Comparing the effects of proactive treatment with tacrolimus ointment and mometasone furoate on the epidermal barrier structure and ceramide levels of patients with atopic dermatitis

Abstract

Background

The epidermal skin barrier and lipids that are integral to its structure are impaired in atopic dermatitis (AD). Current treatment guidelines include proactive therapy.

Objective

This study assessed the effect of 12 weeks of proactive treatment with tacrolimus ointment 0.1% (TAC) compared with mometasone furoate cream (MF) on specific skin barrier lipids in patients with AD who previously received 10 days of reactive treatment with either agent.

Methods

This was an open-label, non-interventional study. In the reactive phase, forearm lesions in 20 patients were treated with either TAC or MF twice daily for 10 days. In the subsequent proactive phase, patients applied TAC or MF twice weekly for 12 weeks (n = 16 patients).

Results

Over the 12-week proactive treatment period, the mean local SCORAD significantly decreased in the TAC and MF treatment group. Levels of total and individual ceramides increased in both groups. Normalized intercellular lipid lamellae values were significantly higher with proactive TAC treatment than MF and undistinguishable from healthy skin.

Conclusion

The results show that proactive treatment with TAC is superior in restoring the skin barrier.

Keywords:

• Atopic dermatitis
• proactive treatment
• tacrolimus ointment
• mometasone furoate
• skin barrier
• transmission electron microscopy

Acknowledgements

The authors would like to thank Claire Lydon, PhD, of iMed Comms, Macclesfield, UK, an Ashfield Healthcare Communications Company, part of UDG Healthcare plc, for medical writing support, funded by LEO Pharma in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Disclosure statement

Dr Dähnhardt-Pfeiffer and Dr Dähnhardt declare no conflicts of interest. Dr Bastian is an employee of LEO Pharma GmbH. Dr Buchner was involved in studies from Astellas, LEO Pharma, Novartis, Regeneron and Beiersdorf. Professor Fölster-Holst reports grants and personal fees from LEO Pharma, during the conduct of the study; grants from Astellas, personal fees from Johnson&Johnson, personal fees from Novartis, personal fees from Nutricia, grants and personal fees from Pfizer, and personal fees from Beiersdorf, outside the submitted work.