Topical immunomodulators for atopic dermatitis

Bernard, Laurie A.; Eichenfield, Lawrence F.

doi:10.1097/00008480-200208000-00010

Cited by 26 publications

(19 citation statements)

References 19 publications

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“…These agents, pimecrolimus and tacrolimus, are topical calcineurin inhibitor immunosuppressants (TCI) [1,2,3]. At the time of FDA marketing approval, concern was raised by the FDA that these agents might be associated with an increased risk of nonmelanoma skin cancer (NMSC) because oral versions of calcineurin inhibitors have been associated with an increased frequency of NMSC, especially in those who have received organ transplants [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Lack of Association between Exposure to Topical Calcineurin Inhibitors and Skin Cancer in Adults

2007

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Background: Two topical calcineurin inhibitors (TCI) are available for the treatment of atopic dermatitis and there has been concern that their use could be associated with an increased risk of nonmelanoma skin cancer (NMSC). Objective: To determine if TCI exposure is associated with an increased risk of NMSC in adults. Methods: A case-control study using a questionnaire mailed to 5,000 adults with dermatitis. Results: We received responses from 70.7% of those surveyed by mail. Overall, 25.7% reported exposure to TCI. TCI exposure was 14.4% for the cases and 30.7% for the controls. Our primary analysis was a comparison between those with NMSC and those without. The unadjusted odds ratio was 0.38 (0.31–0.47) and the adjusted (age, gender, previous NMSC, history of atopic dermatitis) was 0.54 (0.41–0.69). The odds ratio of association for NMSC decreased as the number of tubes used and the potency of the agent increased. Conclusion: This early study shows that TCI use is not associated with an increased risk of NMSC in adults.

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Section: Introductionmentioning

confidence: 99%

Lack of Association between Exposure to Topical Calcineurin Inhibitors and Skin Cancer in Adults

2007

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“…Recently, the calcineurin inhibitors pimecrolimus (Elidel®, SDZ ASM 981) and tacrolimus (Protopic®, FK 506) have become available as the first novel topical treatments for AD since the introduction of the corticosteroids 50 years ago [19]. This review provides information on the discovery of the topical calcineurin inhibitors and the program that led to the identification of pimecrolimus, and summarizes the pharmacological profile and therapeutic potential of this novel non-steroidal anti-inflammatory compound.…”

Section: Introductionmentioning

confidence: 99%

Discovery of Topical Calcineurin Inhibitors and Pharmacological Profile of Pimecrolimus

Stuetz

Baumann

Grassberger

et al. 2006

Int Arch Allergy Immunol

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Using a newly developed model of allergic contact dermatitis in pigs, calcineurin inhibitors of the tacrolimus and ascomycin type were shown to have a highly anti-inflammatory action after topical application. These findings provided the first pharmacological evidence of the efficacy of this novel class of topical agents in the treatment of inflammatory skin diseases, and, thus, their potential to become the first alternative to corticosteroids in more than 40 years. As a result of a large research program into ascomycins, pimecrolimus (Elidel®, SDZ ASM 981) was selected for development due to its favorable pharmacology and safety profile, alongside tacrolimus (Protopic®, FK 506). In vitro, pimecrolimus inhibits the transcription and release of pro-inflammatory cytokines in T cells. Similar to the corticosteroids, betamethasone-17-valerate and dexamethasone, pimecrolimus is effective at nanomolar concentrations. Targeting mainly T cells, pimecrolimus has, however, a more specific mode of action. Moreover, in contrast to corticosteroids, pimecrolimus has no effect on Langerhans’ cells, the professional antigen- presenting dendritic cells of the skin that are crucial for local immunosurveillance. When applied topically, pimecrolimus exerts a high and selective anti-inflammatory activity in the skin, shows minimal percutaneous absorption, and has a low potential to affect systemic immunoreactions. Pimecrolimus cream 1% has proven to be well tolerated, safe, and highly effective in clinical studies in patients with atopic dermatitis.

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“…Both agents have been shown to be effective and well tolerated in the treatment of atopic dermatitis in separate clinical studies. 10 However, no clinical trial has been published that directly compares these two therapeutic agents.…”

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confidence: 99%

A randomized investigator-blinded study comparing pimecrolimus cream 1% with tacrolimus ointment 0.03% in the treatment of pediatric patients with moderate atopic dermatitis

Kempers

Boguniewicz

Carter

et al. 2004

Journal of the American Academy of Dermatology

109

136

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Topical immunomodulators for atopic dermatitis

Cited by 26 publications

References 19 publications

Lack of Association between Exposure to Topical Calcineurin Inhibitors and Skin Cancer in Adults

Lack of Association between Exposure to Topical Calcineurin Inhibitors and Skin Cancer in Adults

Discovery of Topical Calcineurin Inhibitors and Pharmacological Profile of Pimecrolimus

A randomized investigator-blinded study comparing pimecrolimus cream 1% with tacrolimus ointment 0.03% in the treatment of pediatric patients with moderate atopic dermatitis

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