Pimecrolimus cream in the management of patients with atopic eczema

Figures & data

Table 1 Atopic eczema diagnostic criteria⁶³

Major features Pruritis Typical morphology and distribution: Flexural lichenification or linearity in adults Facial and extensor involvement in infant and children Chronic or chronically relapsing dermatitis Personal or family history of atopy (asthma, allergic rhinitis, atopic eczema)

Minor features Xerosis Ichthyosis/palmar hyperlinearity/keratosis pilaris Immediate (type I) skin test reactivity Elevated serum IgE Early age of onset Tendency toward cutaneous infection/impaired cell-mediated immunity Tendency toward nonspecific hand or foot dermatitis Nipple eczema Cheilitis Recurrent conjunctivitis Dennie-Morgan infraorbital fold Keratoconus Anterior subcapsular cataracts Orbital darkening Facial pallor/facial erythema Pityriasis alba Anterior neck folds Itch when sweating Intolerance to wool and lipid solvents Perifollicular accentuation Food allergy Course influenced by environmental/emotional factors White dermatographism/delayed blanch

Table 2 Atopic eczema in infancy diagnostic criteria⁶³

Major features Pruritic dermatitis Typical facial or extensor eczematous or lichenified dermatitis Family history of atopy (asthma, allergic rhinitis, atopic eczema)

Minor features Xerosis/ichthyosis/hyperlinear palms Perifollicular accentuation Chronic scalp scaling Peri-auricular fissures

Table 3 Pimecrolimus pediatric trials

Author	No patients	Study design	Duration	Measurement
Eichenfield^Citation41	403	Randomized/open label	6 weeks/20 weeks	EASI, IGA
Ho^Citation42	186	Randomized/open Label	6 weeks/20 weeks	EASI, IGA
Kapp^Citation39	251	Randomized	1 year	Flares, EASI, IGA
Papp^Citation45	81	Randomized/open label	1 year/1 year	EASI, IGA, Flare
Wahn^Citation44	713	Randomized	1 year	EASI, flare

Abbreviations: EASI, Eczema Area Severity Index; IGA, Investigators’ Global Assessment, IGA.

Table 4 Pimecrolimus adult trials

Author	No patients	Study design	Duration	Measurement
Gollnick^Citation64	266	Randomized/placebo	26 weeks	Flare, IGA
Meurer^Citation65	192	Randomized/placebo	24 weeks	Flares, IGA
Meurer^Citation47	130	Randomized/placebo	24 weeks	Flares, IGA
Luger^Citation59	658	Randomized pimecrolimus/TCS	52 weeks	Safety
Kaufmann^Citation48	198	Randomized/placebo	7 days	Pruritus

Abbreviations: IGA, Investigators’ Global Assessment; TCS, topical corticosteroids.

Figure 1 Median percentage change in Eczema Area Severity Index (EASI) over time for pimecrolimus compared with vehicle. Drawn from data of Meurer et al.^43,47

Figure 2 Percentage of children with mild or absent erythema scores. Drawn from data of Eichenfield et al.⁴¹

Table 5 Long-term treatment trials for atopic eczema

Author	Duration	No patients	Endpoint	Treatment arms
Berth-Jones^Citation52	16 weeks, randomized placebo controlled	295	Flares	Fluticasone/placebo 2 days a week
Hanifin^Citation52	16 weeks, randomized placebo controlled	348	Flares	Fluticasone/placebo 4 days a week
Breneman^Citation53	52 weeks, randomized, placebo controlled.	197	Onset of 1st flare	Tacrolimus/placebo 3 days a week
Paller^Citation54	40 weeks, randomized, placebo controlled	105	Disease-free days	Tacrolimus/placebo 3 days a week
Wollenberg^Citation55	52 weeks, randomized placebo controlled	224	Onset of 1st flare	Tacrolimus/placebo 2 days a week
Thaci^Citation56	52 weeks, randomized, placebo controlled.	250	Onset of 1st flare	Tacrolimus/placebo 2 days a week

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