使用罗氟司特乳膏出现头痛、失眠怎么处理？

Headaches and insomnia caused by using (Zoryve) are mainly caused by the drug. The specific mechanism is not yet clear, and corresponding treatments can be carried out according to different symptoms.

Headache treatments

1. Pay attention to rest: During the medication period, patients should ensure adequate rest time and avoid fatigue or staying up late to avoid aggravating headaches.

2. Keep your mood stable: Emotional excitement can easily aggravate headache symptoms. You should keep your mood stable and avoid getting angry, irritable, etc.

3. Medication treatment: Patients can use nonsteroidal anti-inflammatory drugs such as ibuprofen, diclofenac, indomethacin, and aspirin for analgesic treatment as directed by the doctor.

Treatment measures for insomnia

1. Regular sleep: During medication, you should go to bed at a regular time and get up at a regular time. Avoid sleeping during the day or sleeping for too long during the day. Try to go to bed early and get up early.

2. Avoid excitement before going to bed: Avoid strenuous exercise before going to bed, try to avoid smoking and drinking, and do not drink caffeinated drinks at night, such as coffee, tea, etc.

3. Others: Create a comfortable sleeping environment, such as turning off lights, using blackout curtains, etc. to ensure a quiet sleeping environment and avoid noise. You can drink a cup of hot milk before going to bed to help you fall asleep.

Roflumilast cream to treat psoriasis

In a phase 2b double-blind trial, adults with plaque psoriasis were randomly assigned in a 1:1:1 ratio to receive roflumilast 0.3% cream or roflumilast 0.15% cream placebo once daily for 12 weeks. The primary efficacy outcome was the investigator's global assessment (IGA) of clean or almost clean status at week 6.

Of the 331 patients who underwent randomization, 109 were assigned to the roflumilast 0.3% cream group, 113 to the roflumilast 0.15% cream group, and 109 to the placebo group.

At week 6, IGA scores of clear or almost clear were observed in 28% of patients in the roflumilast 0.3% group, 23% of patients in the roflumilast 0.15% group, and 8% of patients in the vehicle group.

Among approximately 15% of patients with at least mild baseline interchondral psoriasis, 73% of patients in the roflumilast 0.3% group, 44% of patients in the roflumilast 0.15% group, and 29% of patients in the vehicle group showed clear or nearly clear IGA scores plus a grade 2 improvement in the interchondral area IGA score at Week 6.

The average baseline PASI scores for the roflumilast 0.3% group, the roflumilast 0.15% group, and the vehicle group were 7.7, 8.0, and 7.6, respectively; the average changes from baseline at week 6 were -50.0%, -49.0%, and -17.8%, respectively. The incidence of application site reactions was similar in the roflumilast and vehicle groups.

Roflumilast cream administered once daily to psoriasis affected areas was superior to vehicle cream in achieving a clear or nearly clear state within 6 weeks.

References:

Lebwohl MG, Papp KA, Stein Gold L, Gooderham MJ, Kircik LH, Draelos ZD, Kempers SE, Zirwas M, Smith K, Osborne DW, Trotman ML, Navale L, Merritt C, Berk DR, Welgus H; ARQ-151 201 Study Investigators. Trial of Roflumilast Cream for Chronic Plaque Psoriasis. N Engl J Med. 2020 Jul 16;383(3):229-239. doi: 10.1056/NEJMoa2000073. PMID: 32668113.

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