 외용제 병행치료는 외용제만 사용하였을 때보다 L-SCORAD index 및 피부 건조감 VAS, 피부 수분 함유량에 있어서 아토피피부염의 증상을 유의성 있게 개선시켰다.

Keywords

Acknowledgement

This study was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea(Grant No.: HI19C0553). The BHMN patch used in this study was provided free of charge by Raphas Co., Ltd.(Seoul, Republic of Korea).

References

  1. Prausnitz MR, Elias PM, Franz TJ, Schmuth M, Tsai JC, Menon GK, et al. Skin barrier and transdermal drug delivery. Dermatology. 3rd ed. Philadelphia:Saunders Publishing. 2012:2065-74.
  2. Min DL, Park EJ, Kang KH. Review of clinical and experimental studies on external application treatment for atopic dermatitis in the Korean literature. The J Korean Orient Pediatr. 2013;27:36-49.
  3. Leung DY, Guttman-Yassky E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol. 2014;134(4):769-79. https://doi.org/10.1016/j.jaci.2014.08.008
  4. Cho JE, Jeon YH, Yang HJ, Pyun BY. A study of the frequency and characteristics of minor clinical manifestations in children with atopic dermatitis. Korean J Pediatr. 2009;52(7):818-23. https://doi.org/10.3345/kjp.2009.52.7.818
  5. Tagami H, Kobayashi H, O'Goshi K, Kikuchi K. Atopic xerosis: employment of noninvasive biophysical instrumentation for the functional analyses of the mildly abnormal stratum corneum and for the efficacy assessment of skin care products. J Cosmet Dermatol. 2006;5(2):140-9. https://doi.org/10.1111/j.1473-2165.2006.00241.x
  6. Martanto W, Davis SP, Holiday NR, Wang J, Gill HS, Prausnitz MR. Transdermal delivery of insulin using microneedles in vivo. Pharm Res. 2004;21(6):947-52. https://doi.org/10.1023/B:PHAM.0000029282.44140.2e
  7. Thomas BJ, Finnin BC. The transdermal revolution. Drug Discov Today. 2004;9(16):697-703. https://doi.org/10.1016/S1359-6446(04)03180-0
  8. Prausnitz MR, Mitragotri S, Langer R. Current status and future potential of transdermal drug delivery. Nat Rev Drug Discov. 2004;3(2):115-24. https://doi.org/10.1038/nrd1304
  9. Gerstel MS, Place VA. Drug delivery device. US3964482A. 1976.
  10. Bariya SH, Gohel MC, Mehta TA, Sharma OP. Microneedles: an emerging transdermal drug delivery system. J Pharm Pharmacol. 2012;64(1):11-29. https://doi.org/10.1111/j.2042-7158.2011.01369.x
  11. Choi SY, Kwon HJ, Ahn GR, Ko EJ, Yoo KH, Kim BJ, et al. Hyaluronic acid microneedle patch for the improvement of crow's feet wrinkles. Dermatol Ther. 2017;30(6):e12546.
  12. Li J, Zeng M, Shan H, Tong C. Microneedle patches as drug and vaccine delivery platform. Curr Med Chem. 2017;24(22):2413-22. https://doi.org/10.2174/0929867324666170526124053
  13. Wan T, Pan Q, Ping Y. Microneedle-assisted genome editing: A transdermal strategy of targeting NLRP3 by CRISPR-Cas9 for synergistic therapy of inflammatory skin disorders. Sci Adv. 2021;7(11):eabe2888.
  14. Kim JH, Shin JU, Kim SH, Noh JY, Kim HR, Lee J, et al. Successful transdermal allergen delivery and allergen-specific immunotherapy using biodegradable microneedle patches. Biomaterials. 2018;150:38-48. https://doi.org/10.1016/j.biomaterials.2017.10.013
  15. Shin JU, Kim JD, Kim HK, Kang HK, Joo C, Lee JH, et al. The use of biodegradable microneedle patches to increase penetration of topical steroid for prurigo nodularis. Eur J Dermatol. 2018;28(1):71-7. https://doi.org/10.1684/ejd.2017.3164
  16. Lee JH, Jung YS, Kim GM, Bae JM. A hyaluronic acid-based microneedle patch to treat psoriatic plaques: a pilot open trial. Br J Dermatol. 2018;178(1):e24,e25.
