Pharmacological possibilities of prolongation of atopic dermatitis remissions

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Abstract

Atopic dermatitis (AD) is a common chronic recurrent immune-dependent pruritic dermatosis with a typical clinical picture and a damaging effect on the patient’s quality of life. The mechanism of symptom development includes genetic predisposition, defect in the barrier function of the skin and innate and adaptive immunity, and exposure to environmental triggers, infectious agents, allergens and mechanisms of comorbidities. The chronic nature of the dermatosis, the sharply reduced quality of life of patients with AD and poor adherence of patients to treatment create difficulties on the way to effective therapy of patients. These difficulties can be overcome by the proactive use of tacrolimus ointment (Protopic®) in the external therapy of patients with AD, which, after steroid suppression of the acute phase of exacerbation, applied twice a week, can significantly increase the duration of the achieved remission, improve the quality of life of patients and increase their adherence to treatment. The given brief analysis of the literature data and the results of our own observations confirm the high efficacy of the proactive use of Protopic® ointment in prolonging the remissions of atopic dermatitis.

About the authors

Nikolay G. Kochergin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: nkocha@yandex.ru
ORCID iD: 0000-0001-7136-4053
SPIN-code: 1403-3031

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

References

  1. Kowalska-Olędzka E, Czarneckab M, Baranb A. Comparison of treatment standards in Atopic Dermatitis management across selected geographies prior to emerging targeted therapies onset. J Drug Ass. 2019;8(1):122–125. doi: 10.1080/21556660.2019.1619569
  2. Zuberbier T, Orlow SJ, Paller AS, Taïeb A, Allen R, Hernanz-Hermosa JM, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):226–232. doi: 10.1016/j.jaci.2006.02.031
  3. Beattie P, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006;155(1):145–151. doi: 10.1111/j.1365-2133.2006.07185.x
  4. Kasai H, Kawasaki H, Fukushima-Nomura A, Yasuda-Sekiguchi F, Amagai M, Ebihara T, et al. Stratification of atopic dermatitis patients by patterns of response to proactive therapy with topical tacrolimus: low serum IgE levels and inadequately controlled disease activity at the start of treatment predict its failure. Ann Med. 2021;53(1):2205–2214. doi: 10.1080/07853890.2021.2004319
  5. Kimata H. Prevalence of Suicidal Ideation in Patients with Atopic Dermatitis. Suicide Life Threat Behav. 2006;36(1):120–124. doi: 10.1521/suli.2006.36.1.120
  6. Кочергин Н.Г., Григорян Н.С., Лыткина Е.А. Атопический дерматит, качество жизни и приверженность к лечению. Российский журнал кожных и веренических болезней. 2010;13(6):13–16. [Kochergin NG, Grigoryan NS, Lytkina EA. Atopicheskiy dermatit, kachestvo zhizni i priverzhennost’ k lecheniyu. Russian Journal of Skin and Venereal Diseases. 2010;13(6):13–16. (In Russ.)] doi: 10.17816/dv37060
  7. Basra M, Edmunds O, Salek M, Finlay AY. Measurement of family impact of skin disease: further validation of the Family Dermatology Life Quality Index (FDLQI). J Eur Acad Dermatol Venereol. 2008;22(7):813–821. doi: 10.1111/j.1468-3083.2008.02593.x
  8. Kao JS, Fluhr JW, Man MQ, Fowler AJ, Hachem JP, Crumrine D, et al. Short-term glucocorticoid treatment compromises both permeability barrier homeostasis and stratum corneum integrity: inhibition of epidermal lipid synthesis accounts for functional abnormalities. J Invest Dermatol. 2003;120(3):456–464. doi: 10.1046/j.1523-1747.2003.12053.x
  9. Carr WW. Topical calcineurin inhibitors for atopic dermatitis: review and treatment recommendations. Pediatr Drugs. 2013;15(4):303–310. doi: 10.1007/s40272-013-0013-9
  10. Петрунин Д.Д. Медикаментозная терапия с точки зрения влияния на морфофункциональные характеристики эпидермального барьера. Вестник дерматологии и венерологии. 2019;95(1):59–76. [Petrunin DD. Pharmacotherapy: Its impact on morphofunctional characteristics of the epidermal barrier. Vestnik Dermatologii i Venerologii. 2019;95(1):59–76. (In Russ.)] doi: 10.25208/0042-4609-2019-95-1-59-76
  11. Wollenberg A, Bieber T. Proactive therapy of atopic dermatitis — an emerging concept. Allergy. 2009:64(2):276–278. doi: 10.1111/j.1398-9995.2008.01803.x
  12. Mudaliyar VR, Pathak A, Dixit A, Kumar SS. An open-label prospective study to compare the efficacy and safety of topical fluticasone versus tacrolimus in the proactive treatment of atopic dermatitis. Dermatol Pract Concept. 2020;10(4):e2020094. doi: 10.5826/dpc.1004a94
  13. Dähnhardt D, Bastian M, Dähnhardt-Pfeiffer S, Buchner M, Fölster-Holst R. 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. J Dermatol Treat. 2021;32(7):721–729. doi: 10.1080/09546634.2019.1708240
  14. Wollenberg A, Reitamo S, Girolomoni G, Lahfa M, Ruzicka T, Healy E, et al. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy. 2008;63(7):742–750. doi: 10.1111/j.1398-9995.2008.01683.x
  15. Iannone M, Tonini G, Janowska A, Dini V, Romanelli M, et al. Definition of treatment goals in terms of clinician-reported disease severity and patient-reported outcomes in moderateto-severe adult atopic dermatitis: a systematic review. Curr Med Res Opin. 2021;37(8):1295–1301. doi: 10.1080/03007995.2021.1933929
  16. Czarnecka-Operacz M, Jenerowicz D. Topical calcineurin inhibitors in the treatment of atopic dermatitis — an update on safety issues. J Dtsch Dermatol Ges. 2012;10(3):167–172. doi: 10.1111/j.1610-0387.2011.07791.x
  17. Vinodhini R, Mudaliyar, Dixit A, Kumar SS. An Open-Label Prospective Study to Compare the Efficacy and Safety of Topical Fluticasone Versus Tacrolimus in the Proactive Treatment of Atopic Dermatitis. Dermatol Pract Concept. 2020;10(4):e2020094. doi: 10.5826/dpc.1004a94
  18. Schmitt J, Langan SM, Williams HC. What are the best outcome measurements for atopic eczema? A systematic review. J Allergy Clin Immunol. 2007;120(6):1389–1398. doi: 10.1016/j.jaci.2007.08.011
  19. Рациональный подход к наружной терапии атопического дерматита. Особенности лечения на разных стадиях. Эффективная фармакотерапия. Дерматовенерология и дерматокосметология. 2019;2:38–44. [Rational approach to external therapy of atopic dermatitis. Features of treatment at different stages. Effective pharmacotherapy. Dermatovenereology and dermatocosmetology. 2019;2:38–44. (In Russ.)]

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