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spironolactone (Spiroderm)

✓ Approved

Merck KGaA · NR3C2 · 小分子

什么是 spironolactone？

spironolactone 是一种小分子，由Merck KGaA研发。该药已获批，用于治疗相关适应症，给药途径：Topical。

药物档案

商品名Spiroderm
公司Merck KGaA
药物类别小分子
分子靶点NR3C2, SCNN1A
给药途径Topical
状态Approved
来源： ClinicalTrials.gov, Merck KGaA

作用机制

分子靶点

spironolactone 作用于 2 个分子靶点：

NR3C2nuclear receptor subfamily 3 group C member 2 (NR3C2VIT, MR)
SCNN1Asodium channel epithelial 1 subunit alpha (SCNEA, BESC2)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

spironolactone 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Skin and subcutaneous tissue disordersAcne✓ Approved

相关研究文献

PubMedPatient preference and adherence2026-07-27

Patient Expectations, Safety Concerns, and Adherence to Topical Acne Medications: Findings from a Web-Based Survey.

Yang Yutong Y, Fan Qing Q, Zhang Linglin L, Liu Xiaojing X et al.

Suboptimal adherence to first-line topical medications (eg, topical retinoids, benzoyl peroxide, and topical antibiotics) is a major barrier to effective acne vulgaris (AV) management. The influence of patients' pre-treatment expectations and concerns about adverse effects on adherence behavior remains inadequately quantified. To evaluate young patients' perceptions of acne and their expectations, concerns, and adherence regarding topical medications. A web-based cross-sectional survey was conducted from December 2023 to January 2024. Patients aged 16-29 with a history of AV and topical medication use were recruited. Data on demographics, disease perception, medication knowledge, usage patterns, and adherence were collected via a structured questionnaire and analyzed using descriptive and comparative statistics. A total of 501 valid questionnaires were collected. Patients acquired their knowledge about acne through various channels, with dermatologists being the most reliable source of information. Although 82.83% of patients recognized AV as a chronic disease, substantial misconceptions regarding its etiology and treatment persisted. Topical medications were commonly used, most frequently adapalene (40.92%), tretinoin (32.93%), benzoyl peroxide (24.75%), and clindamycin (20.96%). However, patients demonstrated limited knowledge regarding the proper application. Expectations for the onset of topical medications were overly optimistic, whereas the actual duration of use was often inadequate. The information that respondents had the strongest desire to access included the side effects, method of use, onset time, and duration of use. Medication discontinuation was primarily attributed to perceived slow efficacy or concerns about adverse effects, which contributed to a relatively high recurrence rate following treatment cessation. Young patients demonstrated limited comprehension of AV and lacked knowledge of topical medications and their appropriate application, as well as unrealistic expectations regarding onset time. Enhanced education on the nature of AV, along with detailed instructions on topical medication use, is crucial for improving patients' disease awareness and treatment adherence.

PMID 42504315
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PubMedDermatology and therapy2026-07-27

Adverse Effects of Treatments for Anogenital Warts in Non-immunocompromised Adults: A Network Meta-analysis of Randomized Controlled Trials.

Saib Réda R, Joly Elisa E, Fouere Sébastien S, Derancourt Christian C et al.

International guidelines for the management of anogenital warts (AGWs) propose multiple first-line options but do not prioritize treatments based on safety or tolerability. This study aimed to compare the safety profiles of topical, systemic, and ablative treatments used for external AGWs in immunocompetent adults. A systematic review and frequentist network meta-analysis of randomized controlled trials published through August 2025 was performed. Adverse events (AEs) were classified as low-, moderate-, or high-grade local AEs (LGL, MGL, HGL) and low-grade general AEs (LGG). Relative risks were estimated using random-effects models with placebo as the reference. We included 107 RCTs involving 12,423 participants. Ablative procedures were associated with higher rates of moderate-to-severe local AEs compared with topical therapies. Among topical treatments, imiquimod 5% and cidofovir cream were associated with lower rates of severe AEs, whereas podophyllotoxin was more often associated with LGL. SUCRA rankings placed topical treatments above ablative therapies in terms of tolerability. Cidofovir cream demonstrated the best safety profile, followed by imiquimod 5%. This network meta-analysis highlights significant differences in tolerability across AGW treatments and offers a comparative framework for patient-centered therapeutic decision-making. It also emphasizes the need for standardized AE reporting in future trials.

