Topical calcineurin inhibitors in eczema and cancer association: A cohort study

Cai, Sophie; Li, W; Tian, Elizabeth Ai Lian; Allen, John C.; Tey, Hong Liang

doi:10.3109/09546634.2016.1163317

Cited by 20 publications

(32 citation statements)

References 35 publications

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“…When compared to topical corticosteroids, calcineurin inhibitors tend to elicit more adverse events such as burning or pruritus [39-41]. Additionally, studies have linked calcineurin inhibitors to malignancies such as leukemia and lymphoma [42, 43]. Given that past research indicates a correlation between industry funding and pro-industry results [44], these findings raise the question as to whether the obscuring of adverse events is intentional from an industry perspective.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions

et al. 2021

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Background: Spin – the misrepresentation of a study’s results – has been identified in abstracts of studies focused on a variety of disorders from multiple fields of medicine. Objectives: This study’s primary objective was to evaluate the abstracts of systematic reviews and meta-analyses focused on the treatment of atopic dermatitis for the nine most severe forms of spin. Methods: We systematically searched Embase and MEDLINE for systematic reviews of atopic dermatitis therapies. Screening and data extraction occurred in a masked, duplicate fashion. Each included study was evaluated for the nine most severe types of spin and other study characteristics. Results: Our searches retrieved 2,456 studies, of which 113 were included for data extraction. Spin was found in 74.3% of our included studies (84/113). Spin type 6 occurred most frequently (68/113, 60.2%). Spin types 1, 2, and 9 were not identified. All industry-funded systematic reviews contained spin in their abstract. The presence of spin was not associated with any specific study characteristics, including the methodological quality of the study. Conclusions: Severe forms of spin were found in the majority of abstracts for systematic reviews of atopic dermatitis treatments. Steps should be taken to prevent spin to improve the quality of reporting in abstracts.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions

et al. 2021

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“…Use of calcineurin inhibitors in paediatric patients for prolonged periods of time should be monitored carefully. Although the evidence available is insufficient to suggest causality, the Pediatric Advisory Committee for the Food and Drug Administration has retained a 'black box' warning for use in the United States, citing a potential risk of B cell leukaemia with the use of calcineurin inhibitors in paediatric patients (72,73).…”

Section: Topical Immunomodulatorsmentioning

confidence: 99%

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

Yosipovitch¹,

Miséry²,

Proksch³

et al. 2019

Acta Derm Venereol

111

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Itch is a common symptom of many skin barrier-related dermatoses and can severely impact quality of life. However, there are a limited number of effective anti-itch topical therapies currently available and several unmet needs not addressed by current itch management strategies. As our knowledge of the mechanisms underlying itch has improved, several novel therapies have recently emerged that can be incorporated into existing regimens to enhance itch therapy and management. Here, we summarise research and current opinion on available topical therapies and give recommendations for the optimal management of itch. Barrier damage, dry skin and itch are intricately linked and form the basis of many common skin diseases. Damage from environmental insults, or genetic or inflammatory causes, can impair the skin barrier, resulting in an increase in transepidermal water loss and activation of itch-associated nerve fibres. The itch-scratch cycle can perpetuate skin barrier damage and itch. Topical therapeutic strategies are utilised to overcome dry skin and itch, primarily in the form of emollients. Recent advances in our understanding of the mechanisms underlying itch have enabled the development of new topical therapies, which may be incorporated into existing treatment regimes. Ultimately, treatment of dry skin and itch must be highly tailored to the individual according to their needs.

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“…Pimecrolimus is not available for use in Japan b Children aged C 2 years and adolescents aged \ 16 years c Adolescents aged C 16 years and adults found evidence of increased cancer risk [59,60]. Indeed, the first Asian study to investigate the risk of malignancies with TCI in patients with AD found no association between pimecrolimus and tacrolimus use and overall development of malignancies [61]. Furthermore, a recent prospective, observational study of approximately 8000 children with AD who were treated with tacrolimus ointment for C 6 weeks observed no incidence of lymphoma over a 10-year period [62].…”

Section: Anti-inflammatory Treatmentmentioning

confidence: 99%

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

Luk

Hon

Dizon

et al. 2020

Dermatol Ther (Heidelb)

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Introduction There is some evidence to suggest that the prevalence of atopic dermatitis (AD) in Asia is rising. We have therefore developed an algorithm for the topical treatment of AD throughout South and East Asia for use by primary care physicians, pediatricians and dermatologists. Methods Nine AD experts from South and East Asia and one from Europe developed the algorithm based upon treatment guidelines, relevant literature and local treatment practices. The algorithm outlines current best practice for the use of emollients, topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI), with the intention of simplifying the treatment regimen of mild-to-moderate AD in South and East Asia. Results Patients with AD should bathe and cleanse affected skin to remove crusts and scales daily. Emollients should also be applied daily as a maintenance treatment. When selecting appropriate topical anti-inflammatory treatment for AD flares, several factors should be taken into consideration, including the patient’s age, attitude to treatment options and site of AD lesions. Given the concerns regarding the risk of skin atrophy with use of TCS, a TCI should be used to treat AD lesions in sensitive skin areas: pimecrolimus is recommended for mild-to-moderate AD in these locations, while tacrolimus should be considered for moderate and severe cases. Either pimecrolimus or tacrolimus is recommended for flares in other, non-sensitive body locations. A proactive or intermittent maintenance treatment strategy involving regular emollient use and twice-weekly application of a TCI to previously affected areas is encouraged to reduce the risk of flares. Conclusions The algorithm proposed here is intended to simplify the topical treatment of mild-to-moderate AD in daily practice in South and East Asian countries.

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Topical calcineurin inhibitors in eczema and cancer association: A cohort study

Cited by 20 publications

References 35 publications

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions

Evaluation of Spin in the Abstracts of Systematic Reviews and Meta-Analyses of Atopic Dermatitis Treatments and Interventions

Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions

Practical Recommendations for the Topical Treatment of Atopic Dermatitis in South and East Asia

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