  17. Song JH, An EJ, Sung CY, Jeong DH, Lee G, Park SY. A comparative study on a biodegradable hyaluronic acid microneedle patch with a needleless patch for dry skin in atopic dermatitis: a single-blinded, split-body, randomized controlled trial. Arch Dermatol Res. 2022 Oct 15.[Online ahead of print]
  18. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;92:44-7. https://doi.org/10.2340/00015555924447
  19. Kim H. A Clinical Comparison Study of the Efficacy of Moisturizer Containing Licochalcone A and 1% Hydrocortisone in Mild to Moderate Atopic Dermatitis. Seoul:The Graduate School of Hanyang University. 2014:9-11,28-30.
  20. Stettler H, Kurka P, Kandzora J, Pavel V, Breuer M, Macura-Biegun A. A new topical panthenol-containing emollient for maintenance treatment of childhood atopic dermatitis: results from a multicenter prospective study. J Dermatolog Treat. 2017;28(8):774-9. https://doi.org/10.1080/09546634.2017.1328938
  21. Futamura M, Leshem YA, Thomas KS, Nankervis H, Williams HC, Simpson EL. A systematic review of Investigator Global Assessment (IGA) in atopic dermatitis (AD) trials: many options, no standards. J Am Acad Dermatol. 2016;74(2):288-94. https://doi.org/10.1016/j.jaad.2015.09.062
  22. Eichenfield LF, Lucky AW, Boguniewicz M, Langley RG, Cherill R, Marshall K, et al. Safety and efficacy of pimecrolimus (ASM 981) cream 1% in the treatment of mild and moderate atopic dermatitis in children and adolescents. J Am Acad Dermatol. 2002;46(4):495-504. https://doi.org/10.1067/mjd.2002.122187
  23. Consensus Report of the European Task Force on Atopic Dermatitis. Severity scoring of atopic dermatitis: the SCORAD index. Dermatology. 1993;186(1):23-31. https://doi.org/10.1159/000247298
  24. Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-6.
  25. Reich A, Heisig M, Phan NQ, Taneda K, Takamori K, Takeuchi S, et al. Visual analogue scale: evaluation of the instrument for the assessment of pruritus. Acta Derm Venereol. 2012;92(5):497-501. https://doi.org/10.2340/00015555-1265
  26. Schmitt J, Langan S, Williams HC. What are the best outcome measurements for atopic eczema? A systematic review. J Allergy Clin Immunol. 2007;120(6):1389-98. https://doi.org/10.1016/j.jaci.2007.08.011
  27. Lee HJ, Park CO, Lee JC, Lee KH. Life quality assessment among adult patients with atopic dermatitis. Korean J Dermatol. 2007;45(2):159-64.
  28. Waghule T, Singhvi G, Dubey SK, Pandey MM, Gupta G, Singh M, et al. Microneedles: A smart approach and increasing potential for transdermal drug delivery system. Biomed Pharmacother. 2019;109:1249-58. https://doi.org/10.1016/j.biopha.2018.10.078
  29. Clinical Resolution Laboratory, Inc. What is MTS?. 2015[cited 2021 DEC 17]. Available from: URL:https://www.clinicalresolution.com/main/whatismts.html
  30. Sabri AH, Ogilvie J, Abdulhamid K, Shpadaruk V, McKenna J, Segal J, et al. Eur J Pharm Biopharm. 2019;140:121-40. https://doi.org/10.1016/j.ejpb.2019.05.001
  31. Daly S, Claydon NCA, Newcombe RG, Seong J, Addy M, West NX. Randomised controlled trial of a microneedle patch with a topical anaesthetic for relieving the pain of dental injections. J Dent. 2021;107:103617.
  32. Varothai S, Nitayavardhana S, Kulthanan K. Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol. 2013;31(2):91-8.
  33. Saeki H, Furue M, Furukawa F, Hide M, Ohtsuki M, Katayama I, et al. Guidelines for management of atopic dermatitis. J Dermatol. 2009;36(10):563-77. https://doi.org/10.1111/j.1346-8138.2009.00706.x
