Atopic eczema — pimecrolimus
Atopic eczema is an intensely itchy skin condition, most common in children. The most effective treatment is with topical corticosteroids, but these have side effects, including thinning the skin and growth retardation.
A new treatment being developed by Novartis could provide a non-steroidal alternative. Pimecrolimus, originally referred to as SDZ-ASM-981, is a skin-selective inflammatory cytokine inhibitor, and works by selectively targeting the cells that release pro-inflammatory mediators.
A study in 713 patients aged 2-17 compared the new active with a conventional emollient plus topical corticosteroid treatment regime in a multicentre, randomised, double-blind, vehicle-controlled, parallel group trial. A cream containing 1% pimecrolimus was applied twice a day at the first sign of itching; after six months, 61% of the patients treated with pimecrolimus experienced no flare-ups, compared with 35% in those being treated conventionally 1.
A multicentre, randomised, vehicle-controlled clinical trial has been carried out in 183 infants aged 3-23 months. Early results indicate that pimecrolimus was much more effective in improving the symptoms, with 63% of patients having success, compared with 17% of those treated with the vehicle alone2.
The cream also causes little skin thinning. A randomised, double-blind trial using 1% cream showed substantially lower skin thinning than either 0.1% betamethasone-17-valerate or 0.1% triamcinolone acetonide creams3.
Trials have shown pimecrolimus to be well tolerated and very efficient in controlling itching. It could well prove to be a safer treatment for this problematic condition in children.