Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials

Schmitt, Jochen; Kobyletzki, Laura von; Svensson, Åke; Apfelbacher, Christian

doi:10.1111/j.1365-2133.2010.10030.x

Cited by 228 publications

(196 citation statements)

References 37 publications

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“…Patients who received topical tacrolimus had significantly less AD flares and increased time to new flare development when compared with those who received placebo. 49 A similar effect may also be true with topical steroids (fluticasone propionate and methylprednisolone aceponate have been studied), 50 although none of these studies have evaluated the long-term safety of this treatment regimen. The choice of medication used for flare prevention may depend on patient age, location of involvement, and cost.…”

Section: Proactive Treatmentmentioning

confidence: 97%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

111

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Atopic dermatitis is a common inflammatory skin condition characterized by relapsing eczematous lesions in a typical distribution. It can be frustrating for pediatric patients, parents, and health care providers alike. The pediatrician will treat the majority of children with atopic dermatitis as many patients will not have access to a pediatric medical subspecialist, such as a pediatric dermatologist or pediatric allergist. This report provides up-to-date information regarding the disease and its impact, pathogenesis, treatment options, and potential complications. The goal of this report is to assist pediatricians with accurate and useful information that will improve the care of patients with atopic dermatitis. Pediatrics 2014;134:e1735-e1744Atopic dermatitis (AD), commonly referred to as eczema, is a chronic, relapsing, and often intensely pruritic inflammatory disorder of the skin. A recent epidemiologic study using national data suggested that the pediatric prevalence is at least 10% in most of the United States. 1 AD primarily affects children, and disease onset occurs before the ages of 1 and 5 years in 65% and 85% of affected children, respectively. 1 The number of office visits for children with AD is increasing. 2 Up to 80% of children with AD are diagnosed and managed by primary care providers, often pediatricians. 3 Although medical subspecialists, such as pediatric dermatologists and/or pediatric allergists, may be suited to provide more advanced care for children with AD, lack of a sufficient number of such physicians, particularly pediatric dermatologists, 4 likely means the burden of AD care will continue to fall to primary care providers. Although consensus guidelines and practice parameters regarding the management of AD in children have been published, 5-10 considerable variability persists in clinical practice, particularly regarding the roles that bathing, moisturizing, topical medications, and allergies play in management. Inconsistencies in opinion and treatment approach as well as the chronic and relapsing nature of AD can lead to frustration for the patient, family, and primary care providers when managing AD. STATEMENT OF THE PROBLEMNew data support the theory that AD results from primary abnormalities of the skin barrier, 11 suggesting that skin-directed management of AD is of paramount importance. This clinical report reviews AD and provides an up-to-date approach to skin-directed management that is based on pathogenesis. Effectively using this information to create treatment plans

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Section: Proactive Treatmentmentioning

confidence: 97%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

111

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“…Of these, six were Cochrane reviews [242][243][244][245][246][247] and were included in the study. Five non-Cochrane systematic reviews [235][236][237][238][239] with the most recent search end date and which matched all other inclusion criteria were included in the study and 48 were excluded. Details of the excluded reviews are available in the map of systematic reviews of AE.…”

Section: Summary Of Resultsmentioning

confidence: 99%

“…[235][236][237][238][239] The latter were those with the most recent search end dates. Reviews also had to have a full list of citations for the included studies and sufficient details of the review's inclusion criteria to allow a fair comparison with the GREAT database.…”

Section: Objectivesmentioning

confidence: 99%

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A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10177. The contractual start date was in September 2008. The final report began editorial review in April 2014 and was accepted for publication in April 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, ...

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“…Обобщение данных девяти клинических иссле-дований эффективности топических стероидов (флютиказона пропионата, МПА) и ингибиторов кальциневрина в терапии атопической экземы по-зволило отметить более выраженное действие у сте-роидных препаратов в сравнении с такролимусом [23].…”

Section: клиническая дерматология и венерология 6 2015unclassified

Topical glucocorticosteroid and 2% urea as a new topical therapeutic agent used to treat chronic dermatoses

Филимонкова¹,

Bahlykova²

2015

Klin. dermatol. venerol.

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Проблема топической терапии больных хрони-ческими дерматозами остается одной из актуальных в современной дерматологии, несмотря на результа-ты значительного числа исследовательских работ [1, doi: 10.17116/klinderma201514635-40 Топический глюкокортикостероид и 2% мочевина -новое средство наружной терапии хронических дерматозов Стероидчувствительные дерматозы являются важной медико-социальной проблемой, актуальность которой определяется неуклонным ростом заболеваемости, их хроническим рецидивирующим течением и сложностью в выборе метода лечения. Применение глюкокортикостероидных (ГКС) средств, оказывающих комплексное противовоспалительное, противоаллергическое, противозудное действие, является основным принципом наружной терапии стероидчувствительных дерматозов. Несмотря на большое количество различных топических ГКС в арсенале дерматолога, сохраняется актуальность поиска и вывода на рынок новых препаратов. Цель -обзор литературы по современным аспектам наружной терапии стероидчувствительных дерматозов, изучение исследований по ГКС последнего поколения -метилпреднизолона ацепонат (МПА) и компоненту натурального увлажняющего фактора -мочевине. Материал и методы. Работа выполнена на базе ФГБУ «Уральский научно-исследовательский институт дерматовенерологии и иммунопатологии» Минздрава России. Результаты. Данные многих исследований доказали высокую клиническую эффективность МПА, его безопасность, обусловленную отсутствием галогенов хлора и фтора, биоактивацией в очаге воспаления, минимальной системной абсорбцией и удобством применения (1 раз в сутки). Также при наружном лечении хронических воспалительных дерматозов активно используется средство, обладающее выраженным увлажняющим, смягчающим и антисептическим действием -мочевина. Заключение. Полученные выводы исследований и практический опыт применения нового комбинированного лекарственного препарата -крема Комфодерм М 2 , содержащего комбинацию МПА и 2% мочевины, показали возможность применения данного средства на участках с тонкой чувствительной кожей (лицо, шея, складки) и в интермиттирующих программах. Ключевые слова: топическая терапия хронических дерматозов, метилпреднизолона ацепонат, 2% мочевина, Комфодерм М 2 .The steroid-sensitive dermatoses pose an important medical and social problem, whose relevance is determined by the steady growth of the incidence, chronic relapsing course, and complexity of treatment choice. Application of glucocorticosteroids (GCS) that have complex anti-inflammatory, antiallergic, and antipruritic effect is the basic principle of external therapy of steroidsensitive dermatoses. Despite the wide variety of various topical corticosteroids in the arsenal of a dermatologist, the discovery and market launch of new drug products is still relevant. Objective. This study is aimed at reviewing the literature on the modern aspects of the topical therapy of the steroid-sensitive dermatoses, the study of the investigations on the methylprednisolone aceponate (MPA), the new-generation GCS, and urea, the natural moisturizing factor. Material ...

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Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials

Cited by 228 publications

References 37 publications

Atopic Dermatitis: Skin-Directed Management

Atopic Dermatitis: Skin-Directed Management

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Topical glucocorticosteroid and 2% urea as a new topical therapeutic agent used to treat chronic dermatoses

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