Tacrolimus: A New Option in Therapy‐Resistant Chronic External Otitis

Caffier, Philipp P.; Harth, W.; Mayelzadeh, Babak; Haupt, H.; Sedlmaier, B.

doi:10.1097/mlg.0b013e31804b1aad

Cited by 27 publications

(22 citation statements)

References 14 publications

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“…This is consistent with preliminary findings in humans. No hearing loss or other signs of ototoxicity were noted with use of tacrolimus ointment impregnated ear wicks in human ears, 27,28 but since the formulation and method of application and time frame of application (shorter duration in people) was different than what was done in the present study, treatment protocols were not entirely comparable. While hearing loss was not expected based on limited data from topical use of tacrolimus in human ears, sudden onset, bilateral sensorineural hearing loss has been potentially associated with high dose systemic tacrolimus use in human transplant patients, though cause and effect are not certain and a mechanism is not known 32,33 .…”

Section: Discussioncontrasting

confidence: 62%

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Safety and tolerability of 0.1% tacrolimus solution applied to the external ear canals of atopic beagle dogs without otitis

Kelley

Flynn-Lurie

House

et al. 2010

Veterinary Dermatology

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Tacrolimus is a nonsteroidal alternative to treat noninfectious otitis externa (OE) in people. This 21-day study investigated whether twice daily application (0.2 mL/dose) of sterile olive oil based 0.1% tacrolimus suspension in ears of atopic beagle dogs without OE was associated with adverse local reactions, development of OE, change in otic cytology, vestibular dysfunction, or hearing loss detected by brainstem auditory evoked response (BAER). The study was randomized, double-blinded, and placebo-controlled. Twenty-two dogs matched for age and sex were randomized to tacrolimus or vehicle control treatment groups. Two investigators independently evaluated dogs for signs of adverse effects including OE the first 4 days of treatment, then every 3 days. A logistic regression model was fit for each investigator's clinical scores (SAS, 9.2, 2008). Time (P = 0.0032) and group (P = 0.0167) were always significant for OE. Inter-observer reliability of clinical scores was strong, measured using Kappa coefficients and proportion of agreement. All nine exclusions (7/10 control- and 2/12 tacrolimus-treated dogs) were excluded for yeast OE. Inter-observer agreement to exclude was 100%. All dogs not excluded had normal BAER assessments before treatment, weekly during treatment, and after 21 days of treatment. None showed vestibular abnormalities at these times. Tacrolimus blood concentrations (Abbott IMx Tacrolimus II) were below detection limits (3 ng/mL) at baseline and after 21 days of treatment. Results suggest otic application of olive oil based tacrolimus suspension to canine ears with intact tympanic membranes is unlikely to result in hearing loss or vestibular dysfunction but yeast OE is a possible risk.

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Section: Discussioncontrasting

confidence: 62%

“…Cause and effect have not been verified and the mechanism is unknown. There were no reports of hearing loss in people who were treated with tacrolimus for otitis externa 27,28 …”

Section: Introductionmentioning

confidence: 99%

Safety and tolerability of 0.1% tacrolimus solution applied to the external ear canals of atopic beagle dogs without otitis

Kelley

Flynn-Lurie

House

et al. 2010

Veterinary Dermatology

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“…9 Primary ear itching constitutes a feeling of itching occurring in the absence of localised or systemic disease, such as diabetes mellitus, hepatic and renal conditions, and lymphoma, leukaemia and other malignancies. 3,6,12 The treatment approach for these patients includes diagnosis and control of predisposing factors, such as: increased moisture in the external auditory canal; changes in cerumen pH; presence of foreign objects (e.g. Despite repeated warnings by the clinician, infection as a result of local trauma by the patient may still occur.…”

Section: Discussionmentioning

confidence: 99%

New treatment strategy and assessment questionnaire for external auditory canal pruritis: topical pimecrolimus therapy and Modified Itch Severity Scale

Acar¹,

Karabulut²,

Sahin³

et al. 2009

J. Laryngol. Otol.

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Topical pimecrolimus appears to be as effective as topical hydrocortisone in relieving external auditory canal pruritus. We used a novel scoring system, the Modified Itch Severity Scale, to evaluate external auditory canal pruritus; this is the first self-reporting questionnaire for the quantification of external auditory canal pruritus severity. Further studies are needed to validate this scoring system.

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“…We read with great interest the paper by Phillip P. Caffier, et al entitled “Tacrolimus: a new option in therapy‐resistant chronic external otitis.” 1 In this paper, the authors report the role and efficacy of tacrolimus in the treatment of therapy‐resistant chronic external otitis in 53 patients. Literature on this treatment is scarce.…”

mentioning

confidence: 99%

In Reference to Tacrolimus: A New Option in Therapy‐Resistant Chronic External Otitis

et al. 2007

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Tacrolimus: A New Option in Therapy‐Resistant Chronic External Otitis

Abstract: The topical application of 0.1% tacrolimus ointment in the outer ear canal appears to be an effective and well-tolerated new option in corticosteroid-free treatment of chronic therapy-resistant EO.

Cited by 27 publications

References 14 publications

Safety and tolerability of 0.1% tacrolimus solution applied to the external ear canals of atopic beagle dogs without otitis

Safety and tolerability of 0.1% tacrolimus solution applied to the external ear canals of atopic beagle dogs without otitis

New treatment strategy and assessment questionnaire for external auditory canal pruritis: topical pimecrolimus therapy and Modified Itch Severity Scale

In Reference to Tacrolimus: A New Option in Therapy‐Resistant Chronic External Otitis

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