Balancing efficacy and safety in the management of atopic dermatitis: the role of methylprednisolone aceponate

Abstract

Although emollients can be sufficient to manage mild atopic dermatitis (AD), acute flares resulting in moderate-to-severe symptoms require treatment with anti-inflammatory agents, such as topical corticosteroids (TCs) and topical calcineurin inhibitors (TCIs). This review examines the role of a member of the newest class of TCs, the fourth-generation compound methylprednisolone aceponate (MPA) in AD management, with reference to the chemical structure, pharmacokinetics, efficacy in AD, safety assessed in preclinical and clinical trials and dosing considerations. MPA has an optimized efficacy/safety profile with minimal local or systemic adverse effects. In addition, it offers the opportunity for once-daily dosing, which provides benefits in terms of patient compliance with treatment.

Methylprednisolone aceponate for atopic dermatitis

“…Methylprednisolone aceponate is included in the group of potent TCS (category III/IV); triamcinolone acetonide and bethametasone valerate are reference TCS also included in this group . Multiple double‐blind studies, both placebo‐controlled and compared to reference TCS, have shown a high clinical efficacy of MPA in the treatment of eczema after 1–4 weeks of application once daily .…”

“…Epidermal thinning is partly reversible, but atrophy of the dermis and even subcutaneous tissue is often permanent. Striae and telangiectasias are a reflection of permanent atrophy and are often motive of concern for patients and physicians . Skin atrophy is mostly an effect of long‐term use of TCS, but the epidermal and stratum corneum atrophy can be induced even in short‐term treatments.…”

Modern algorithm of topical treatment of steroid-sensitive dermatoses

“…При применении один раз в сутки МПА -эффективное и безопасное средство для лечения АД у детей [21,22].…”

Circadian rhythm in atopic dermatitis—Pathophysiology and implications for chronotherapy

“…18 In a separate study by Chang and colleagues, 25 adherence, and minimal adverse effects, which defines the ultimate goal of chronotherapy in dermatology. 30 Implementation of chronotherapy in AD is a novel and potentially transformative treatment approach. TEWL, hydration, and sebum production have daily variation patterns and should be considered when using topically applied medications to alter absorption of topically applied compounds.…”