From the Journals

Topical steroid reduces atopic dermatitis relapse in children



Topical fluticasone propionate twice a week effectively reduces the risk of mild to moderate atopic dermatitis relapse in children, according to Elena Rubio-Gomis of the Consorcio Hospital General Universitario de Valencia, Spain, and her associates.

Most atopic disease management is based on managing active disease, but atopic dermatitis is a chronic relapsing disease for which long-term maintenance therapies are being sought.

“Fluticasone 0.05% cream is a potent topical corticosteroid with a low systemic absorption and rapid metabolism and clearance,” which argues for low likelihood of causing systemic side effects and possible use in preventing atopic dermatitis relapse, the investigators wrote. And it is not very expensive.

Atopic dermatitis on the upper arm © -aniaostudio-/Thinkstock

In a randomized, double-blind, placebo-controlled study of 54 children with mild to moderate atopic dermatitis treated with twice-daily fluticasone propionate 0.05% cream up to 2 weeks, 49 children aged 2-10 years entered the second phase of the study. These children were randomly assigned to receive fluticasone propionate or vehicle twice weekly on consecutive days for 16 weeks; treatment was stopped then or at relapse.

Children treated with fluticasone propionate had a 2.7-fold lower risk of relapse than that of children treated with vehicle; 7 of 26 (27%) in the fluticasone propionate group and 13 of 23 patients (57%) in the vehicle group experienced relapse, the investigators wrote. The report was published in Allergologia et Immunopathologia. The median time to relapse with fluticasone propionate exceeded 16 weeks (the duration of the study), while in the vehicle group it was 65 days (a little over 9 weeks).

The treatment with fluticasone propionate and vehicle both were well tolerated. During the second phase of the study, 9 patients (35%) reported at least one adverse event in the fluticasone propionate group and 11 (48%) in the vehicle group. None of these were believed to be related to the drug studied, the investigators said.

SOURCE: Rubio-Gomis E et al. Allergol Immunopathol (Madr). 2018. doi: 10.1016/j.aller.2017.12.001.

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