Atopic Eczema; Consensus on atopic dermatitis treatment stresses long-term management;
Drug Week   05-09-2003
Atopic Eczema; Consensus on atopic dermatitis treatment stresses long-term management
ISSN: 15316440
Publication Date: 05-09-2003
Page: 23
Type: Periodical
Language: English

2003 MAY 9 - (NewsRx.com & NewsRx.net) -- Atopic dermatitis, an itchy rash that often affects infants and children, should be treated in a novel way, according to new international treatment principles on the disease published this month.

The treatment principles urge physicians to focus on optimal long- term management of atopic dermatitis, also called atopic eczema, with a new type of treatment known as calcineurin inhibitors, for example Elidel (pimecrolimus) cream. Previous management of the disease focused on treating acute attacks with short courses of corticosteroid creams. The new therapies turn off specific inflammatory cells in the skin that cause the redness and broken skin of atopic dermatitis.

The consensus, published this month in the British Journal of Dermatology1, was adopted at the second International Consensus Conference on Atopic Dermatitis (ICCAD II) by expert clinicians from 10 countries in Europe and the Americas.

Charles Ellis, coauthor of the new publication, explained that safety concerns have led to restrictions on the intensity and duration of topical corticosteroid use, especially in children and on delicate areas such as the face, neck and skin folds. This has resulted in under-treatment of many patients with atopic dermatitis.

"A new consensus is needed to ensure patients can get the best treatment, including the new therapies such as topical calcineurin inhibitors, and see how these might be used in a coordinated way to improve long-term symptom control while minimizing safety concerns," said professor Ellis, professor and associate chair of the Department of Dermatology, at the University of Michigan. "We are grateful to Novartis Pharmaceuticals Corporation for sponsoring the conference that led to these important treatment principles," he added.

The Consensus Conference resulted in a comprehensive treatment algorithm that considers how all the key treatments for atopic dermatitis, including emollients, topical corticosteroids, topical calcineurin inhibitors, phototherapy and oral cyclosporine, can be used to greatest effect at the various stages of the condition.

"All of these treatments - including topical corticosteroids - have an important place in the effective management of atopic dermatitis. But we should be using new and emerging therapies to complement our more traditional approaches," pointed out professor Thomas Luger, from the Department of Dermatology, at the University of Munster, Germany, and also co-chairman of the Consensus Group.

"For example, the topical calcineurin inhibitor, pimecrolimus (Elidel), could be used for maintenance therapy because it has been shown both to prevent disease progression and to reduce the incidence of flares. It could be used at the first signs and symptoms of atopic dermatitis and be used for as long as these persist, while corticosteroids could be reserved for the treatment of severe exacerbations," he added.

Atopic dermatitis affects 10-15% of children under 5 years of age in developed countries, and its prevalence is rising2. It is a chronic disease characterized by intense itching and recurrent flares. At present, there is no cure.

This article was prepared by Drug Week editors from staff and other reports.

Copyright 2003, Drug Week via NewsRx.com & NewsRx.net