Pimecrolimus : A Topical Nonsteroidal Cream for the Treatment of Atopic Dermatitis

Abstract

Pimecrolimus (SDZ ASM 981), an ascomycin derivative, is a topical nonsteroid calcineurin inhibitor. It exerts anti-intlammatory activity, and has demonstrated efficacy in reducing signs and symptoms of atopic dermatitis in adult and pediatric patients when applied topically. The production of inflammatory cytokines by activated T cells in skin is thought to play an important role in the pathogenesis of atopic dermatitis. Pimecrolimus potently suppresses cytokine production by dermal T cells without significantly impairing systemic immune responses. In randomized controlled clinical studies, twice-daily application of pimecrolimus 1% cream was shown to significantly improve the signs and symptoms of atopic dermatitis in infants, children, and adults. Pimecrolimus is well tolerated. The risk of application-site reactions such as itching or burning is comparable with that of vehicle. Adverse effects were generally mild in patients receiving pimecrolimus 1% cream and occurred at rates comparable with those in patients receiving vehicle treatment. In a 1-year study, pimecrolimus 1% cream significantly reduced the incidence of flares when used at the first signs and symptoms of acute atopic dermatitis. As a result, overall corticosteroid use to treat acute flares was significantly lower in patients using pimecrolimus when the first signs or symptoms of atopic dermatitis appears (early intervention). Furthermore, pimecrolimus 1% cream has shown no potential for skin atrophy, a problem commonly associated with topical corticosteroids treatment. Pimecrolimus provides a promising and well tolerated treatment option in the management of infants, children and adults with mild to moderate atopic dermatitis.