Topical vitamin B12-a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial

Stücker, Markus; Pieck, C; Stoerb, C; Niedner, R.; Härtung, Joachim; Altmeyer, Peter

doi:10.1111/j.1365-2133.2004.05866.x

Cited by 55 publications

(55 citation statements)

References 21 publications

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“…In the trial by Stücker and colleagues, 217 33 cutaneous events were reported, which were all mild except for one, which involved a moderate reaction after applying the placebo cream. Of these cutaneous events, four cases were considered 'probably related' and two cases were 'possibly related' to the application of vitamin B 12 .…”

Section: Harmsmentioning

confidence: 99%

“…The two trials 217,218 appear to show a significant beneficial effect of topical vitamin B 12 cream on the severity of eczema. The lack of CIs for the results presented in both trials means that there is no way to judge the statistical robustness of the results.…”

Section: Overall Implications For Research and Practicementioning

confidence: 99%

“…In the trial by Januchowski, 218 22 children aged from 6 months to 18 years (no severity inclusion criteria stated) were randomised to treatment for 4 weeks, but it was not clear how often they were instructed to use the treatment. The trial by Stücker and colleagues 217 found that there was a significant decrease in eczema severity after 8 weeks of topical vitamin B 12 treatment compared with the base cream, as measured using a modified SASSAD score (maximum of 240 points). The mean decrease for topical vitamin B 12 was 55.34 (standard error of the mean 5.74) whereas the mean decrease for the base cream was 28.87 (standard error of the mean 4.86; p < 0.0002).…”

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

“…217,218 These two within-person trials, 217,218 both industry funded, compared cyanocobalamin (0.07%) cream with a base cream. In the trial by Stücker and colleagues, 217 48 adults aged 18-70 years applied the treatments twice a day for 8 weeks. In the trial by Januchowski, 218 22 children aged from 6 months to 18 years (no severity inclusion criteria stated) were randomised to treatment for 4 weeks, but it was not clear how often they were instructed to use the treatment.…”

Section: Studiesmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Harmsmentioning

confidence: 99%

Section: Overall Implications For Research and Practicementioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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Hydrogels: A Promising Vehicle for the Topical Management of Atopic Dermatitis

Barbosa

Torres

Lima

2021

Advanced Therapeutics

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Atopic dermatitis (AD) is an inflammatory skin disease with a high worldwide prevalence. AD is characterized by fluctuating and recurrent eczematous lesions and intense itch, being associated with high physical and psychological impact leading to disturbed sleep quality, anxiety, and depression. Most of the patients have mild to moderate forms of atopic dermatitis and topical therapies (emollients, corticosteroids, calcineurin, and phosphodiesterase 4 inhibitors) are the mainstay of therapy for these patients. Hydrogels are explored in the field of cutaneous application and have proven to be a good solution as a topical vehicle for atopic dermatitis, due to their high water content, improved drug delivery, responsiveness to stimuli and versatility in terms of preparation and drug-loading, representing a good alternative to regular ointments or creams. This review highlights some of the atopic dermatitis characteristics and the use of hydrogels in the management of this disease. An outline of hydrogels as drug delivery systems for bioactive compounds is discussed, as well as their major advantages and drawbacks when compared to other galenic forms, and also an overview of clinical trials and patents engaged in the past 20 years.

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Handbook of Integrative Dermatology

Lio¹,

Patel²,

Peters³

et al. 2015

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Topical vitamin B12-a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial

Cited by 55 publications

References 21 publications

Scoping systematic review of treatments for eczema

Scoping systematic review of treatments for eczema

Hydrogels: A Promising Vehicle for the Topical Management of Atopic Dermatitis

Handbook of Integrative Dermatology

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