PMID 42507080
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PubMedKorean journal of anesthesiology2026-07-27

Perioperative management of modern dermatologic medications: an anesthesia-focused narrative review.

Şimşek Oğuz Kaan OK, Aba Fatih Can FC, Yılmaz Yusuf Y

Dermatologic diseases are highly prevalent worldwide and are managed with a broad pharmacologic spectrum ranging from topical agents to biologic therapies. Increasing life expectancy and chronic comorbidities have raised the surgical needs of these patients, creating a demand for careful perioperative management of wound healing, hemostasis, and infection risk, particularly in those receiving immunosuppressive or biologic agents. The existing literature, however, is scattered and largely extrapolated from dermatology, rheumatology, and orthopedic sources. This narrative review aims to provide an anesthesia-focused, evidence-based, drug-class-organized framework for the perioperative management of dermatologic medications in adults undergoing non-dermatologic surgery. Topical agents, systemic retinoids, conventional immunosuppressants, systemic corticosteroids, biologic agents, small molecules, and antimicrobial/antimalarial drugs are reviewed with respect to indications, pharmacokinetics, current guideline recommendations, and clinically relevant drug-anesthesia interactions. In general, most dermatologic medications, including topical agents, conventional immunosuppressants, and oral retinoids, can be safely continued perioperatively. However, biologic agents warrant half-life-based timing, Janus kinase inhibitors should be withheld at least three days before high-infection-risk surgery, and patients on chronic systemic corticosteroids require an individualized stress-dose approach. Specific interactions (isotretinoin-succinylcholine, dapsone-prilocaine, cyclosporine-CYP3A4 substrates, and hydroxychloroquine-QT-prolonging agents) require targeted attention. Because the evidence base is heterogeneous and largely observational, the recommendations are directional rather than definitive, and anesthesiologist-led prospective multicenter studies are needed.

PMID 42504671
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PubMedGels (Basel, Switzerland)2026-07-27

Dextrin Palmitate and Disteardimonium Hectorite Construct a Gel-like EHMC Matrix: Enhanced UVB Photoprotection and Plasma Exposure Modulation.

Li Zhiwei Z, Liang Yonghang Y, Liu Chen C, Wang Weiyan W et al.

2-Ethylhexyl-4-methoxycinnamate (EHMC) is among the most widely adopted organic UVB filters in commercial sunscreens. Nevertheless, its practical application potential is limited by unfavorable formulation compatibility and safety risks stemming from systemic exposure after topical administration. In this study, an oil-continuous structured gel matrix consisting of EHMC, disteardimonium hectorite (DDH) and dextrin palmitate (DP) was constructed to enhance UVB photoprotection and modulate the plasma exposure profile of EHMC following topical application. Comprehensive characterizations including rheology, XRD, Raman spectroscopy, FTIR spectroscopy, TGA and SEM collectively revealed that the combined incorporation of DDH and DP facilitates matrix structural rearrangement, enables EHMC to bind within the structured network, and promotes the formation of more intact continuous surface films. In vitro SPF assays demonstrated that the finished topical formulation SC-4 delivered superior UVB blocking efficacy compared with the EHMC-only control SC-1; furthermore, SC-4 exhibited improved short-term physical stability under the preset thermal and centrifugal acceleration test conditions. Follow-up skin safety assessments, mass spectrometry imaging (MSI) and pharmacokinetic assays verified that SC-4 elicited no remarkable acute skin irritation across all experimental conditions. Relative to SC-1, the reference formulation with EHMC as the sole UV filter, SC-4 displayed weaker EHMC-related distribution signals in skin tissues, accompanied by lower early plasma EHMC concentrations and a slightly lower AUC0-48h trend. Collectively, these findings indicate that DDH/DP co-assembly serves as a viable matrix-structuring strategy to modulate EHMC-related skin distribution and early plasma exposure. Further research into UVA blocking performance, photostability, skin retention and transdermal permeation profiles, as well as long-term storage stability, is required to advance the development of broad-spectrum sunscreen formulations built on this novel matrix platform.

