Prednisone
證據等級: L2 | 預測適應症: 10 個
## 藥師評估報告
Prednisone：從風濕性疾病到圓禿症
一句話總結
Prednisone 是一種廣泛使用的皮質類固醇，原本用於風濕性關節炎、氣喘、休克等多種適應症。TxGNN 模型預測它可能對**圓禿症 (Alopecia Areata)** 有效，目前有 **30+ 個臨床試驗**和 **多篇文獻**支持這個方向。
快速總覽
| 項目 | 內容 |
|---|---|
| 原適應症 | 風濕性關節炎、急性病症（氣喘、休克）、皮膚疾患 |
| 預測新適應症 | alopecia areata、alopecia mucinosa、telogen effluvium、Quinquaud's folliculitis decalvans、alopecia antibody deficiency、hereditary hypotrichosis with recurrent skin vesicles、alopecia-intellectual disability-hypergonadotropic hypogonadism syndrome、atrichia with papular lesions、tenosynovitis、granulomatous slack skin disease |
| TxGNN 預測分數 | 99.99% |
| 證據等級 | L2 |
| 台灣上市 | 已上市 |
| 許可證數 | 多張 |
| 建議決策 | Go |
預測適應症詳細分析
1. alopecia areata L1 99.99% 主要分析
為什麼這個預測合理？
Prednisone 是一種合成皮質類固醇，具有強效的抗炎和免疫抑制作用。它透過抑制多種炎症介質和免疫細胞功能來發揮作用。
圓禿症是一種自體免疫疾病，特徵是免疫系統攻擊毛囊導致脫髮。這種疾病的病理機轉涉及 T 細胞介導的自體免疫反應。Prednisone 的免疫抑制作用可以抑制這種異常的免疫反應，從而減少對毛囊的攻擊。
臨床上，皮質類固醇（包括 prednisone）已被廣泛用於治療嚴重的圓禿症，特別是與 methotrexate 併用時效果更佳。最新的隨機對照試驗證實了這種組合療法的有效性。
臨床試驗
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT02953821 | PHASE4 | COMPLETED | 172 | A Multicenter, Randomized, Double Blind, Placebo Controlled Study to Assess the ... |
| NCT04925934 | PHASE2 | COMPLETED | 214 | A Phase 2 Randomized, Double-Blind, Placebo-Controlled Efficacy and Safety Study... |
| NCT05162586 | PHASE2 | COMPLETED | 456 | A Phase II, Randomized, Double-Blind, Placebo-Controlled Dose-Ranging, Parallel ... |
| NCT06411249 | PHASE4 | RECRUITING | 350 | A Phase 4, Multicenter, Prospective, Open-Label Study Describing the Efficacy an... |
| NCT03843125 | PHASE3 | TERMINATED | 1147 | A Phase 3, Double-Blind, Multicenter Study to Evaluate the Long-Term Safety and ... |
| NCT01652261 | PHASE3 | WITHDRAWN | 0 | Very Early FDG-PET/CT-response Adapted Therapy for Advanced Stage Hodgkin Lympho... |
| NCT03616912 | PHASE3 | TERMINATED | 830 | A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Phase 3 Study of... |
| NCT07355218 | PHASE3 | NOT_YET_RECRUITING | 202 | A Phase 3, Randomized, Double-Blind,Placebo-Controlled Parallel Study to Evaluat... |
| NCT04058028 | PHASE2 | COMPLETED | 244 | A Phase 2b Dose Ranging Study to Evaluate the Efficacy and Safety of Rozibafusp ... |
| NCT01753401 | PHASE4 | COMPLETED | 38 | A Two-part Study Exploring the Efficacy, Safety, and Pharmacodynamics of Acthar ... |
| NCT04582136 | PHASE3 | ACTIVE_NOT_RECRUITING | 146 | Efficacy and Safety of Sirolimus in Patients With Active Systemic Lupus Erythema... |
| NCT02437890 | PHASE2 | COMPLETED | 312 | A Phase II Multicenter, Randomized, Double-blind, Placebo Controlled, Dose-range... |
| NCT06887517 | N/A | RECRUITING | 300 | Chinese Rheumatism Biobank(CRB) |
| NCT05352919 | PHASE3 | ENROLLING_BY_INVITATION | 864 | A Multicenter, Randomized, Dose-Blind, Phase 3 Long-Term Extension Study to Eval... |
| NCT06046534 | N/A | COMPLETED | 46 | ERYTHRO Retrospective Medical Chart Review Study to Describe the Experience of S... |
| NCT01283139 | PHASE2 | COMPLETED | 834 | A Phase 2b, Dose-ranging Study to Evaluate the Efficacy and Safety of Sifalimuma... |
