Ensaio clínico duplo-cego controlado e randômico, comparando a eficácia da Clofazimina com a Cloroquina, no tratamento das lesões cutâneas do Lúpus Eritematoso Sistêmico

PURPOSE: To evaluate the capacity of clofazimine (CFZ) to control cutaneous activity of systemic lupus erythematosus (SLE), compared with chloroquine diphosphate (CDP). METHODS: A prospective, randomized, controlled, double blind clinical trial was carried out in thirty-three patients with SLE and cutaneous lesions (malar rash and/or discoid lupus and/or subacute cutaneous lupus), after approval by the respective Ethics Committee. Sixteen patients received clofazimine - 100mg/day (CFZ group) and 17 received chloroquine diphosphate - 250mg/day (CDP group), during six months. Both groups applied broad-spectrum sunscreens twice a day. The dose of prednisone was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers and photographed at baseline and at months 1, 2, 4 and 6. RESULTS: Thirty-three patients began and 27 completed the 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-patients and one CDP-patients dropped out due to severe flare of disease requiring other treatment. At the end of the study, 12 CFZ-patients (75%) and 14 CDP-patients (82,4%) presented complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects in both groups were frequent, but patients didn t have to discontinue the drugs. CONCLUSIONS: Clofazimine and chloroquine were effective in controlling cutaneous lesions in SLE patients

Desenvolvimento de emulsões o/a contendo extrato glicólico de açai e avaliação da atividade fotoprotetora

Sunscreen use is the most common photoprotection alternative used by the population, and so these products should offer improved protection with broad - spectrum, UVA and UVB protection . Vegetal substances have recently been considered as resources for sunscreen formulations due to their UV spectrum absorption and antioxidant properties. The Euterpe oleracea Mart., popularly known as açai, in its che mical composition contain polyphenols compounds, such as anthocyanins and flavonoids , to which antioxidant properties have been attributed . The aim of this work was to develop O/W sunscreens emulsions con taining açai glycolic extract ( AGE) and to evaluate both their physical stability , safety and photoprotective efficacy. The safety of the extract was evaluated by in vitro phototoxicity and cytotoxicity tests. Emulsions containing AGE and sunscreens were formulated using different types and concentrations o f polymeric surfactant (Acrylates/C 10 - 30 Alkyl Acrylate Crosspolymer and Sodium Polyacrylate). The influence of two rheology modifiers (Polyacrylamide (and) C13 - 14/Isoparaffin (and) Laureth - 7 and Carbomer) on the stability was also investigated. Physical stability was evaluated by preliminary and accelerated studies. The macroscopic analyses, pH value and electrical conductivity determinations and rheological behavior were evaluated at different time intervals . The in vivo Sun Protect Factor ( SPF ) was determined according to the International Sun Protection Factor Test Method – 2006 and UVA Protection Factor (FPUVA), wavelength critical and reason SPF/FPUVA were performed according to the method Colipa 2011. The extract did not present cytotoxic ity and phototoxic ity . The stable emulsion containing 5% glycolic extract of açai and 1.0% of sodium poliyacrylate showed pseudoplastic and thixotropic behavior . The sunscreen emulsion containing açai glycolic extract showed a SPF 25.3 and PF - UVA = 14.97. Whe n açai glycolic extract was added in the emulsion sunscreen, no significant increase in the in vivo SPF and FPUVA values were observed. This emulsion showed 1.69 of the SPF/PF - UVA ratio and a critical wavelength value of 378 nm, so may therefore be conside red a sunscreen with UVA and UVB protection.