Open-label, pilot study examining sequential therapy with oral tacrolimus and topical tacrolimus for severe atopic dermatitis - 14/09/12
, Tina Bhutani, MD b, Priya Sivanesan, MD, MPH c, Grace D. Bandow, MD c, Sari Beth Weinstein, MD d, Lawrence C.C. Cheung, MD d, Farah Malick, MD e, John Koo, MD f
Reprint requests: Terrence Colin Keaney, MD, Department of Dermatology and Cutaneous Surgery, University of Miami, 1800 Purdy Ave, Apt 1901, Miami Beach, FL 33139.Abstract |
Background |
Systemic treatment options for generalized atopic dermatitis (AD) are limited. To our knowledge, there have been no prospective trials examining the use of oral tacrolimus, a calcineurin inhibitor, in AD.
Objectives |
We assessed the safety and efficacy of sequential therapy with oral tacrolimus and topical tacrolimus in the treatment of generalized AD using the Eczema Area and Severity Index and the Physician Global Assessment scores as the primary end points.
Methods |
Twelve patients with AD covering at least 50% body surface area were enrolled. Patients in both phases of the study received sequential therapy with oral and topical tacrolimus over a 14-week treatment period. Eczema Area and Severity Index, Physician Global Assessment, and pruritus scores were calculated at each study visit.
Results |
Patients recorded a 67% improvement in the Eczema Area and Severity Index score, a 45% improvement in the Physician Global Assessment score, and a 69% reduction in the pruritus score.
Limitations |
This investigator-initiated, open-label, single-center, proof-of-concept study lacks a large sample size and placebo control group.
Conclusion |
Sequential therapy with oral tacrolimus and topical tacrolimus may be an effective treatment for AD. A large, randomized control study is warranted.
Le texte complet de cet article est disponible en PDF.Key words : atopic dermatitis, calcineurin inhibitor, oral tacrolimus, sequential therapy, topical tacrolimus
Abbreviations used : AD, EASI, mRNA, PGA, TGF
Plan
| Supported by Astellas Pharma US. |
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| Disclosure: Dr Koo is an investigator and serves on the advisory board and speaker’s bureau for Amgen, Biogen, Genentech, Connectics, Valiant, Novartis, and Astellas. He also serves on the speaker’s bureau for Centacor; serves on the advisory board and is an investigator for Abbott; and is an investigator for Teikoku Parma USA Inc. Dr Cheung is currently a speaker for Amgen and is a consultant for Teikoku Pharma USA Inc. Drs Keaney, Bhutani, Sivanesan, Bandow, Weinstein, and Malick have no conflicts of interest to declare. |
Vol 67 - N° 4
P. 636-641 - octobre 2012 Retour au numéro
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