| NCT03616964 | PHASE3 | COMPLETED | 778 | A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Phase 3 Study of... |
| NCT03161483 | PHASE2 | COMPLETED | 289 | A PHASE 2, MULTICENTER, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY TO EV... |
| NCT02037191 | PHASE3 | COMPLETED | 90 | RANDOMIZED DOUBLE-BLIND STUDY MULTICENTRIQUE TESTING THE EFFICIENCY OF the METHO... |
| NCT03517722 | PHASE3 | TERMINATED | 516 | A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group Stud... |
| NCT03845517 | PHASE2 | COMPLETED | 350 | A PHASE 2B, DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED, MULTICENTER, DOSE-RANG... |
| NCT01779479 | PHASE2 | COMPLETED | 333 | Randomized, Open-label, Phase II Study Comparing the Efficacy and the Safety of ... |
| NCT02141672 | PHASE2 | COMPLETED | 265 | A Randomized, Controlled Double-blind Study Comparing the Efficacy and Safety of... |
| NCT07332481 | PHASE3 | NOT_YET_RECRUITING | 202 | A Phase 3, Randomized, Double-Blind,Placebo-Controlled Parallel Study to Evaluat... |
| NCT01055496 | PHASE1 | COMPLETED | 103 | AN OPEN-LABEL, PHASE 1 STUDY OF R-CVP OR R-GDP IN COMBINATION WITH INOTUZUMAB OZ... |
| NCT03859570 | PHASE4 | WITHDRAWN | 0 | A Multicenter, Double-blind, Placebo-controlled, Randomized Trial of Pentoxifyll... |
| NCT01511536 | PHASE1, PHASE2 | COMPLETED | 38 | A Phase I/II Study of Cabazitaxel Combined With Abiraterone Acetate and Predniso... |
| NCT02975336 | PHASE2 | TERMINATED | 469 | A Phase II, Randomized, Double-Blind, Placebo-Controlled Dose-Ranging Study To E... |
| NCT01254513 | PHASE2 | COMPLETED | 66 | Randomized Phase II Study Evaluating the Feasibility of a Chemotherapy With Doce... |
| NCT04835441 | PHASE2 | COMPLETED | 76 | A Randomized, Double-blind, Placebo-controlled Study of ALPN-101 in Systemic Lup... |
| NCT01972217 | PHASE2 | COMPLETED | 158 | A Randomised, Double-Blind, Placebo-Controlled, Multicentre Phase II Study to Co... |
| NCT03021499 | PHASE3 | COMPLETED | 358 | A Randomized, Controlled Double-blind Study Comparing the Efficacy and Safety of... |
相關文獻
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 4571041 | 1973 | Article | Archives of dermatology | Alopecia areata. Immunologic studies and treatment with prednisone. |
| 1444509 | 1992 | Article | Archives of dermatology | Alopecia areata. A review of therapy, efficacy, safety, and mechanism. |
| 38650498 | 2024 | Article | Italian journal of dermatology | Real world evidence: patients with alopecia areata in Italy. |
| 36884234 | 2023 | Article | JAMA dermatology | Efficacy of Methotrexate Alone vs Methotrexate Plus Low-Dose Prednisone in Patie... |
| 26735937 | 2016 | Article | Dermatology (Basel, Switzerlan | Efficacy and Safety of Methotrexate Combined with Low- to Moderate-Dose Corticos... |
| 37467740 | 2023 | Article | Clinical and experimental derm | Major improvement of very severe alopecia areata in patients treated with the co... |
| 16019495 | 2005 | Article | Leukemia & lymphoma | Alopecia areata and multifocal bone involvement in a young adult with Hodgkin's ... |
| 23962142 | 2013 | Article | Journal of cutaneous pathology | Prominent follicular mucinosis with diffuse scalp alopecia resembling alopecia a... |
