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Tacrolimus ointment vs steroid ointment for eyelid dermatitis in patients with atopic keratoconjunctivitis.

AbstractAIMS:
The main objective of this explorative study was to evaluate if tacrolimus ointment could be safer than corticosteroid ointment, with special reference to the intraocular pressure in the treatment of eyelid eczema in patients with atopic keratoconjunctivitis (AKC). Secondary aims were to compare the effects of the treatments on eyelid eczema and their potential impact on ocular surface inflammation.
METHODS:
Tacrolimus 0.1% ointment and clobetasone butyrate 0.05% ointment were compared in a double-masked explorative crossover study. In total, 25 AKC patients were included. Each ointment was applied twice daily for 3 weeks, with 2 weeks of washout before, between, and after treatments. Efficacy was determined by eye examination and the patients' own symptom scoring. Cytology and cytokine measurements were performed on tear samples. Safety parameters were intraocular pressure, presence of bacteria and fungi, and the patients' reports of adverse events. The validity of the crossover design was explored with analysis of variance, and the effect of each medication was calculated with paired t-test and Wilcoxon paired test.
RESULTS:
A total of 20 patients completed the study. Both treatments were effective in reducing signs and symptoms of eyelid eczema, with a near superior benefit for tacrolimus in terms of eczema (total skin score) signs (P=0.05). No serious adverse events occurred and interestingly, intraocular pressure was not evidently affected by either treatment.
CONCLUSION:
Tacrolimus 0.1% ointment is a promising alternative therapy for eyelid eczema in AKC patients. Long-term studies are needed to further determine the value of tacrolimus in this patient group.
AuthorsE Nivenius, I van der Ploeg, K Jung, E Chryssanthou, M van Hage, P G Montan
JournalEye (London, England) (Eye (Lond)) Vol. 21 Issue 7 Pg. 968-75 (Jul 2007) ISSN: 0950-222X [Print] England
PMID16680103 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Bacterial
  • Biomarkers
  • Cytokines
  • Glucocorticoids
  • Immunosuppressive Agents
  • Inflammation Mediators
  • Ointments
  • clobetasone butyrate
  • Clobetasol
  • Tacrolimus
Topics
  • Adolescent
  • Adult
  • Aged
  • Antibodies, Bacterial (blood)
  • Biomarkers (metabolism)
  • Blepharitis (complications, drug therapy)
  • Clobetasol (adverse effects, analogs & derivatives, therapeutic use)
  • Cross-Over Studies
  • Cytokines (metabolism)
  • Dermatitis, Atopic (complications, drug therapy)
  • Eyelids (microbiology)
  • Female
  • Glucocorticoids (adverse effects, therapeutic use)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Inflammation Mediators (metabolism)
  • Intraocular Pressure (drug effects)
  • Keratoconjunctivitis (complications)
  • Male
  • Middle Aged
  • Ointments
  • Tacrolimus (adverse effects, therapeutic use)
  • Tears (metabolism)
  • Treatment Outcome

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