Preventive treatment curbs eczema flare-ups

NEW YORK (Reuters Health) - Among adults with eczema, otherwise known as atopic dermatitis, "proactive" long-term treatment with tacrolimus ointment applied twice-weekly safely reduces exacerbations of the condition, European investigators have shown.

Conventional "reactive" treatment of atopic dermatitis involves applying anti-inflammatory medication to skin lesions only while they are visible. With a proactive approach, intensive treatment until lesions are no longer visible is followed by low-dose treatment of previously affected skin areas to prevent flare-ups, the researchers explain in the medical journal Allergy.

Dr. Andreas Wollenberg, from Ludwig-Maximilian Universitat in Munich, Germany, and members of the European Tacrolimus Ointment Study Group conducted a clinical trial in which 247 adult patients with atopic dermatitis initially applied tacrolimus ointment twice daily for up to 6 weeks to visible lesions.

Patients who responded well were then randomly assigned to apply tacrolimus or placebo ointment twice-weekly for 12 months. If exacerbations occurred, they were treated with daily tacrolimus until the flare-up subsided.

The average time to a first exacerbation was substantially longer for the proactively treated patients (142 days) than for the reactively treated patients (15 days), the investigators report.

The proactive group also had a lower percentage of days in which their condition flared up, the report indicates, and more of them had no exacerbations .

Proactive treatment with tacrolimus ointment "prevented, delayed and reduced the occurrence of atopic dermatitis exacerbations," Wollenberg and his associates conclude.

SOURCE: Allergy, June 2008.