Oct. 29, 1998 DENVER-In the first study of its kind in children, tacrolimus, used to fight organ rejection, has been found to combat atopic dermatitis in children, according to research published recently in the Journal of Allergy and Clinical Immunology. “We’ve had patients that after four days of treatment were already looking significantly better,” said Mark Boguniewicz, M.D., who treats children with atopic dermatitis at National Jewish Medical and Research Center and is the study’s lead author.
Although ointments with high concentrations of corticosteroids may get similar results, they can have unacceptable side effects. “There would be concern about the effects to the skin and body, especially with more potent preparations,” he said.
“Unlike corticosteroids, tacrolimus doesn’t cause thinning of the skin, which can be permanent,” Dr. Boguniewicz said. “Some people have tissue paper thin skin and bruise easily from chronic corticosteroid use. The face is a special concern because it’s most susceptible to steroid side effects.”
Tacrolimus, a drug that can suppress the immune system when given intravenously, was used as a topical skin treatment in this clinical trial involving 180 children, ages 7-16 at 18 centers throughout the United States. The children had moderate-to-severe atopic dermatitis, which affected 5-30 percent of the body’s skin.
Children were supplied with one of three different concentrations of tacrolimus ointment. Improvement or clearing of the condition ranged from 67-70 percent of the children using the tacrolimus ointment, compared to 38 percent that had ointment with no medication.
In topical form the medication appears safe, according to the study, except for a minor burning sensation of the skin that disappears after about four days.
“What we see is that the medication works so quickly and heals the skin that it isn’t further absorbed,” Dr. Boguniewicz said. “That’s why there aren’t systemic side effects.”
The most common chronic skin disease of young children, atopic dermatitis affects about 10 percent of children in the United States. But it affects people of all ages. “It impacts significantly on their quality of life,” he said. “It’s a cause of school absenteeism and occupational disabilities, hampers social interaction and disrupts sleep.”
Atopic dermatitis, characterized by chronic skin inflammation, skin redness, areas of hard, rough skin and severe itching, is complicated by staph bacteria infections on the skin.
A year-long study of tacrolimus is underway at National Jewish. Tacrolimus should be available as a treatment for atopic dermatitis in about one year.
National Jewish Medical and Research Center is ranked as the best hospital in the United States for pulmonary disease treatment by U.S. News & World Report, 1998.
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