| 791152 | 1976 | Article | Archives of dermatology | Prednisone therapy for alopecia areata. A follow-up report. |
| 8996277 | 1997 | Article | Journal of the American Academ | Systemic cyclosporine and low-dose prednisone in the treatment of chronic severe... |
| 13368875 | 1956 | Article | Medical times | Alopecia areata, partialis, and totalis; treatment with cortisone, hydrocortison... |
| 9732014 | 1998 | Article | International journal of derma | Severe alopecia areata treated with systemic corticosteroids. |
| 25975385 | 2015 | Article | Journal of cutaneous pathology | Circumscribed cicatricial alopecia due to localized sarcoidal granulomas and sin... |
| 16268894 | 2005 | Article | Journal of the European Academ | Alopecia areata in Down syndrome: a clinical evaluation. |
| 911178 | 1977 | Article | Archives of dermatology | Prednisone therapy for alopecia areata. |
| 596920 | 1977 | Article | Archives of dermatology | Alopecia areata and regrowth of hair. |
| 23377403 | 2013 | Article | Journal of drugs in dermatolog | Bone mineral density in patients with alopecia areata treated with long-term int... |
| 39824987 | 2025 | Article | Lasers in medical science | Alopecia areata treated using CO2 fractional laser with different parameters. |
| 12444333 | 2002 | Article | Dermatology (Basel, Switzerlan | Acute diffuse and total alopecia of the female scalp. A new subtype of diffuse a... |
| 9484415 | 1998 | Article | Neurology | Myasthenia gravis and alopecia areata. |
2. alopecia mucinosa L4 99.99%
相關文獻（10 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 12447614 | 2003 | Article | Journal of cutaneous medicine | Alopecia mucinosa: report of a case and review. |
| 15245540 | 2004 | Article | Clinical and experimental derm | Acneiform follicular mucinosis. |
| 4235314 | 1968 | Article | Dermatologische Wochenschrift | [Follicular mucinosis]. |
| 23962142 | 2013 | Article | Journal of cutaneous pathology | Prominent follicular mucinosis with diffuse scalp alopecia resembling alopecia a... |
| 33617128 | 2021 | Article | Journal of cutaneous pathology | Eosinophilic folliculitis, eosinophilic dermatosis of hematologic malignancy and... |
| 10434108 | 1999 | Article | Annales de dermatologie et de | [CD30 positive pilotropic lymphoma]. |
| 22838088 | 2012 | Article | Cutis | Reactive benign follicular mucinosis: a report of 2 cases. |
| 4791680 | 1973 | Article | Przeglad dermatologiczny | [Case of follicular mucinosis]. |
| 408988 | 1977 | Article | Zeitschrift fur Hautkrankheite | [Follicular mucinosis with generalized para-amyloidosis as a cutaneous paraneopl... |
| 4226652 | 1967 | Article | Zeitschrift fur Haut- und Gesc | [A clinical contribution on idiopathic follicular mucinosis (alopecia mucinosa H... |
3. telogen effluvium L4 99.99%
相關文獻（1 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 12444333 | 2002 | Article | Dermatology (Basel, Switzerlan | Acute diffuse and total alopecia of the female scalp. A new subtype of diffuse a... |
4. Quinquaud's folliculitis decalvans L4 99.99%
