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Objective:To systematically evaluate the efficacy and safety of filiform fire needle combined with tacrolimus ointment in the treatment of vitiligo.Methods:The RCTs of combination of filiform fire needle and tacrolimus ointment on the treatment of vitiligo were searched in the Chinese Biomedical Literature Database (CBM), China Knowledge Network Full-text Database (CNKI), Wanfang Full-text Database, VIP and PubMed databases. The studies were selected with the inclusion and exclusion criteria, then data extracted, and the quality of the included studies was evaluated according to Cochrane System Evaluation Manual. Meta-analysis was performed using RevMen 5.3 software.Results:Four studies involving 218 patients were included. After analysis, it was found that the effective rate [ OR=4.42, 95% CI (1.39-14.03), P<0.05)] and the apparent efficiency [ OR=2.89, 95% CI (1.40-5.95), P=0.004] of filiform fire needle combined with tacrolimus ointment were significantly better than that of tacrolimus ointment alone. Adverse reactions werelocal slight redness, pain and itching. None of adverse reactionswas reported. Recurrence occurred in the follow-up of were reported in two studies, which found that the recurrence rate [ OR=0.17, 95% CI (0.04-0.77), P<0.05] in the combined treatment group was significantly lower than that in the control group. Conclusions:The clinical efficacy of filiform fire needle combined with tacrolimus ointment in the treatment of vitiligo is better than that of tacrolimus ointment alone, and the recurrence rate can be reduced without any adverse reactions. However, in view of the limited number, average quality and bias of the included studies, it is suggested to carry out more multi-center, large sample and high quality randomized controlled trials for further verification.
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Objective To evaluate the efficacy and safety of near-infrared light combined with tacrolimus 0.1％ ointment in the treatment of facial glucocorticoid-dependent dermatitis.Methods A total of 68 patients with facial glucocorticoid-dependent dermatitis were enrolled from Department of Dermatology of Yantai Yuhuangding Hospital between December 2014 and December 2015,and randomly and equally divided into treatment group and combination group by a random number table.The treatment group was treated topically with tacrolimus ointment twice a day for 4 weeks.Besides the treatment with tacrolimus ointment,the combination group was irradiated with near-infrared light once a week for 4 sessions.After 4-week treatment,improvement in clinical manifestations such as itching and burning sensation was evaluated,so was the therapeutic effect.Results The combination group showed significantly higher response rate (85.3％ [29/34]) compared with the treatment group (61.8％ [21/34],x2 =4.84,P ＜ 0.05).Additionally,response rates for itching and burning sensation,erythema,scales and papules were all significantly higher in the combination group than in the treatment group (x2 =4.84,6.35,8.42 and 5.52,respectively,all P ＜ 0.05).Conclusion Near-infrared light combined with tacrolimus ointment is effective and safe for the treatment of facial glucocorticoid-dependent dermatitis.
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OBJECTIVE:To study the percutaneous absorption of 0.03% Tacrolimus ointment,and to compare the difference of domestic test preparation and imported reference preparation. METHODS:Modified Franz diffusion cells were adopted in trans-dermal test in vitro;HPLC-MS method was used to determine permeation amount and rate in vitro,delay time of domestic test preparation and imported reference preparation 0.03%Tacrolimus ointment. RESULTS:24 h in vitro permeation amount of test and reference preparations were(3 907±1 191)and(3 896±1 064)ng/cm2;permeation rates were 186.7 and 182.9 ng/(cm2·h);de-lay time were 1.95 and 2.00 h,respectively(P>0.05). CONCLUSIONS:Test preparation shows good percutaneous property,and is similar to reference preparation in penetration absorbency through nude mice skin.
