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Tacrolimus ointment in the management of atopic dermatitis
Antonello Baldo, Mariana Cafiero, Paola Di Caterino, Luisa Di Costanzo
Clinical, Cosmetic and Investigational Dermatology , 2009, DOI: http://dx.doi.org/10.2147/CCID.S3378
Abstract: crolimus ointment in the management of atopic dermatitis Review (5981) Total Article Views Authors: Antonello Baldo, Mariana Cafiero, Paola Di Caterino, Luisa Di Costanzo Published Date January 2009 Volume 2009:2 Pages 1 - 7 DOI: http://dx.doi.org/10.2147/CCID.S3378 Antonello Baldo, Mariana Cafiero, Paola Di Caterino, Luisa Di Costanzo Department of Dermatology, University of Naples Federico II, Naples, Italy Abstract: Atopic dermatitis (AD) is a chronic, relapsing, highly pruritic inflammatory skin disease. AD long-term treatment is usually required to control and prevent flares, and patients need a treatment that is safe and efficacious when applied continuously or intermittently over a prolonged period of time. The treatment options should be chosen according to age, clinical features and severity of the disease in every single patient. For the treatment of a chronic disease like AD, sustained tolerability and efficacy of the applied medications are essential. A topical immunomodulator, tacrolimus ointment, provides an alternative to topical corticosteroids without the associated adverse events. Tacrolimus is a macrolide lactone with unique immunomodulatory properties and strong anti-inflammatory activities and can be used without increasing the risk of infection or other non-application site adverse events, and without loss of effectiveness, in patients with AD.
Topical Tacrolimus In Atopic Dermatitis : A Placebo Controlled Study With 15 Children  [cached]
Dhar Sandipan,Banerjee Raghubir
Indian Journal of Dermatology , 2004,
Abstract: Fifteen children aged 3 to 15 (mean 8.92) years with moderate to severe atopic dermatitis (AD) of 6 months to 5 years (mean 2.5 years) duration were treated with 0.1% topical tacrolimus ointment. Tacrolimus ointment was applied on 3 patches of 3 x 3 cm, twice daily for 2 weeks. An equal number of age and sex matched controls were treated with sunflower oil application on eczema lesions. There was significant reduction of severity scores (P < 0.05) after tacrolimus treatment as compared to sunflower oil application in all 15 children. Three children experienced mild and transient burning, erythema and pruritus over the lesions. Topical tacrolimus (0.1%) was found to be effective and safe in the treatment of moderate to severe AD in children.
Efficacy and Safety of Topically Applied Tacrolimus Ointment in Patients with Moderate to Severe Atopic Dermatitis  [PDF]
Wen-Rou Wong,Hsiang-Ju Tsai,Hong-Shang Hong
Chang Gung Medical Journal , 2003,
Abstract: Background: Tacrolimus is a T-cell-selective cytokine inhibitor. The topical formulationwas specifically developed for treating inflammatory skin diseases, includingatopic dermatitis (AD). The purpose of this study was to evaluate the efficacyand safety of topically applied tacrolimus ointment (Protopic ) in treatingTaiwanese patients with moderate to severe AD.Methods: This was an open-labeled, non-comparative, single-center study. Enrolledpatients applied Protopic twice daily for up to 4 weeks. Efficacy was evaluatedon the basis of the physician’s global evaluation of clinical response(PG). Other evaluations included the Eczema Area and Severity Index andthe percentage of body surface area; the total score for clinical signs wasused for evaluating the efficacy. A safety assessment was based on adverseevents reported by patients or observed by the physician. Blood was sampledfor the evaluation of tacrolimus levels.Results: In total, 30 patients (16 pediatric and 14 adult patients) with moderate tosevere AD were enrolled in this study. At the end of treatment, the PG was92.3% for the pediatric group and 100% for the adult group. Other efficacyevaluations also showed significant improvement. Two patients haddetectable blood tacrolimus concentrations. Skin itching and burning on theapplication site was a common but temporary side effect. No significantadverse events related to Protopic were observed.Conclusion: The results of the study suggest that Protopic ointment may be a safe andeffective therapy for treating patients at least 2 years of age with moderate tosevere AD.