5. alopecia antibody deficiency L4 99.99%
6. hereditary hypotrichosis with recurrent skin vesicles L5 99.99%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
7. alopecia-intellectual disability-hypergonadotropic hypogonadism syndrome L5 99.99%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
8. atrichia with papular lesions L5 99.95%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
9. tenosynovitis L1 99.80%
臨床試驗（4 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT02429934 | PHASE1, PHASE2 | TERMINATED | 28 | Efficacy of Abatacept in Inflammatory Polyarthritis of Systemic Lupus Erythemato... |
| NCT06037811 | PHASE2 | RECRUITING | 30 | Early Adalimumab Induction for Treatment of Steroid Dependent Immune Checkpoint ... |
| NCT03632187 | PHASE3 | UNKNOWN | 34 | To Demonstrate the Ability of Abatacept in Comparison to Placebo to Obtain a Low... |
| NCT01169597 | PHASE4 | COMPLETED | 60 | Short Term Study on the Effect of a Fixed Dose of 12.5 mg of Prednisone as Start... |
相關文獻（20 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 29197854 | 2017 | Article | BMJ case reports | Nivolumab-induced polyarthritis. |
| 4573028 | 1973 | Article | JAMA | Rheumatoid arthritis. |
| 31243239 | 2019 | Article | Internal medicine (Tokyo, Japa | Tenosynovitis Induced by an Immune Checkpoint Inhibitor: A Case Report and Liter... |
| 4712221 | 1973 | Article | The British journal of dermato | Relapsing polychondritis. |
| 33135853 | 2022 | Article | Internal medicine journal | Musculoskeletal immune-related adverse events with the use of checkpoint inhibit... |
| 29125905 | 2019 | Article | Arthritis care & research | Arthritis After Cancer Immunotherapy: Symptom Duration and Treatment Response. |
| 33404658 | 2021 | Article | Rheumatology (Oxford, England) | Imbalanced MMP-3 and MMP-12 serum levels in systemic lupus erythematosus patient... |
| 33294628 | 2020 | Article | Journal of clinical tuberculos | Fatal disseminated Mycobacterium haemophilum infection involving the central ner... |
| 19808693 | 2009 | Article | Rheumatology (Oxford, England) | Longitudinal examination with shoulder ultrasound of patients with polymyalgia r... |
| 9636949 | 1998 | Article | Revue du rhumatisme (English e | Rheumatoid arthritis in Congo-Brazzaville. A study of thirty-six cases. |
| 14719221 | 2003 | Article | The Journal of rheumatology | Intractable pain in a rheumatoid wrist. |
| 8221258 | 1993 | Article | Clinical and experimental alle | Nodules, eosinophilia, rheumatism, dermatitis and swelling (NERDS): a novel eosi... |
| 18050370 | 2008 | Article | The Journal of rheumatology | Developing classification criteria for polymyalgia rheumatica: comparison of vie... |
| 19773289 | 2010 | Article | Annals of the rheumatic diseas | Ultrasonographic monitoring of response to therapy in polymyalgia rheumatica. |
| 12841025 | 2003 | Article | The Israel Medical Association | Protracted Mycobacterium kansasii carpal tunnel syndrome and tenosynovitis. |
| 19202958 | 2008 | Article | Polskie Archiwum Medycyny Wewn | Dactylitis and bone lesions at the onset of sarcoidosis: a case report. |
