Proactive disease management with 0·03% tacrolimus ointment for children with atopic dermatitis: results of a randomized, multicentre, comparative study

Thaçi, Diamant; Reitamo, Sakari; Enseñat, María Antonia González; Moss, Celia; Boccaletti, Valeria; Cainelli, T.; Valk, P. van der; Bučková, Hana; Sebastian, Michael; Schuttelaar, Marielouise; Ruzicka, Thomas

doi:10.1111/j.1365-2133.2008.08813.x

Cited by 165 publications

(158 citation statements)

References 33 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: 99%

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: 99%

Atopic Dermatitis: Skin-Directed Management

Tollefson¹,

Bruckner²,

Dermatology³

2014

Pediatrics

111

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“…Таким образом, пимекролимус является препаратом выбора как стероидсберегающее средство наружного применения, он также может использоваться в качестве местного проти-вовоспалительного средства первой линии на коже лица и в крупных складках кожи [49,51,52]. Пимекролимус может использоваться как в случае обострений, так и для снижения риска рецидивов в области ранее пораженной кожи в качестве средства проактивной поддерживающей интермиттирующей терапии [53][54][55]: так, исследования с участием детей и подростков показали, что длительная проактивная терапия с использованием пимекролимуса снижает риск рецидивов заболевания [56][57][58]. Одним из самых крупных исследований эффектив-ности и безопасности пимекролимуса является иссле-дование Petite, в котором принимали участие около 2500 детей, начиная с 3-месячного возраста (дети полу-чали лечение и наблюдались в течение первых 5-6 лет жизни).…”

Section: топические ингибиторы кальциневринаunclassified

Current Views on the Pathogenesis and Principles of External Treatment of Atopic Dermatitis in Children

Мурашкин¹,

Материкин²,

Амбарчян³

et al. 2016

Vopr. sovr. pediatr.

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“…Hierbei wird das subklinische Ekzem im Bereich der patientenindividuell besonders rezidivfreudigen Problemzonen mit einer 2-mal wöchentlich applizierten, intermittierenden entzündungshem-menden Langzeittherapie behandelt [31]. Für das Kindesalter sind gute Ergebnisse mit fluticason-und tacrolimushaltigen Externa publiziert [6,25]. Da proaktiv behandelte Patienten signifikant weniger Schü-be entwickeln und diese Schübe weniger schwer verlaufen, wird bei einer proaktiven Therapie nicht mehr Tacrolimussalbe verbraucht als bei einer nur die Schü-be behandelnden, reaktiven Therapie [36].…”

Section: Therapieunclassified