Pimecrolimus for the Treatment of Atopic Dermatitis in Infants: An Asian Perspective

Abstract

Atopic dermatitis (AD) is a common chronic, multisystem inflammatory skin disease in pediatric patients. There has been an increase in the incidence of AD in the pediatric population of the Asia–Pacific region. Studies have shown that genetic, epigenetic, environmental and cultural factors may lead to differences in the clinical manifestation and prevalence of AD between races. Early treatment of AD is necessary to prevent the atopic march leading to comorbidities such as asthma and allergic rhinitis. Topical corticosteroids (TCS) are used as first-line therapy for the treatment of AD, but their long-term usage poses a risk to the patient’s health. Pimecrolimus (1%) is a topical calcineurin inhibitor (TCI) that is indicated for the treatment of mild to moderate AD. Pimecrolimus has no apparent increase in adverse events compared to TCS, and it causes less of a burning sensation than tacrolimus. The safety and efficacy of pimecrolimus has been established through various clinical trials; yet, in many Asian countries, the use of pimecrolimus in infants is still restricted due to safety concerns. Based on the available evidence, the expert panel recommends pimecrolimus in infants between 3 months and 2 years of age in the Asian population.

Challenges of current treatment and exploring the future prospects of nanoformulations for treatment of atopic dermatitis

“…The United States Food and Drug Administration (USFDA) has issued a black box warning for TCIs, citing a theoretical risk of lymphoma based on studies in mice given high doses of the drug. However, the use of TCIs in humans does not appear to increase the incidence of lymphoma [ 30 , 33 ].…”