Safety and Efficacy of Tacrolimus 0.03% Ointment in the Treatment of Atopic Dermatitis: A Randomized, Double-Blind, Placebo Controlled Clinical Trial
Parvin Mansouri,Soheila Hasouri,Alireza Firooz,Alireza Khatami
Dermatology and Cosmetic , 2011,
Abstract: Background and Aim: Atopic dermatitis (AD) is a chronic, relapsing, pruritic skin disease more common in infancy and childhood. Emollients, topical corticosteroids, and avoidance of irritating factors are the mainstay of its treatment, but fear of side effects has limited the use of topical corticosteroids. The objective of this study was to evaluate the safety and efficacy of topical tacrolimus 0.03% ointment in the treatment of AD. Methods: In this randomized, double-blind, clinical trial, 76 patients with AD older than 2 years were randomly allocated in two groups and treated with either tacrolimus 0.03% ointment (Abu-Rayhan Co., Iran) or placebo, twice a day for 6 weeks. Responses to treatment were compared every 2 weeks using SCORAD. Results: Twenty-nine patients in tacrolimus group and 26 in placebo group completed the trial. The reduction in SCORAD after 2 and 4 weeks in tacrolimus group was significantly higher than placebo group (P<0/05). The frequency of treatment-induced pruritus and burning sensation was similar in both groups but erythema was more observed in the placebo group (P<0/05). Conclusion: Tacrolimus 0.03% ointment is more effective than placebo in the treatment of AD. ackground and Aim: Anti-inflammatory and hypo- pigmenting effects of topical tretinoin and alpha-hydroxy acids have been documented. This study was designed to compare the efficacy of 0.05% tretinion cream with 7% alpha-hydroxy acid in the treatment of ephelides. Methods: In this clinical trial 80 patients with ephelides were selected and allocated into two groups. One group was treated with 0.05% tretinoin cream every other night. The other group was treated with 7% alpha-hydroxy acid cream in the same manner. Both groups were treated with antisolar creams and followed every month for 5 months. Results: After 5 months excellent therapeutic response was achieved in 3 (7.5%) of patients who were treated with 0.05% tretinoin cream compared to 8 (20%) in alpha-hydroxy acid cream. Good therapeutic response was observed in 20 (50%) of tretinoin group versus 16 (40%) in alpha-hydroxy acid group. Patient's satisfaction from treatment was consistent with evaluation by dermatologists (P=0.384 and P=0.132). Conclusion: Both 0.05% tretinoin cream and 7% alpha-hydroxy acid cream are equally efficient in the treatment of ephelides.
The Use of Topical Tacrolimus 0.1% Skin Ointment for Anterior Segment Conditions: A Case Series
Poorna Abeysiri, Nicholas R. Johnston and Anthony C.B. Molteno
Ophthalmology and Eye Diseases , 2012, DOI: 10.4137/OED.S0
Abstract: Tacrolimus (FK 506) is a macrolactam derivative with immunomodulatory and anti-inflammatory activity. Topical tacrolimus 0.03% has been used for inflammatory conditions of the anterior segment. This article adds to the literature on the off-license application of tacrolimus ointment, by describing the safe and effective use of the higher strength of 0.1% topical tacrolimus skin ointment in four patients. To our knowledge this is the first report of topical tacrolimus 0.1% ointment applied to the conjunctival sac for the treatment of atopic keratoconjunctivitis, vernal keratoconjunctivitis and the post-operative management of trabeculectomy and graft rejection in steroid responders.
Atopic dermatitis: tacrolimus vs. topical corticosteroid use
Y Langa, E Van der Merwe
South African Family Practice , 2011,
Abstract: Atopic dermatitis (AD), the dermatological manifestation of the atopic diathesis, has a variety of clinical presentations. It is a chronic and relapsing inflammatory disorder, requiring a multifaceted treatment approach. Topical corticosteroids are the backbone of therapy. However, concerns over adverse drug reactions associated with their long-term application limit their use. Tacrolimus, on the other hand, has been shown to be effective in stabilising the symptoms of AD in the long-term setting, without the side-effects that hamper the use of topical corticosteroids. Long-term safety data up to ten years are available in the literature. Despite this, the US Food and Drug Administration (FDA) black box warning of possible malignancies has resulted in much debate among experts. The main focus of this article is to compare the safety and efficacy of topical corticosteroids to calcineurin inhibitors, particularly tacrolimus. Furthermore, the aim is to evaluate the place of tacrolimus in AD therapy. A brief overview of the condition and other treatment modalities will also be discussed.
