title: Efficacy and safety of tacrolimus ointment compared with that of hydrocortisone butyrate ointment in adult patients with atopic dermatitis.
abstract: BACKGROUND
  Vehicle-controlled studies have demonstrated the efficacy and safety of tacrolimus ointment for patients with atopic dermatitis.
  
  
  OBJECTIVE
  This study was undertaken to compare 0.03% and 0.1% tacrolimus ointment with 0.1% hydrocortisone-17-butyrate ointment, a midpotent to potent topical corticosteroid, in the treatment of adult patients with moderate-to-severe atopic dermatitis.
  
  
  METHODS
  Patients applied ointment twice daily to all affected areas for 3 weeks in this multicenter, randomized, double-blind, parallel-group study. The primary endpoint was the modified eczema area and severity index (mEASI) mean area under the curve as a percentage of baseline.
  
  
  RESULTS
  Five hundred seventy patients were randomized and received treatment. Discontinuations included 22 of 193 patients from the 0.03% tacrolimus group, 22 of 191 patients from the 0.1% tacrolimus group, and 17 of 186 patients from the hydrocortisone butyrate group. The median mEASI mean area under the curve as a percentage of baseline was 47.0%, 36.5%, and 36.1% for patients who received 0.03% tacrolimus, 0.1% tacrolimus, and 0.1% hydrocortisone butyrate, respectively. There was no statistically significant difference between 0.1% tacrolimus and 0.1% hydrocortisone butyrate; however, the lower improvement in mEASI for 0.03% tacrolimus was statistically significant when compared with 0.1% tacrolimus (P <.001) or hydrocortisone butyrate (P =.002). Skin burning and pruritus at the application site showed a higher incidence in the tacrolimus treatment groups than in the hydrocortisone butyrate group (P <.05). Laboratory parameters showed no treatment differences and no marked changes over time.
  
  
  CONCLUSIONS
  The efficacy of 0.1% tacrolimus ointment was similar to that of 0.1% hydrocortisone butyrate ointment and was lower for 0.03% tacrolimus ointment. No serious safety concerns were identified.
authors.affiliation: Department of Dermatology, Hospital for Skin and Allergic Diseases, University of Helsinki, Helsinki, Finland.
authors.forename: Sakari
authors.initials: S
authors.lastname: Reitamo
authors.forename: Malcolm
authors.initials: M
authors.lastname: Rustin
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.forename: Frédéric
authors.initials: F
authors.lastname: Cambazard
authors.forename: Kirsti
authors.initials: K
authors.lastname: Kalimo
authors.forename: Peter S
authors.initials: PS
authors.lastname: Friedmann
authors.forename: Erwin
authors.initials: E
authors.lastname: Schoepf
authors.forename: Mourad
authors.initials: M
authors.lastname: Lahfa
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: Harryono
authors.initials: H
authors.lastname: Judodihardjo
authors.forename: Andreas
authors.initials: A
authors.lastname: Wollenberg
authors.forename: John
authors.initials: J
authors.lastname: Berth-Jones
authors.forename: Thomas
authors.initials: T
authors.lastname: Bieber
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009824:Ointments; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D006854:Hydrocortisone; D016559:Tacrolimus