Abstract
Tacrolimus ointment and pimecrolimus cream have proved to be suitable for the treatment of atopic dermati-tis. We conducted a meta-analysis of the efficacy, adverse events/withdrawal of tacrolimus versus pimecrolimus in the treatment of atopic dermatitis. According to our meta-analysis, 0.1% tacrolimus was more effective than 1% pimecrolimus in the treatment of adult patients and moderate to very severe pediatric patients, and more 0.1% mild pediatric patients treatal with pimecrolimus withdrew from the trials because of a lack of efficacy or the oc-currence of adverse events, compared with mild pediatric patients treated with 0.03% tacrolimus. The combined analyses of tacrolimus with pimecrolimus showed that tacrolimus was more effective than pimecrolimus (week 3: RR=0.67, 95%CI=0.56-0.80; week 6/end of study: RR=0.65, 95%CI=0.57-0.75), and fewer tacrolimus-treated patients withdrew because of a lack of efficacy (RR=0.32, 95CI% =0.19-0.53) or the occurrence of adverse events (RR=0.43, 95%CI=0.24-0.75), compared with pimecrolimus-treated patients. In conclusion, tacrolimus has higher efficacy and better tolerance than pimecrolimus in the treatment of atopic dermatitis.
Highlights
IntroductionTopical corticosteroids are rapidly effective in treating the acute symptoms of Atopic dermatitis (AD), but their use for long-term control of AD are not ideal because of the risk of side
The cohort for efficacy analyses was composed of 910 tacrolimus patients and 919 pimecrolimus patients ( Table 1), whereas the cohort for adverse events/withdrawal analyses was comprised of 912 tacrolimus patents and pimecrolimus patients (Table 2)
The combined analyses of withdrawal showed that fewer tacrolimus-treated patients withdrew because of a lack of efficacy (RR=0.32, 95%confidence intervals (CI)=0.19-0.53) or adverse event (RR=0.43, 95%CI=0.24-0.75), compared with pimecrolimus-treated patients (Fig. 4). This meta-analysis shows that tacrolimus ointment is more effective than pimecrolimus cream at the end of the six-week therapy of Atopic dermatitis (AD), and the therapeutic
Summary
Topical corticosteroids are rapidly effective in treating the acute symptoms of AD, but their use for long-term control of AD are not ideal because of the risk of side. Tacrolimus ointment and pimecrolimus cream, two non-steroid topical calcineurin inhibitors, have been used for the treatment of AD over the past 10 years and have proved to be suitable for the treatment of both AD flares and long-term control of AD. Two randomized controlled trials (RCTs) [2,3] have compared tacrolimus ointment with pimecrolimus cream in the treatment of AD, but the sample size of each study was not large enough to draw definitive conclusions. We conducted a meta-analysis of RCTs to compare the efficacy, incidences of adverse events and withdrawal (due to a lack of efficacy and due to adverse event) of tacrolimus ointment versus pimecrolimus cream in the treatment of AD
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