Efficacy of Pimecrolimus 1% Cream in Various Clinical Forms of Atopic Dermatitis

Abstract

ÖzetAmaç: Atopik dermatit bilindi¤i gibi farkl› klinik tiplerde karfl›m›za ç›kar. Bu deneysel çal›flman›n temel amac›, atopik dermatitin bu tipleri aras›nda pimekrolimusun etkinli¤ini karfl›laflt›rmakt›r. Gereç ve Yöntem: Çal›flmaya 2-38 yafllar› aras›nda, 50'si erkek, 20'si kad›n, toplam 70 hasta al›nd›. Hastalar›n 22'si (%31,4) çocuktu (2-10 yafl). Hastalarda, solunum yolu allerjisi, total IgE yüksekli¤i, deri "prick" test pozitifli¤i ve tetikleyici allerjenler araflt›r›ld›. Hastalar Wüthrich s›n›flamas›na göre, "mikst", "pür intrinsik" ve "pür ekstrinsik" olarak s›n›fland›r›ld›. Hastalara 6 hafta boyunca günde iki kez %1 pimekrolimus krem tedavisi uyguland› ve hastalar SCORAD indeksi kullan›larak de¤erlendirildi. Bulgular: Sonuç olarak hastalar›n %58,6's›nda (n=41) tedavi baflar›l›, %4,3'ünde (n=3) tedavi k›smen baflar›l›, %37,1'inde (n=26) tedavi baflar›s›z bulundu. 35 hastada tam remisyon elde edildi. Tedavi öncesi ve sonras›ndaki SCORAD de¤erleri aras›ndaki fark, istatistiksel olarak anlaml› bulundu (p<0,0001). Sonuç: Çal›flmada, mikst, pür intrinsik ve pür ekstrinsik atopik dermatit tipleri aras›nda pimekrolimus etkinli¤i karfl›laflt›r›l-d›¤›nda, pür intrinsik tipte pimekrolimus daha etkili bulunmas›na ra¤men bu durum istatistiksel olarak anlaml› de¤ildi (p=0,75). Yine, pimekrolimus etkinli¤i aç›s›ndan, hafif ve orta fliddetli atopik dermatit hastalar› aras›nda, istatistiksel olarak anlaml› bir fark saptanmad›. (p=0,107) Ayr›ca, bu çal›flmada optimum tedavi süresinin eriflkinlerde yaklafl›k 6 hafta, çocuklarda ise 4 hafta oldu¤u kan›s›na var›ld›. (Türkderm 2010; 44: 83-7) Anahtar Kelimeler: Atopik dermatit, tedavi, pimekrolimus, etkinlik SummaryBackground and Design: Atopic dermatitis shows some different clinical appearances.The main aim of this experimental study is to compare the efficacy of pimecrolimus among these clinical subgoups of atopic dermatitis. Material and Method: A total of 70 patients, 50 male and 20 female, aged between 2-38 years were included in the study. Twenty-two patients (%31.4) were pediatric (2-10 years). Patients were investigated in regard to high levels of total IgE, airway allergy, positive skin prick test and triggering allergens. Patients were classified as: mixed, pure intrinsic and pure extrinsic according to Wüthrich classification. Pimecrolimus 1% cream was applied to the patients twice daily for 6 weeks and patients were evaluated with SCORAD index before and after treatment. Results: FAs a result, 58.6% of the patients (n=41) had a successful therapy with pimecrolimus while 4.3% (n=3) had partially successful. Thirty-five patients achieved full remission. The difference between the SCORADs before and after the treatment was found to be statistically significant (p<0.0001). Conclusion: In this study, efficacy of pimecrolimus was compared to mixed, pure intrinsic and pure extrinsic types of atopic dermatitis. Although pimecrolimus was more effective in the pure intrinsic type, it was not statistically significant (p=0,75). There was also an insignificant difference b...