PMID 42505245
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PubMedDentistry journal2026-07-27

The Cariostatic Mechanisms of Fluoride-An Updated Review.

Šutej Ivana I, Bašić Krešimir K, Peroš Kristina K

Fluoride remains the keystone of evidence-based caries prevention by stabilizing the mineral balance at the tooth-biofilm-saliva interface. Contemporary understanding emphasizes a predominantly post-eruptive, topical mode of action where fluoride inhibits demineralization and accelerates remineralization. This interfacial catalysis is reinforced by pH-responsive calcium-fluoride-like reservoirs that release fluoride during acid challenges. While community water fluoridation confers population-level reductions, the most effective approach is sustaining low-level fluoride in the biofilm environment. Evidence confirms that toothpastes with 1000-1500 ppm fluoride provide a dose-response benefit in children, while 5000 ppm concentrations are indicated for high-risk scenarios such as root caries and xerostomia. Beyond physicochemical effects, fluoride modulates the oral microbiome by inhibiting bacterial enzymes and proton pumps, shifting community function toward a health-associated state without reducing overall diversity. In restorative dentistry, glass ionomer cements offer superior preventive effects against secondary caries compared to amalgam; however, marginal integrity, adhesive performance, and clinical technique, rather than fluoride release alone, remain the primary determinants of success. Despite well-known risks associated with high systemic intake, such as fluorosis, current evidence does not indicate genotoxic or adverse microbiome effects in humans from routine topical use of standard fluoride products at recommended preventive concentrations. Overall, fluoride's cariostatic value rests on frequent, low-level exposures that maintain tissues in a repair-favoring state.

PMID 42505698
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PubMedJournal of arthropod-borne diseases2026-07-27

Efficacy of a Hemolymph-Based Cream Derived from Lucilia sericata Larvae in Treating Cutaneous Leishmaniasis: An In Vitro and In Vivo Study in BALB/c Mice.

Moghimian Razieh R, Mohebali Mehdi M, Basseri Hamid Reza HR, Akhoundi Behnaz B et al.

Cutaneous leishmaniasis (CL) is a neglected tropical disease with limited therapeutic options due to drug resistance, systemic toxicity, and prolonged treatment duration associated with pentavalent antimonials such as meglumine antimoniate (MAT). Lucilia sericata larvae produce hemolymph containing bioactive compounds with antimicrobial and immunomodulatory properties, suggesting potential as an alternative or adjunct therapy for CL. Hemolymph was extracted from sterile third-instar L. sericata larvae and characterized using SDS-PAGE and Fast Protein Liquid Chromatography. The antileishmanial activity of whole hemolymph, its most active fraction, MAT, and their combinations was assessed against promastigote and amastigote forms of L. major. Cytotoxicity, cytokine gene expression and reactive oxygen species production were evaluated. In vivo efficacy was examined in BALB/c mice infected with L. major and treated for 28 days with topical hemolymph cream, intramuscular MAT, or combination therapy. Lesion size and parasite burden were measured. Whole hemolymph and the active fraction significantly inhibited parasite growth in vitro, while combination treatments showed strong synergistic effects. Treatments enhanced Th1-associated cytokines, suppressed Th2 cytokines, and increased reactive oxygen species production. In vivo, hemolymph cream reduced lesion size and parasite load, with the greatest improvement observed in the combination group. No significant cytotoxicity was detected. Lucilia sericata larval hemolymph exhibits potent antileishmanial and immunomodulatory activity and represents a promising and safe topical therapy for CL. Combination with MAT enhances efficacy and may reduce systemic toxicity.

PMID 42504185
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