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Published on: July 11, 2013
Tacrolimus treatment of atopic eczema/dermatitis syndrome
1Department of Dermatology, Aarhus University Hospital, Denmark. ovl12ktp@aas.auh.dk
Insights
Topical steroids are standard for atopic dermatitis but have side effects. New treatments like tacrolimus offer effective, long-term control for this common childhood skin disease without steroid risks.
Area of Science:
- Dermatology
- Pediatrics
- Immunology
Background:
- Atopic dermatitis is a prevalent chronic skin condition in children globally.
- Topical glucocorticosteroids are the current standard treatment but are limited to short-term use due to side effect risks.
- Emollients are insufficient for controlling atopic dermatitis inflammation.
Purpose of the Study:
- To review the efficacy and safety of new treatment options for atopic dermatitis.
- To evaluate tacrolimus and pimecrolimus as alternatives to topical steroids.
- To assess the potential for long-term management of atopic dermatitis.
Main Methods:
- Clinical studies involving over 16,000 individuals with atopic dermatitis.
- Analysis of treatment outcomes for tacrolimus over 12-week and 1-year periods.
- Evaluation of side effect profiles, including burning sensations.
Main Results:
- Tacrolimus demonstrated significant improvement in moderate to severe atopic dermatitis.
- Over 90% disease improvement was observed in one-third of patients within 12 weeks.
- Long-term (1-year) treatment with tacrolimus resulted in over 90% improvement for 75% of patients.
- A burning sensation was the most common side effect, affecting up to 60% of patients.
Conclusions:
- Tacrolimus and pimecrolimus represent new, steroid-free therapeutic options for atopic dermatitis.
- These agents effectively control active eczema and prevent relapses, offering long-term management.
- A shift towards the long-term use of tacrolimus is anticipated for sustained inflammation control and potentially shortening disease course.
Purpose Of Review:
Atopic dermatitis is today the most common chronic disease of children in Europe, the US and Japan. The 'golden standard' of therapy is topical glucocorticosteroids and emollients. The steroids have been on the market for four decades, are efficacious, but only advised for short-term treatment due to their risks of side effects.
Recent Findings:
More than 16,000 persons suffering from atopic dermatitis have been enrolled in clinical studies of tacrolimus. One third of patients with moderate to severe atopic dermatitis experience over 90% improvement in their disease over a 12-week treatment period and up to 70% of patients have over 50% improvement. A 1-year treatment leads to more than 90% improvement in 75% of patients. The most pronounced side effect is a burning sensation occurring in up to 60% of patients.
Summary:
Atopic dermatitis is a chronic skin disease leading to a demand for long-term treatment control. Such treatment options have not previously been available--except for emollients which are not efficacious for controlling skin inflammation. Tacrolimus and pimecrolimus are new treatment options, free from the potential side effects of topical steroids, which are known for their efficacy in short-term treatment. The new treatment modalities prevent the eczema from relapsing and at the same time they control active eczema. The future will see a shift towards the long-term use of tacrolimus which is able to control the skin inflammation and, hopefully, shorten the course of the eczema.
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