FK-506/Tacrolimus

Wollenberg, Andreas; Bieber, Thomas

doi:10.1007/978-3-642-60752-3_5

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…In view of the much more favourable relation between therapeutic and adverse effects, the topical use of tacrolimus will probably increase over the next several years. This drug may represent an alternative to glucocorticoids in the treatment of chronic inflammatory skin diseases, especially for patients who have long‐standing AD [23–26] and extensive body surface area involvement, or facial lesions. Both case reports and large, multi‐centre, randomized, controlled, double‐blind clinical trials have shown the efficacy and safety of tacrolimus.…”

Section: Discussionmentioning

confidence: 99%

“…This drug may represent an alternative to glucocorticoids in the treatment of chronic inflammatory skin diseases, especially for patients who have long-standing AD [23][24][25][26] and extensive body surface area involvement, or facial lesions. Both case reports and large, multi-centre, randomized, controlled, double-blind clinical trials have shown the efficacy and safety of tacrolimus.…”

Section: Discussionmentioning

confidence: 99%

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Comparing tacrolimus ointment and oral cyclosporine in adult patients affected by atopic dermatitis: a randomized study

Pacor

Lorenzo

Martinelli

et al. 2004

Clin Experimental Allergy

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SummaryBackground Atopic dermatitis (AD) is a chronic allergic inflammatory disease, which manifests itself with eczematous skin lesions. Objective We compared the clinical efficacy of tacrolimus ointment (0.1%) given twice a day and oral cyclosporine (3 mg/kg) given once daily. Rescue medication for itching included cetirizine 10-20 mg (equal to one or two tables). Methods Thirty patients, aged 13-45 years (mean AE SD 27.1 AE 10.9), with a history of moderateto-severe AD were randomized to treatments, 15 patients for each treatments. Assessment of efficacy was based on SCORAD, on scores of daily itching, erythema, interference with sleep, due to the skin condition and days without use of cetirizine tablets. SCORAD, measured on a scale (0-103), was evaluated before treatment (0) and at 7, 14, 21, 28, 35 and 42 days after treatment. Similarly, the means of daily symptoms, on a scale (0-3), were evaluated before the treatment (0) and at 7, 14, 21, 28, 35 and 42 days after treatment; finally, on day without use of cetirizine tablets. The safety of the study treatments was assessed through haematologic, biochemical and urinary testing and on systolic and diastolic blood pressures and heart rate measurements. Results SCORAD decreased in the two treatment groups 14 days after the beginning of the period study. However, the patients in tacrolimus ointment group reported significantly lower SCORAD than those treated with oral cyclosporine. Overall SCORAD, as assessed by the area under the curve (AUC) day 0-42 (score/day), was significantly lower in the tacrolimus ointment group when compared with oral cyclosporine (Po0.001). Similarly, AUC day 0-42 (score/day) for itching, erythema and number of nights without interference with the sleep due to skin condition were significantly lower in the group of patients treated with tacrolimus compared with those treated with cyclosporine (P 5 0.003, 0.005 and 0.01, respectively). As regards the use of rescue medication, expressed by median of number of days without use of anti-H 1 , it was significantly lower in the group treated with tacrolimus (82.5) than in the cyclosporine group (76.5) (P 5 0.03). There were no appreciable changes in haematological and biochemical indices, in both treatments groups. Conclusion The results of this comparative study demonstrate that tacrolimus ointment twice daily and cyclosporine administered orally once daily are effective on SCORAD, daily symptoms and anti-H 1 rescue. When we compared tacrolimus and cyclosporine there was a faster onset of action in the group treated with tacrolimus. The two drugs presented the same safety. However, these data support the preferential use of topical tacrolimus 0.1% in AD, because cyclosporine has potential side-effects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing tacrolimus ointment and oral cyclosporine in adult patients affected by atopic dermatitis: a randomized study

Pacor

Lorenzo

Martinelli

et al. 2004

Clin Experimental Allergy

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“…The key substance tacrolimus (FK-506) (15,17), as well as the ascomycinderivative ASM-981 (99), has been shown to be effective in the control of AD, and short-term clinical trials with tacrolimus (100) and ASM 981 (16), as well as a longterm safety study with tacrolimus (101), have been successful in this disease.…”

Section: Current Therapeutic Options In Admentioning

confidence: 99%

Atopic dermatitis: from the genes to skin lesions

Wollenberg

Bieber

2000

Allergy

Self Cite

118

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“…Tacrolimus can also exert a broad range of immunomodulatory effects on various skin disorders by binding to cell surface steroid receptors and inhibiting mast cell adhesion, inhibiting the release of mediators from mast cells and basophils, decreasing intercellular adhesion molecule‐1 and E‐selectin lesional blood vessel expression, and downregulating the expression of IL‐8 receptor and FcɛRI on Langerhans cells 4–6 . Langerhans cells are considered to be important in the pathophysiology of many inflammatory diseases 7 .…”

Section: Mechanism Of Action (Fig 1)mentioning

confidence: 99%

“…Topical corticosteroids continue to be the most effective measure against chronic atopic dermatitis 123 . They do, however, have numerous side‐effects, such as epidermal atrophy, striae and telangiectases, which can be irreversible 5,69 . Other side‐effects are hirsutism and suppression of growth in children 124 .…”

Section: Comparative Studiesmentioning

confidence: 99%

Tacrolimus: a review of its use for the management of dermatoses

Gupta

Adamiak

Chow

2002

Acad Dermatol Venereol

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The newly developed immunomodulator tacrolimus (FK506) is the first of a new class of agents that have enormous potential to change the way that dermatoses are treated and managed. Tacrolimus has been found to be active in a topical formulation with the latter exerting its effects by acting on the signal transduction pathways inside T cells and inhibiting gene transcription. The result is decreased responsiveness of T cells to antigens. Percutaneous absorption of tacrolimus is higher in diseased skin as opposed to healthy skin and, therefore, the drug will be taken in at progressively lower quantities as lesions heal. There is limited systemic absorption of tacrolimus over the course of therapy. The most extensive experience with tacrolimus has been in treating atopic dermatitis. In numerous trials, tacrolimus ointment 0.03-0.3% has shown to be effective in reducing the symptoms and severity of atopic dermatitis in adults and the paediatric population. Furthermore, there have been no significant toxic effects associated with topical therapy with tacrolimus. The most common complaint is that of local irritation after applying the ointment. This is generally transient and the patient is able to continue with therapy. The other dermatoses where tacrolimus has been used include contact dermatitis, psoriasis and pyoderma gangrenosum.

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FK-506/Tacrolimus

Cited by 8 publications

References 15 publications

Comparing tacrolimus ointment and oral cyclosporine in adult patients affected by atopic dermatitis: a randomized study

Comparing tacrolimus ointment and oral cyclosporine in adult patients affected by atopic dermatitis: a randomized study

Atopic dermatitis: from the genes to skin lesions

Tacrolimus: a review of its use for the management of dermatoses

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