Among adults with eczema, otherwise known as atopic dermatitis, proactive long-term treatment with tacrolimus ointment applied twice-weekly safely reduces exacerbations of the condition, European investigators have shown.
Conventional reactive treatment of atopic dermatitis involves applying anti-inflammatory medication to skin lesions only while they are visible. With a proactive approach, intensive treatment until lesions are no longer visible is followed by low-dose treatment of previously affected skin areas to prevent flare-ups, the researchers explain in the medical journal Allergy.
Dr. Andreas Wollenberg, from Ludwig-Maximilian Universitat in Munich, Germany, and members of the European Tacrolimus Ointment Study Group conducted a clinical trial in which 247 adult patients with atopic dermatitis initially applied tacrolimus ointment twice daily for up to 6 weeks to visible lesions.
Patients who responded well were then randomly assigned to apply tacrolimus or placebo ointment twice-weekly for 12 months. If exacerbations occurred, they were treated with daily tacrolimus until the flare-up subsided.
The average time to a first exacerbation was substantially longer for the proactively treated patients (142 days) than for the reactively treated patients (15 days), the investigators report.
The proactive group also had a lower percentage of days in which their condition flared up, the report indicates, and more of them had no exacerbations.
Proactive treatment with tacrolimus ointment "prevented, delayed and reduced the occurrence of atopic dermatitis exacerbations," Wollenberg and his associates conclude.
SOURCE: Allergy, June 2008
Reuters, May 28, 2008