title: Systemic tacrolimus in the treatment of severe atopic keratoconjunctivitis.
abstract: OBJECTIVE
  Severe atopic keratoconjunctivitis (AKC) forms part of the spectrum of allergic eye disease and is often refractory to conventional topical treatment. Topical cyclosporin A and tacrolimus have been shown to reduce immunologic activation, symptoms, and signs of patients suffering from AKC, but there are no reports on safety and efficacy of systemic tacrolimus for this condition.
  
  
  METHODS
  We report on a retrospective study of 3 patients with severe AKC, where the disease did not respond to conventional therapy, and they were therefore treated with low-dose systemic tacrolimus for at least 1 year as an adjunct to their existing treatment.
  
  
  RESULTS
  There was a good clinical response in all patients to low-dose systemic tacrolimus, with a low incidence of side effects and no relapse of symptoms after discontinuation of treatment.
  
  
  CONCLUSIONS
  Low-dose systemic tacrolimus is a safe and effective treatment of some patients with severe AKC, which is refractory to conventional treatment. Such patients need careful monitoring for side effects, and the long-term benefits need to be assessed as part of a clinical trial.
authors.affiliation: Bristol Eye Hospital, Bristol, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Stumpf
authors.forename: Nabeel
authors.initials: N
authors.lastname: Luqmani
authors.forename: Peter
authors.initials: P
authors.lastname: Sumich
authors.forename: Stuart
authors.initials: S
authors.lastname: Cook
authors.forename: Derek
authors.initials: D
authors.lastname: Tole
mesh_terms: D000328:Adult; D017024:Chemotherapy, Adjuvant; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus