title: Efficacy of tacrolimus 0.1% ointment in cutaneous lupus erythematosus: a multicenter, randomized, double-blind, vehicle-controlled trial.
abstract: BACKGROUND
  Topical calcineurin inhibitors are licensed for the treatment of atopic dermatitis; however, the efficacy of tacrolimus in cutaneous lupus erythematosus (CLE) has only been shown in single case reports.
  
  
  OBJECTIVE
  In a multicenter, randomized, double-blind, vehicle-controlled trial, we sought to evaluate the efficacy of tacrolimus 0.1% ointment for skin lesions in CLE.
  
  
  METHODS
  Thirty patients (18 female, 12 male) with different subtypes of CLE were included, and two selected skin lesions in each patient were treated either with tacrolimus 0.1% ointment or vehicle twice daily for 12 weeks. The evaluation included scoring of clinical features, such as erythema, hypertrophy/desquamation, edema, and dysesthesia.
  
  
  RESULTS
  Significant improvement (P < .05) was seen in skin lesions of CLE patients treated with tacrolimus 0.1% ointment after 28 and 56 days, but not after 84 days, compared with skin lesions treated with vehicle. Edema responded most rapidly to tacrolimus 0.1% ointment and the effect was significant (P < .001) in comparison to treatment with vehicle after 28 days. Clinical score changes in erythema also showed remarkable improvement (P < .05) after 28 days, but not after 56 and 84 days. Moreover, patients with lupus erythematosus tumidus revealed the highest degree of improvement. None of the patients with CLE demonstrated any major side effects.
  
  
  CONCLUSIONS
  The study was limited by the small sample size.
  
  
  CONCLUSIONS
  Explorative subgroup analyses revealed that topical application of tacrolimus 0.1% ointment may provide at least temporary benefit, especially in acute, edematous, non-hyperkeratotic lesions of CLE patients, suggesting that calcineurin inhibitors may represent an alternative treatment for the various disease subtypes.
authors.affiliation: Department of Dermatology, University of Muenster, Muenster, Germany. kuhnan@uni-muenster.de
authors.forename: Annegret
authors.initials: A
authors.lastname: Kuhn
authors.forename: Kristina
authors.initials: K
authors.lastname: Gensch
authors.forename: Merle
authors.initials: M
authors.lastname: Haust
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Schneider
authors.forename: Gisela
authors.initials: G
authors.lastname: Bonsmann
authors.forename: Noemi
authors.initials: N
authors.lastname: Gaebelein-Wissing
authors.forename: Percy
authors.initials: P
authors.lastname: Lehmann
authors.forename: Annette
authors.initials: A
authors.lastname: Wons
authors.forename: Peter
authors.initials: P
authors.lastname: Reitmeir
authors.forename: Vincent
authors.initials: V
authors.lastname: Ruland
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Luger
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000367:Age Factors; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009824:Ointments; D012008:Recurrence; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D009824:Ointments; D016559:Tacrolimus