title: Randomized comparison of the type 4 phosphodiesterase inhibitor cipamfylline cream, cream vehicle and hydrocortisone 17-butyrate cream for the treatment of atopic dermatitis.
abstract: BACKGROUND
  Therapeutic options to treat atopic dermatitis are limited. Leukocytes from atopic patients have an abnormally high activity of cyclic adenosine monophosphate (AMP)-phosphodiesterase (PDE), which can be normalized in vitro by PDE inhibitors. Cipamfylline is a new potent and selective inhibitor of PDE-4.
  
  
  OBJECTIVE
  To compare the efficacy and safety of up to 14 days' topical treatment with cipamfylline (0.15%) cream with vehicle and with hydrocortisone 17-butyrate (0.1%) cream.
  
  
  METHODS
  International, multicentre, prospective, randomized double-blind, left-right studies of cipamfylline vs. vehicle and cipamfylline vs. hydrocortisone 17-butyrate in adult patients with stable symmetrical atopic dermatitis on the arms.
  
  
  RESULTS
  Both cipamfylline and hydrocortisone 17-butyrate reduced the Total Severity Score significantly (P < 0.001). The reduction with cipamfylline was significantly greater than that with vehicle (difference vehicle-cipamfylline 1.67 95% confidence interval (CI) 1.06, 2.28; P < 0.001) and was significantly less than with hydrocortisone 17-butyrate (difference hydrocortisone-cipamfylline -2.10 95% CI -2.93, -1.27; P < 0.001). Investigator and patient assessments of the overall treatment response showed a similar picture.
  
  
  CONCLUSIONS
  Cipamfylline cream is significantly more effective than vehicle, but significantly less effective than hydrocortisone 17-butyrate cream in the treatment of atopic dermatitis.
authors.affiliation: Dermatology Centre, University of Manchester, Hope Hospital, Eccles Old Road, Manchester M6 8HD, UK. christopher.griffiths@man.ac.uk
authors.forename: C E M
authors.initials: CE
authors.lastname: Griffiths
authors.forename: E J M
authors.initials: EJ
authors.lastname: Van Leent
authors.forename: M
authors.initials: M
authors.lastname: Gilbert
authors.forename: J
authors.initials: J
authors.lastname: Traulsen
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010726:Phosphodiesterase Inhibitors / Q000097:blood / Q000627:therapeutic use*; D011446:Prospective Studies; D012008:Recurrence; D018709:Statistics, Nonparametric; D014970:Xanthines / Q000097:blood / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D009824:Ointments; D010726:Phosphodiesterase Inhibitors; D014970:Xanthines; C466758:cipamfylline; D006854:Hydrocortisone