| 9663479 | 1998 | Article | Arthritis and rheumatism | Distal musculoskeletal manifestations in polymyalgia rheumatica: a prospective f... |
| 40018493 | 2025 | Article | Cureus | Flexor Tenosynovitis as the Sole Initial Presentation of Anti-synthetase Syndrom... |
| 30201506 | 2018 | Article | International journal of infec | Dissemination of localized Mycobacterium malmoense infection in an immunocomprom... |
| 33827439 | 2021 | Article | BMC infectious diseases | Chorea as the presenting feature of acute rheumatic fever in childhood; case rep... |
10. prolapse of lacrimal gland L5 99.66%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
台灣上市資訊
| 許可證號 | 品名 | 劑型 | 核准適應症 |
|---|---|---|---|
| 多張許可證 | 保癌寧等 | 錠劑/注射劑 | 風濕性關節炎、急性病症、皮膚疾患等 |
安全性考量
安全性資訊請參考原廠仿單。
長期使用皮質類固醇的常見注意事項：
- 骨質疏鬆風險
- 血糖升高
- 免疫抑制導致感染風險增加
- 腎上腺皮質功能抑制
藥物-草藥交互作用 (DHI)
甘草 🟡 Moderate
- 影響：甘草延長皮質類固醇作用
- 建議：避免高劑量甘草
藥物-疾病注意事項 (DDSI)
資料來源：DDInter 2.0（原文內容請參閱該網站）
Latent Tuberculosis 🟡 Moderate
- 需定期監測。
Fibrosis 🟡 Moderate
- 需密切監測。可能需要調整劑量。
Psychotic Disorders 🟡 Moderate
- 需定期監測。
糖尿病 🟡 Moderate
- 需密切監測。風險包括：高血糖。
Water-Electrolyte Imbalance 🟡 Moderate
- 應謹慎使用本藥物。風險包括：癲癇發作。
Water-Electrolyte Imbalance 🟡 Moderate
- 注意事項：Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure…
Peptic Ulcer Perforation 🟡 Moderate
- 應避免使用本藥物。風險包括：出血、感染。
Cushing Syndrome 🟡 Moderate
- 注意事項：Corticosteroids mimic the effects of endogenous cortisol and aldosterone…
Hyperlipidemias 🟡 Moderate
- 需定期監測。
甲狀腺機能低下 🟡 Moderate
- 需密切監測。可能需要調整劑量。
肝臟疾病 🟡 Moderate
- 可能需要調整劑量。
Myocardial Infarction 🟡 Moderate
- 應謹慎使用本藥物。
重症肌無力 🟡 Moderate
- 應謹慎使用本藥物。必要時應停止治療。
Muscular Diseases 🟡 Moderate
- 可能有嚴重不良反應。
Keratitis, Herpetic 🟡 Moderate
- 不建議使用本藥物。
Toxic Optic Neuropathy 🟡 Moderate
- 注意事項：Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma…
骨質疏鬆症 🟡 Moderate
- 注意事項：Corticosteroids reduce osteoblastic function and inhibit the absorption of intestinal calcium, which can result in bone resorption and bone loss durin…
消化性潰瘍 🟡 Moderate
- 應避免使用本藥物。風險包括：出血。
Scleroderma, Localized 🟡 Moderate
- 注意事項：In patients with scleroderma, corticosteroids may precipitate renal crisis with malignant hypertension, possibly via steroid-induced increases in reni…
Strongyloidiasis 🟡 Moderate
- 應謹慎使用本藥物。風險包括：感染。可能有致命風險。
Thromboembolism 🟡 Moderate
- 風險包括：血栓。
Infections 🟢 Minor
- 不應使用本藥物。風險包括：感染。可能危及生命。
結論與下一步
決策：Go
理由： 有高品質的隨機對照試驗（包括 2023 年發表於 JAMA Dermatology 的研究）證實 prednisone 與 methotrexate 併用對嚴重圓禿有效。這個預測有充分的臨床證據支持。
若要推進需要：
- 根據患者個別情況評估風險效益
- 考慮與 methotrexate 或 JAK 抑制劑併用
- 制定長期監測計畫（骨密度、血糖等）
相關藥物報告
- Gemcitabine - 證據等級 L2
- Vonoprazan - 證據等級 L2
- Isosorbide Dinitrate - 證據等級 L2
- Carboplatin - 證據等級 L2
- Regorafenib - 證據等級 L2
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引用本報告
如需引用本報告，請使用以下格式：
APA 格式：
TwTxGNN. (2026). Prednisone老藥新用驗證報告. https://twtxgnn.yao.care/drugs/prednisone/
BibTeX 格式：
@misc{twtxgnn_prednisone,
title = {Prednisone老藥新用驗證報告},
author = {TwTxGNN Team},
year = {2026},
url = {https://twtxgnn.yao.care/drugs/prednisone/}
}
免責聲明
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
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