A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis

Peña, Joseph E.; Zameza, Priscila Arellano; Pixley, Jessica N.; Remitz, Anita; Feldman, Steven R.

doi:10.1016/j.jaip.2023.03.022

Cited by 12 publications

(5 citation statements)

References 66 publications

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“…It can be used on relapsing AD and on sensitive skin areas. Tacrolimus 0.1% efficacy is similar to TCS class IV, and it has been demonstrated to have a greater improvement in the EASI compared to moderate potency TCS class V [ 13 , 14 ••] The main AE consists of local burning and stinging. Although tacrolimus carries a black box warning of cancer risk, studies during the past 20 years and a recent meta-analysis showed that TCI do not increase the risk of cancer [ 15 , 16 , 17 •].…”

Section: Conventional Management and Treatmentsmentioning

confidence: 99%

Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis

Yim,

Jean,

Ong

2024

Curr Allergy Asthma Rep

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Purpose of Review Historically, systemic treatments for atopic dermatitis (AD) primarily consisted of immunosuppressive agents such as corticosteroids and Disease Modifying Antirheumatic Drugs (DMARDS), which provided symptomatic relief but often had long-term adverse effects. Newer treatments have shown significant efficacy with less side effects in clinical trials. This review discusses and compares conventional and newer systemic treatments for AD. Recent Findings Newer medications for AD including dupilumab, tralokinumab, lebrikizumab, and oral JAK inhibitors have been shown to be safe and efficacious. High dose cyclosporine and dupilumab were more effective than methotrexate and azathioprine in improving clinical signs of AD. High-dose upadacitinib was shown in another meta-analysis to be most effective in the measured outcomes but had the highest frequency of adverse events. Summary Targeted biologic treatments are increasingly favored over traditional immunosuppressive treatments of AD. Treatment can be individualized based on potency, adverse side effects, mechanism of action, and administration preference. Ongoing research continues to expand treatment options for AD.

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Section: Conventional Management and Treatmentsmentioning

confidence: 99%

Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis

Yim,

Jean,

Ong

2024

Curr Allergy Asthma Rep

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“…These drugs are used to prevent fl ares and extend symptom-free periods. 26,27 They are approved as second-line therapy for short-term, noncontinuous chronic treatment of AD in patients 2 years of age and older who are not immunocompromised and who have not adequately…”

Section: Topical Calcineurin Inhibitorsmentioning

confidence: 99%

“…34 Ruxolitinib is generally well tolerated. 26,35 Possible adverse reactions include nasopharyngitis, diarrhea, bronchitis, ear infection, eosinophilia, urticaria, folliculitis, tonsillitis, and rhinorrhea. 17,27,35 All JAK inhibitors carry a boxed warning for serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis.…”

Section: Topical Janus Kinase Inhibitorsmentioning

confidence: 99%

Therapeutic management of atopic dermatitis

Jarrell

2024

The Nurse Practitioner

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Atopic dermatitis (AD), a chronic inflammatory, pruritic skin disorder, is seen primarily in the pediatric population but can be found among all age groups. The symptoms of AD can cause embarrassment in patients and can interrupt daily activities and productivity, potentially resulting in avoidance of social situations. In addition to nonpharmacologic management, mainstay pharmacologic treatments for AD are topical medications including corticosteroids, calcineurin inhibitors, phosphodiesterase-4 inhibitors, and topical Janus kinase (JAK) inhibitors. Promising new drugs—oral JAK inhibitors and monoclonal antibodies—have emerged as new treatment options for moderate-to-severe AD.

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“…Prolonged inflammation with excessive production of inflammatory mediators and cytokines induced by external stimuli can lead to cellular and tissue damage [ 1 ]. Currently, topical corticosteroids are widely used in the treatment of chronic inflammatory skin diseases, but their long-term use causes side effects, such as atopic dermatitis, contact allergies, and acne [ 10 , 11 ]. Therefore, there is a great deal of interest in the development of natural compounds with safe anti-inflammatory effects and minimal side effects.…”

Section: Introductionmentioning

confidence: 99%

Anti-Inflammatory Effects of Chamaecyparis obtusa (Siebold & Zucc.) Endl. Leaf Extract Fermented by Ganoderma applanatum Mycelia

Kim,

Kwon,

Jang

2024

Pharmaceutics

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Corticosteroids are commonly used anti-inflammatory agents. However, their prolonged use can lead to side effects. Therefore, the development of natural compounds with minimal side effects is necessary. This study was performed to investigate the anti-inflammatory effects and mechanisms of action of Chamaecyparis obtusa (Siebold & Zucc.) Endl. leaf (COL), bioconverted using Ganoderma applanatum (G. applanatum) in lipopolysaccharide (LPS)-induced RAW264.7 cells. The COL 70% EtOH extract fermented by G. applanatum (70COLGA) improved the high cytotoxicity of 70% EtOH extracts (70COL). When RAW264.7 cells were pre-treated with 100 and 200 μg/mL of 70COLGA for 2 h and then treated with LPS for 16 h, LPS induced the production of nitric oxide (NO), and the expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) were significantly inhibited. When RAW264.7 cells were pre-treated with 100 and 200 μg/mL of 70COLGA for 2 h and then treated with LPS for 4 h, the phosphorylation of signal transducers and activators of transcription (STAT) was markedly decreased. In addition, 70COLGA markedly suppressed the production of the inflammatory cytokines interleukin (IL)-1β and IL-6 in LPS-induced RAW264.7 cells. Analysis of pro-inflammatory molecules using cytokine arrays showed that macrophage inflammatory protein (MIP)-2, granulocyte–macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF) and IL-27 expressions were also suppressed by 200 μg/mL of 70COLGA in LPS-induced RAW264.7 cells. These results demonstrate that 70COLGA significantly prevented inflammatory responses by inhibiting the secretion of pro-inflammatory molecules in LPS-induced RAW264.7 cells. When RAW264.7 cells were pre-treated with 100 and 200 μg/mL of 70COLGA for 2 h and then treated with LPS-conditioned medium (LPS-CM) for 30 min, 70COLGA directly inhibited STAT activation. In summary, our findings suggest that 70COLGA has therapeutic potential for the treatment of inflammatory diseases.

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A Comparison of Topical Corticosteroids and Topical Calcineurin Inhibitors for the Treatment of Atopic Dermatitis

Cited by 12 publications

References 66 publications

Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis

Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis

Therapeutic management of atopic dermatitis

Anti-Inflammatory Effects of Chamaecyparis obtusa (Siebold & Zucc.) Endl. Leaf Extract Fermented by Ganoderma applanatum Mycelia

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