Atopic eczema in school children
Kibrebeal Melaku
Ethiopian Journal of Health Development , 2000,
Abstract: Information on Atopic eczema is sparse in Ethiopia. This survey was conducted to determine the prevalence of eczema among school children in Addis Ababa, Ethiopia, in 1995. A standardized self-administered questionnaire developed by the International Study of Asthma and Allergies in Children (ISAAC) was used. A total of 2951 children (52.8% were females) participated in the study. A 29.2% of life time experience of recurrent itchy rash and 22.1% of 12 months prevalence of rash was reported by the children. However, only 11.2% of the children reported having eczema. Sleep disturbing rash, a sign of severe eczema, was reported by 2.6% of children. By using a simple standardized questionnaire, an internationally comparable local data was generated by this study. However, further studies with a more objective diagnostic criteria which includes skin prick test is recommended. (Ethiopian Journal of Health Development: 2000, 14(1): 105-108)
Therapy of atopic eczema  [cached]
Werfel, Thomas,Claes, Christa,Kulp, Werner,Greiner, Wolfgang
GMS Health Technology Assessment , 2006,
Abstract: Objectives: Major objective is the evaluation of the medical effectiveness of different therapeutical approaches and the cost effectiveness with relevance for Germany. Methods: This health technology assessment (HTA) evaluates systemically randomized controlled studies (RCT) on the therapy of atopic dermatitis which were published between 1999 and 2004. Further it includes some important clinical studies which have been published after 2004 and other updates the English HTA report by Hoare et al. [1]. Results: Topical corticosteroids and topical calcineurin-inhibitors are the principal substances which are currently used for anti-inflammatory therapy in atopic dermatitis. These substances have shown a significant therapeutic efficacy in controlled studies. In newer controlled studies no difference was observable when corticosteroids were applied once or more than once daily onto the skin. Moreover, there is now one controlled study available which points to the fact that an interval therapy with a stronger topical corticosteroid over a limited time (some weeks) may lower the risk of recurrent flares of atopic dermatitis. Both topical calcineurin-inhibitors pimecrolimus and tacrolimus have shown a significant therapeutical efficacy in a number of placebo-controlled prospective studies. The wealth of data is high for these substances. Both substances have been shown to be efficient in infants, children and adult patients with atopic dermatitis. The importance of a so-called basic therapy with emollients which have to be adapted to the current status of skin is generally accepted in clinical practice. Controlled studies show the efficacy of ”basic therapy” - although the level of evidence is quite low for this approach. The skin of patients with atopic dermatitis is colonized in the majority with Staphylococcus aureus, a gram-positive bacterium. Therefore, a therapeutical approach for the treatment of atopic dermatitis is the anti-bacterial or anti-septic treatment of the skin. Due to the lack of randomized controlled studies there is still not certain proof that antimicrobial or anti-septic treatment of non-infected eczematous skin is efficient for the treatment of atopic dermatitis. A reduction of Staphylococcus aureus is observable during an anti-inflammatory treatment of the skin with topical corticosteroids and/or the topical calcineurin-inhibitor tacrolimus. Antihistaminic drugs which are orally applied in atopic dermatitis may support the therapy of the itching skin disease. One controlled study showed a rapid reduction of itch during the use of a no
An overview of topical treatment for atopic eczema
MH Motswaledi
South African Family Practice , 2011,
Abstract: Atopic eczema is a chronic, relapsing inflammatory disease of the skin. It is characterised by dry, itchy skin and a typical distribution on the elbows and knees in younger children, and the cubital and popliteal fossae in older children and adults. Treatment modalities include emollients, topical corticosteroids, calcineurin inhibitors, phototherapy and immunosuppressive therapy. This article provides a brief overview of topical treatments for atopic eczema.
Topical tacrolimus as treatment of atopic dermatitis
Masutaka Furue, Satoshi Takeuchi
Clinical, Cosmetic and Investigational Dermatology , 2009, DOI: http://dx.doi.org/10.2147/CCID.S4122
Abstract: pical tacrolimus as treatment of atopic dermatitis Review (8691) Total Article Views Authors: Masutaka Furue, Satoshi Takeuchi Published Date November 2009 Volume 2009:2 Pages 161 - 166 DOI: http://dx.doi.org/10.2147/CCID.S4122 Masutaka Furue, Satoshi Takeuchi Department of Dermatology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan Abstract: Atopic dermatitis (AD) is a common, chronic, relapsing, severely pruritic, eczematous skin disease. The mainstays of treatment for AD are topical tacrolimus and topical steroids. Tacrolimus, a calcineurin inhibitor, not only complements existing treatment options but also overcomes some of the drawbacks of topical steroid therapy when given topically and thus meets the long-term needs of patients in preventing disease progression. Topical tacrolimus has been widely recognized in terms of its short- and long-term efficacies and safety, and it is also accepted as a first-line treatment for inflammation in AD. The recent proactive use of topical tacrolimus may emphasize a long-term benefit of this calcineurin inhibitor for AD treatment. To reduce possible long-term adverse effects, it is important to monitor its topical doses in daily clinics.
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