RU2123334C1 - Method of treatment of patients with psoriasis - Google Patents

Abstract

FIELD: medicine, dermatology. SUBSTANCE: method involves treatment of damaged skin surface with a preparation of omega-3-fatty acids that have a total content of eicosapentaenic and docosahexaenic acids at amount from 5% to 100%. Preparation shows rapid skin absorption, high biological potential and good tolerance in patients. EFFECT: enhanced effectiveness of preparation. 3 cl, 3 ex

Description

 The invention relates to medicine.

 There are many methods for treating psoriasis described in the book by S. I. Dovzhansky and S. R. Utz "Psoriasis or Psoriatic Disease", v.2, ed. Saratov University, 1992, when cytostatics and immunosuppressants (for severe forms of dermatosis), vitamins and coenzymes, immunostimulants and immunomodulators, psychotropic drugs, antihistamines, calcium, sodium, potassium, magnesium, detoxification agents, and stimulants are used to treat this disease metabolic processes in the patient’s body, hormonal drugs, antiflogistic drugs, etc., as well as physiotherapy: UVI, photochemotherapy, ultrasound and other physiotherapeutic tion methods providing anti-inflammatory, analgesic and resolving action (diadynamic, UHF, SMV-therapy), UV laser FHT.

A known method of treating the initial stages of psoriasis and other diseases with impaired kerotinization and skin integrity (RF Patent N 2036640, IPC 6 A 61 K 7/48, 31/07), when the treatment is carried out by applying the following composition to the affected surface of the ointment (in wt.% ):
Retinol palmitate - 0.3 - 0.7
Vaseline oil - 9.5 - 10.5
Emulsifier N 1 - 9.5 - 10.5
Antioxidant - 0.18 - 0.22
Glycerin - 9.5 - 10.5
Ethyl alcohol - 9.5 - 10.5
Sorbic acid - 0.098 - 0.102
Distilled Water - Else
A known method for the treatment of chronic psoriatic plaques ("Actual problems of scientific and practical dermatology and venereology", Republican interdepartmental collection, issue 5, Publishing House of the Ministry of Health of Ukraine, Dnipropetrovsk Medical Academy, Dnepropetrovsk, 1994, p. 9), when ointment was used as a therapeutic agent containing bentonite in an amount of 20% and a fat base in an amount of 80%. The ointment was applied to areas of old psoriatic plaques for 24-36 hours under an occlusive dressing. During this time, a complete detachment of psoriatic scales occurs. Next, corticosteroid or sulfur-tar ointments are used for 7-9 days, which contributes to the complete resolution of psoriatic rashes.

 A known method of treating psoriasis (patent application of the Russian Federation 92007126/14, MKI 5 A 61 K 31/595, publ. BI N 4-96, p. 17), which consists in the fact that appoint tigazole 1 capsule (25 g) in day simultaneously with photochemotherapy according to a 4-day regimen puvalen photosensitizer. Clinical recovery is observed after 4 weeks.

 A known method of treating psoriasis (RF Patent N 2026068, MKI 6 A 61 K 31/00), which consists in the fact that against the background of conducting a tube with a solution of magnesium sulfate 1 time for 7 days, then 1 time per month, thyroid preparations are prescribed and choleretic drugs.

The closest in essence is the method of external treatment of psoriasis with the use of an antipsoriatic agent (S. I. Dovzhensky, S. R. Utz "Psoriasis or psoriatic disease", published by Saratov University, 1992, p. 47), which is an ointment of the following composition :
Salicylic Acid - 0.3 - 0.5
Tar birch - 30.0
Vaseline - 30.0
Treatment is carried out by lubricating the affected areas 2-3 times a day, until the inflammatory process is resolved, which is usually observed after 1-3 months or more.

 The problem solved by the invention is the expansion of the arsenal of drugs for the treatment of psoriasis.

 The essence of the proposed method for the treatment of psoriasis is that as an antipsoriatic agent use a mixture of ethyl esters of polyene fatty acids omega-3 series with a content of the amount of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids equal to 5-100%, mainly 30-75% . Treatment is carried out by applying applications to affected areas of the skin or under an occlusive dressing for 12-24 hours.

The mixture of omega-3 series polyenoic acid ethyl esters is a yellow oily mobile liquid with a faint, specific, fishy odor. The mixture does not lose its liquid consistency even at -30 ^o C. The mixture is not combustible and does not contain any solvents.

 The content in the preparation of an effective beginning - ethyl esters of EPA and DHA can range from 5 to 100%. The lower limit is determined on the basis that a decrease in the total content of these acids below 5% significantly reduces the effectiveness of the drug due to the high "ballast" content of other fatty acid esters that do not have such an effect. The upper limit corresponds to the moment when the preparation contains only ethyl esters of EPA and DHA. Such a drug will be most effective. In practice, mainly, a mixture of ethyl esters of polyenoic acids of omega-3 series with a total content of EPA and DHA esters of 30-75% is used.

