An experimental ointment formulation of pimecrolimus is effective in psoriasis without occlusion.
Pimecrolimus (Elidel, SDZ ASM 981), a new macrolactam ascomycin derivative, was highly effective in treating plaque-type psoriasis when applied under Finn-chamber occlusion. A two-centre, randomized, double-blind, vehicle- and positive-controlled within-patient study was therefore conducted in 23 adult psoriasis patients. Pimecrolimus 1% was applied, twice daily, in an experimental ointment formulation, along with the corresponding vehicle, 0.005% calcipotriol ointment and 0.05% clobetasol-17-propionate ointment to test sites without occlusion for 21 days. Erythema, induration and scaling (score: 0 [absent] to 4 [severe]) were evaluated. The total sign score was defined as the sum of the erythema, induration and scaling scores (range 0-12). Pimecrolimus 1% ointment was significantly (p = 0.03) more effective than the corresponding vehicle, with an improvement in total sign score of 51.4% compared with 36.7% for the corresponding vehicle. Improvements with calcipotriol and clobetasol-17-propionate were 71.5% and 88.3%, respectively. No local or systemic drug-related side effects were observed in the study. We conclude that pimecrolimus 1% in the experimental ointment formulation was significantly more effective than its corresponding vehicle, but less effective than calcipotriol and clobetasol ointment. This is the first study reporting a significant therapeutic effect of pimecrolimus in an ointment formulation applied without occlusion to psoriatic plaques.
Mrowietz
Ulrich
U
Department of Dermatology, University of Schleswig-Holstein, Campus Kiel, Germany. umrowietz@dermatology.uni-kiel.de
Wustlich
Stefan
S
Hoexter
Godehart
G
Graeber
Michael
M
Bräutigam
Matthias
M
Luger
Thomas
T
D000287:Administration, Topical; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D009824:Ointments; D014677:Pharmaceutical Vehicles; D011565:Psoriasis / Q000188:drug therapy*; D016559:Tacrolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D009824:Ointments; D014677:Pharmaceutical Vehicles; C117268:pimecrolimus; D016559:Tacrolimus