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BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Subject(s)
Humans , Calcineurin , Dermatitis, Atopic , Dermatitis, Seborrheic , Placebo Effect , Recurrence , Research Personnel , TacrolimusABSTRACT
BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Subject(s)
Humans , Calcineurin , Dermatitis, Atopic , Dermatitis, Seborrheic , Placebo Effect , Recurrence , Research Personnel , TacrolimusABSTRACT
Objective To investigate clinical effect of collagen dressing in treatment of facial hormone dependent dermatitis.Methods 107 patients were divided randomly into treatment group and control group.53 cases of control group were given citrate desloratadine,ompound glycyrrhizin tablets, 0.3% tacrolimus ointment, cod liver oil ointment for 4 weeks.54 cases of treatment group were given collagen dressing 25 minutesper night, based on control group.After 4 weeks of drug treatment,treatment group continued to be given collagen dressing once every other night, control group were given cod liver oil ointment twice a day, morning and night.Both groups continued to observe for 12 weeks, at the same time, 0.3% tacrolimus ointment was given once every other day.Compared effect of two groups in the short-term and long-term.Results There were no significant differences in symptom scores between the two groups pre-treatment; compared with pre-treatment,the symptom scores were decreased(P<0.05).Compared with control group, the symptoms of treatment group were lower than that of treatment group(P<0.05).Compared with control group, the clinical total effective rate was higher than treatment group ( P<0.05 ) .Conclusion The collagen dressing can improve the facial treatment of hormone-dependent dermatitis.
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ObjectiveTo evaluate the clinical efficiency of 0.1％ tacrolimus ointment combined with paroxetine in patients with neurodermatitis associated with insomnia.MethodsTotally,74 patients suffering from neurodermatitis and insomnia were consecutively enrolled in this study,and randomly assigned into the combination group and control group according to their number(odd or even).Both groups were given topical 0.1％ tacrolimus ointment twice a day,and the combination group was additionally given oral paroxetine 10 mg once a day,for 8 weeks.The outcome parameters included main symptoms of neurodermatitis and Pittsburgh sleep quality index(PSQI) score.ResultsNo significant difference was observed in the cure rate (54.3％(19/35) vs.53.1％ (17/32),P＞ 0.05) or response rate (82.9％ (29/35) vs.81.3％ (26/32),P＞ 0.05),between the combination group and control group.PSQI score was significantly lower in the combination group than in the control group after 8 weeks of treatment(P ＜ 0.05).ConclusionsThe 0.1％ tacrolimus ointment can be used to treat neurodermatitis safely.Antianxiety treatment can reduce the recurrence of neurodermatitis associated with insomnia,and improve the quality of sleep in patients.
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A 45-year-old woman presented with a six-month history of Hailey-Hailey disease, which was recalcitrant to many dermatologic therapies including systemic antibiotics, dapsone, and topical corticosteroids. We precribed tacrolimus (0.1%) ointment for application to the lesions twice a day and examined weekly for the efficacy; the lesions were much improved after 6 weeks of treatment.
Subject(s)
Female , Humans , Middle Aged , Adrenal Cortex Hormones , Anti-Bacterial Agents , Dapsone , Pemphigus, Benign Familial , TacrolimusABSTRACT
BACKGROUND: It is well known that topical tacrolimus is safe and effective on the treatment of atopic dermatitis (AD) patients. Tacrolimus is a primarily immunosuppressive agent without antistaphylococcal effect. Thus the colonization of staphylococcus aureus (S. aureus), on the skin of patients treated with this agent, might be increased. OBJECT: The purpose of this study is to know the effect of tacrolimus on S. aureus colonization of patients with AD and to compare the result with clinical severity and skin barrier function. METHOD: We enrolled 65 patients with moderate to severe AD. They were treated with 0.03% tacrolimus ointment twice daily for 4 weeks. Clinical severity was assessed by the eczema area and severity index (EASI). S. aureus colonization was measured by tape method. Skin barrier function was checked by measuring the transepidermal water loss (TEWL). Evaluations were performed at week 0 (baseline), 1st, 2nd and 4th. The results were compared and the statistical analysis was performed. RESULTS: S. aureus colonization was significantly decreased with tacrolimus treatment at week 1st as compared with baseline. But there were no differences among week 1st, 2nd and 4th. EASI and TEWL showed a decreasing tendency in a time dependent fashion. The correlations between each data were variable. CONCLUSION: Topical application of tacrolimus ointment reduce the colonization of S. aureus on the skin of patients with AD. Moreover, the severity of AD and skin barrier function were improved with treatment. However it is not sure the effect of tacrolimus as a long-term maintenance therapy based on this data, because this is a short term study. In future assessment of topical agents and S. aureus colonization, it will be important to make a study by the comparative method and for a long term period.