ROLE OF CONDITIONING IN THE PHARMACOTHERAPY OF PSORIASIS

调理在银屑病药物治疗中的作用

基本信息

批准号：
6760879
负责人：
ROBERT ADER
金额：
$ 46.88万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-08-14 至 2007-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6760879
关键词：
behavioral /social science research tag clinical research conditioning corticosteroids drug administration rate /duration human subject human therapy evaluation placebos psoriasis skin disorder chemotherapy

项目摘要

DESCRIPTION (adapted from investigator's abstract): The lack of scientific attention devoted to the placebo effect as a phenomenon in its own right probably reflects the paucity of theoretical positions within which to organize the existing data and design new research. The proposed research is an attempt to advance from a descriptive to an experimental analysis of the placebo effect as a reflection of learning processes and examine the clinical implications of such an analysis in the case of an autoimmune disease. As such, this research addresses the clinical significance of behavior- immune system interactions. Conditioning is an inherent component of most pharmacotherapeutic regimens. The proposed research will capitalize on conditioned immunosuppressive responses to reduce the cumulative amount of corticosteroid medication used in the treatment of psoriasis. Patients would continue to be treated with steroid, but experimental patients would be shifted from their current schedule of continuous reinforcement (active drug whenever medication was applied) to a partial schedule of reinforcement (active drug a percentage of the time and placebo alone at other times). To equate amount of medication, other patients would be treated with a (reduced) dose of steroid in a standard (continuous schedule of reinforcement) treatment regimen. It is hypothesized that, holding cumulative dose constant, a partial schedule of reinforcement will enable patients to be maintained on lower cumulative amounts of corticosteriod than patients treated under a continuous schedule of active drug. Psoriasis is an especially appropriate model in which to evaluate the therapeutic affect of partial schedules of pharmacologic reinforcement which could decrease the amount of drug required to reduce psoriatic plaques and the deleterious "side" effects of long-term steroid treatment. Thus, it may be possible to increase the benefit: risk ratio of drug therapy and, at the same time, reduce the costs of medication. The proposed research is not an attempt to offer a behavioral alternative to drug treatment; it is an attempt to add a behavioral dimension to the design of drug treatment protocols. This is the first attempt to adopt conditioning principles and use schedules of reinforcement to design regimens of drug therapy. If proven effective, this new approach to pharmacotherapy and placebo effects is likely to stimulate new interdisciplinary research in neuropharmacology and behavioral pharmacology for the treatment of autoimmune and a variety of other chronic diseases.

描述（根据研究者的摘要改编）：缺乏科学注意安慰剂效应本身就是一种现象可能反映了组织的理论立场的匮乏现有数据和设计新研究。拟议的研究是一个尝试从描述性到安慰剂效应的实验分析作为学习过程的反映，并检查在自身免疫性疾病的情况下进行了这种分析。因此，这项研究解决了行为免疫系统相互作用的临床意义。调理是大多数药物治疗方案的固有组成部分。这拟议的研究将利用条件免疫抑制反应减少治疗中使用的皮质类固醇药物的累积量牛皮癣。患者将继续接受类固醇治疗，但实验患者将从当前的时间表转移连续加固（每当服用药物时活跃药物）加强的部分时间表（活跃药物的时间百分比在其他时候独自安慰剂）。为了等于药物，其他患者将在标准中用（降低）类固醇治疗（连续）加强时间表）治疗方案。假设，累积剂量常数，一部分加固的时间表将启用患者要维持在累积量较低的皮质固醇上在连续的活性药物时间表中接受治疗的患者。牛皮癣是一个特别适合评估治疗影响的模型药理加固的部分时间表，这可能会降低减少银屑病斑块和有害的“侧”所需的药物量长期类固醇治疗的影响。因此，可能有可能增加好处：药物治疗的风险比率，同时降低成本药物。拟议的研究不是试图提供行为的尝试替代药物治疗；这是添加行为维度的尝试进行药物治疗方案的设计。这是第一次通过条件原理和使用加固时间来设计方案药物疗法。如果被证明有效，这种新的药物治疗方法和安慰剂效应可能会刺激新的跨学科研究自身免疫治疗的神经药理和行为药理学以及其他各种慢性疾病。