  34. Giam YC, Hebert AA, Dizon MV, Bever HV, Tiongco-Recto M, Kim KH, et al. A review on the role of moisturizers for atopic dermatitis. Asia Pac Allergy. 2016;6(2):120-8. https://doi.org/10.5415/apallergy.2016.6.2.120
  35. Miller DW, Koch SB, Yentzer BA, Clark AR, O'Neill JR, Fountain J, et al. An over-the-counter moisturizer is as clinically effective as, and more cost-effective than, prescription barrier creams in the treatment of children with mild-to-moderate atopic dermatitis: a randomized, controlled trial. J Drugs Dermatol. 2011;10(5):531-7.
  36. Grimalt R, Mengeaud V, Cambazard F. The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology. 2007;214(1):61-7. https://doi.org/10.1159/000096915
  37. Pazyar N, Yaghoobi R, Bagherani N, Kazerouni A. A review of applications of tea tree oil in dermatology. Int J Dermatol. 2013;52(7):784-90. https://doi.org/10.1111/j.1365-4632.2012.05654.x
  38. Koh KJ, Pearce AL, Marshman G, Finlay-Jones JJ, Hart PH. Tea tree oil reduces histamine-induced skin inflammation. Br J Dermatol. 2002;147(6):1212-7. https://doi.org/10.1046/j.1365-2133.2002.05034.x
  39. Seo YM, Jeong SH. Effects of blending oil of lavender and thyme on oxidative stress, immunity, and skin condition in atopic dermatitis induced mice. J Korean Acad Nurs. 2015;45(3):367-77.
  40. Sugarman JL, Parish LC. Efficacy of a lipid-based barrier repair formulation in moderate-to-severe pediatric atopic dermatitis. J Drugs Dermatol. 2009;8(12):1106-11.
  41. Kim SK, Karadeniz F. Biological importance and applications of squalene and squalane. Adv Food Nutr Res. 2012;65:223-33. https://doi.org/10.1016/B978-0-12-416003-3.00014-7
  42. Kim DI, Kim SH, Ahn IS, Choi MS. Analysis of patent information for the development of Korea traditional herbal formulation for acne and that of functional cosmetics. The Journal of Korean Obstetrics and Gynecology. 2014;27(3):104-15. https://doi.org/10.15204/jkobgy.2014.27.3.104
  43. Han SK, Lee SJ, Ha HY. Skin Moisturizing Effects of a Microneedle Patch Containing hyaluronic acid and Lonicerae flos. Processes. 2021;9(2):321.
  44. Lee YJ, Kim HT, Lee WJ, Chang SE, Lee MW, Choi JH, et al. Anti-aging and hydration efficacy of a cross-linked hyaluronic acid microstructure patch. Dermatol Ther. 2019;32(3):e12888.
  45. Pavicic T, Gauglitz GG, Lersch P, Schwach-Abdellaoui K, Malle B, Korting HC, et al. Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment. J Drugs Dermatol. 2011;10(9):990-1000.
  46. Stojanovic L, Majdic N. Effectiveness and safety of hyaluronic acid fillers used to enhance overall lip fullness: A systematic review of clinical studies. J Cosmet Dermatol. 2019;18(2):436-43. https://doi.org/10.1111/jocd.12861
  47. Jang M, Baek S, Kang G, Yang H, Kim S, Jung H. Dissolving microneedle with high molecular weight hyaluronic acid to improve skin wrinkles, dermal density and elasticity. Int J Cosmet Sci. 2020;42(3):302-9. https://doi.org/10.1111/ics.12617
  48. Seok J, Hong JY, Choi SY, Park KY, Kim BJ. A potential relationship between skin hydration and stamp-type microneedle intradermal hyaluronic acid injection in middle-aged male face. J Cosmet Dermatol. 2016;15(4):578-82. https://doi.org/10.1111/jocd.12244
  49. Park KY, Jang WS, Lim YY, Ahn JH, Lee SJ, Kim CW, et al. Safety evaluation of stamp type digital microneedle devices in hairless mice. Ann Dermatol. 2013;25(1):46-53. https://doi.org/10.5021/ad.2013.25.1.46