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Journal of the Dermatology Nurses' Association - Featured Journal

April 2009, Volume 1 Number 2 , p 147 - 148 [FREE]

Authors

  • William Abramovits MD
  • Debra L. Breneman MD
  • Alan B. Fleischer MD
  • Joshua Zeichner MD
  • Toni Shull RN, CCRC

Abstract

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Atopic dermatitis (AD) is characterized by disease-free periods interrupted by exacerbations (C. A. Akdis, 2006). Maintenance therapy with tacrolimus ointment may prevent disease recurrence.

 

Pediatric and adult patients with clear or almost clear disease after <=16 weeks of treatment with tacrolimus ointment were randomized to receive either vehicle or tacrolimus ointment (pediatric = 0.03%; adult = 0.1%) in the maintenance phase of this study. The safety and efficacy of tacrolimus therapy for recurrence prevention were evaluated (D. Breneman, 2008).

 

A total of 197 of 288 patients with clear or almost clear disease were eligible and entered the maintenance phase of this study. Patients treated with tacrolimus ointment had more flare-free treatment days than those treated with vehicle (M = 177.4 vs. 134.1; p = .003), a longer time to first relapse (median = 169 vs. 43; p = .037), fewer relapse days (45.5 vs. 64.5; p = .027) and fewer relapses per patient (p = .027). The severity of relapses was similar for both groups (p = .140) as was the incidence of cutaneous adverse events (tacrolimus ointment = 8.0%; vehicle = 8.5%). The most common adverse events were application-site burning and pruritus (D. Breneman, 2008).

 

Long-term treatment with tacrolimus ointment in patients with clear or almost clear AD results in significantly more disease-free days and safely and effectively reduces the risk for disease relapse.

 

When used as directed, treatment with tacrolimus ointment is a safe and effective method to control disease in patients with stabilized AD.

INTRODUCTION

Atopic dermatitis (AD) is characterized by disease-free periods interrupted by exacerbations (C. A. Akdis, 2006). Maintenance therapy with tacrolimus ointment may prevent disease recurrence.

METHODS

Pediatric and adult patients with clear or almost clear disease after <=16 weeks of treatment with tacrolimus ointment were randomized to receive either vehicle or tacrolimus ointment (pediatric = 0.03%; adult = 0.1%) in the maintenance phase of this study. The safety and efficacy of tacrolimus therapy for recurrence prevention were evaluated (D. Breneman, 2008).

RESULTS

A total of 197 of 288 patients with clear or almost clear disease were eligible and entered the maintenance phase of this study. Patients treated with tacrolimus ointment had more flare-free treatment days than those treated with vehicle (M = 177.4 vs. 134.1; p = .003), a longer time to first relapse (median = 169 vs. 43; p = .037), fewer relapse days (45.5 vs. 64.5; p = .027) and fewer relapses per patient (p = .027). The severity of relapses was similar for both groups (p = .140) as was the incidence of cutaneous adverse events (tacrolimus ointment = 8.0%; vehicle = 8.5%). The most common adverse events were application-site burning and pruritus (D. Breneman, 2008).

CONCLUSIONS

Long-term treatment with tacrolimus ointment in patients with clear or almost clear AD results in significantly more disease-free days and safely and effectively reduces the risk for disease relapse.

NURSING IMPLICATIONS

When used as directed, treatment with tacrolimus ointment is a safe and effective method to control disease in patients with stabilized AD.

REFERENCES

 

Akdis, C. A., Akdis, M., Bieber, T., Bindslev-Jensen, C., Boguniewicz, M., Eigenmann, P., et al. (2006). Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. Allergy, 61, 969-987. [Context Link]

 

Breneman, D., Fleischer, A. B. Jr., Abramovits, W., Zeichner, J., Gold, M. H., Kirsner, R. S., et al. (2008). Intermittent therapy for flare prevention and long-term disease control in stabilized atopic dermatitis: A randomized comparison of 3-times-weekly applications of tacrolimus ointment versus vehicle. Journal of the American Academy of Dermatology, 58, 990-999. [Context Link]