 The proposed mixture of ethyl esters of polyene fatty acids of the omega-3 series is made according to RF patent N 1581737, MKI 5 C 11 C 1/00, C 11 B 7/00, as follows: fish oil is hydrolyzed by mixing with a solution of potassium alkali in ethanol, free fatty acids are isolated by acidifying the mixture with a solution of sulfuric acid, then crystallization of the fatty acids with urea in an ethanol solution is carried out, after some exposure the polyene fatty acids are isolated from the filtrate, they are converted to ethyl esters in a solution of ethanol and sulfuric acid, then after purifications get the final product.

 The advantage of using the preparation of omega-3 series polyene fatty acid ethyl esters for the treatment of psoriasis, in comparison with the prototype, is to reduce the average treatment period for patients to 2-3 weeks. The drug penetrates the skin very quickly, does not stain clothes, has virtually no smell, is convenient to use; may be used on an outpatient basis.

 A mixture of ethyl esters of polyene fatty acids of the omega-3 series has been introduced into clinical practice at the Regional Dermatovenerologic Dispensary in Vladivostok. Studies have shown sufficient therapeutic efficacy in the external use of the drug in patients with various forms of psoriasis with good tolerability.

 Example 1. Patient G., 40 years old, a sailor, lives in Vladivostok. He was admitted to outpatient treatment on April 22, 1996 with a diagnosis of widespread psoriasis, stationary stage, mixed form. Has been ill with this disease for 15 years. Previously treated with conventional traditional methods. Upon admission to treatment, the pathological process was represented by multiple psoriatic plaques located on the skin of the scalp, trunk, arms and legs. Plaques are covered with dense silver scales. General clinical tests without deviations.

 Treatment: once a day, all plaques were smeared with EPA and DHA preparations. Plaques began to clear from the 3rd day, infiltrates resolved by the 10th day. Plaques completely resolved by day 25. Discharged with recovery.

 Example 2. Patient P., 34 years old, docker-machine operator, lives in Vladivostok. Received treatment 22.11.96. Has psoriasis for 10 years. I used to receive treatment with traditional methods. At the time of the examination, the diagnosis was made: psoriasis is widespread leuticular-cumular, stationary stage, winter form. Upon admission, the patient noted severe itching, the presence of a pathological process in the form of psoriatic plaques, sometimes draining, on the skin of the trunk, arms and legs. The plaques were covered with dense scales, on the skin of the legs the plaques cracked, peeled. General clinical tests without deviations.

 Treatment: daily, all plaques were smeared once with EPA and DHA. On the legs on plaques this drug was applied under an occlusive dressing for a period of 24 hours. Starting from the 5th day, the itching intensified, but the plaques began to clear. By the 10th day of treatment, the itching disappeared, plaques began to resolve. On the legs, where a 24-hour dressing was used with the drug from the 10th day, the plaques completely cleared of scales, the cracks were epithelized, and the itching disappeared. The final clinical resolution of the entire pathological process was observed by the 25th day. Discharged with recovery.

 Example 3. Patient A., 26 years old, educator, lives in Vladivostok. Suffers from psoriasis for 5 years. In 1944, after birth, rashes appeared on the skin of the extensor surfaces of the extremities, the trunk. Since 1994, the patient received treatment with traditional methods. Since January 1996, receives methotrexate. Despite all the therapy, the process on the skin is unchanged.

 Treatment: starting from 11.11.96, the surface of the plaques was smeared daily with EPA and DHA once a day, and on the plaques located on the hands, a viscose cotton dressing impregnated with the preparation was applied under waterproof material for a period of 24 hours. Methotriksat has been canceled. Starting from 9-10 procedures, plaques began to be cleaned, infiltration decreased. On the hands where the occlusive dressing was applied, plaques resolved to the 6th procedure. Two weeks later, all the rashes on the skin disappeared. In place of plaques on the body, hyperpigmented spots remained. Discharged with recovery.

Claims (3)

 1. A method of treating psoriasis, including applying an antipsoriatic agent to the affected skin surface by applications or under an occlusive dressing, characterized in that a mixture of ethyl esters of omega-3 polyene fatty acids with an amount of eicosapentaenoic and docosahexaenoic acid of 5-100 is used as an antipsoriatic agent %  2. The method according to claim 1, characterized in that a mixture of ethyl esters of polyene fatty acids of omega-3 series with a content of the sum of eicosapentaenoic and docosahexaenoic acids 35 - 70% is mainly used.  3. The method according to claim 1, characterized in that for the treatment of chronic psoriatic plaques, the treatment is carried out by applying to the foci a mixture of ethyl esters of polyene fatty acids omega-3 series under an occlusive dressing for 12 to 24 hours