A 10-year open follow-up of eczema and respiratory symptoms in patients with atopic dermatitis treated with topical tacrolimus for the first 4 years.
OBJECTIVE
To examine the 10-year outcome of affected body surface area (BSA), respiratory symptoms, and serum IgE in adult AD patients 6 years after a 4-year intervention with topical tacrolimus.


METHODS
Patients who 10 years ago participated in a 4-year, open tacrolimus study (n = 65) were contacted for assessment of affected BSA, bronchial hyper-reactivity (BHR), respiratory symptoms, skin prick tests and serum IgE.


RESULTS
Altogether, 50 (77%) patients attended the follow-up visit. The median affected BSA decreased from 19% to 1.6% during the 10-year follow-up (p < 0.0001). Patients with active asthma and rhinitis symptoms at baseline reported a significant decrease at the follow-up (p = 0.02 andp = 0.01). In patients with BHR at baseline, the provocative dose of inhaled histamine producing a 15% decrease in FEV(1) increased. Responders (>or= 60% improvement of affected BSA) to tacrolimus treatment at the 1-year visit had a significantly smaller affected BSA at the 4- and 10-year visits than non-responders (< 60% improvement). Responders also showed a significant decrease in serum IgE at the follow-up visit compared to baseline (p = 0.002).


CONCLUSIONS
The long-term, effective treatment of patients with AD may have a beneficial effect on affected BSA, respiratory symptoms, and serum IgE.
Mandelin
Johanna M
JM
Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland. johanna.mandelin@hus.fi
Remitz
Anita
A
Virtanen
Hannele M
HM
Malmberg
L Pekka
LP
Haahtela
Tari
T
Reitamo
Sakari
S
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications / Q000503:physiopathology; D001830:Body Surface Area; D016535:Bronchial Hyperreactivity / Q000150:complications / Q000503:physiopathology*; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004485:Eczema / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012882:Skin Tests; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
D007073:Immunoglobulin E; D016559:Tacrolimus