Atopic dermatitis: topical PDE4 inhibitors safe, effective in meta-analysis

  • Yang H & al.
  • JAMA Dermatol
  • 27 Mar 2019

  • International Clinical Digest
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Takeaway

  • In a meta-analysis, topical phosphodiesterase 4 (PDE4) inhibitors are an effective treatment for mild to moderate atopic dermatitis (AD).

Why this matters

  • Options for topical treatment of AD are limited.

Key results

  • Topical PDE4 inhibitor decreased target lesion score (standardized mean difference [SMD], −0.40; P<.001 and improved investigator-assessed response rate risk compared with vehicle control.>
  • Beneficial effects on target lesion score at days 14 and 28 were only found for the PDE4 inhibitors crisaborole (Eucrisa; SMD, −0.59 [P=.04] at day 14 and SMD, −0.86 [P=.004] at day 28) and AND2898 (SMD, −0.76 [P=.02] at day 14 and SMD, −0.68 [P=.03] at day 28).
  • PDE4 inhibitors and vehicle control led to similar rates of treatment-related adverse events (AEs; RR, 1.45; P=.48) and AEs resulting in discontinuation (RR, 0.74; P=.39).
    • Crisaborole led to a higher rate of treatment-related AEs than vehicle control (RR, 3.70; P=.002).

Study design

  • 7 randomized controlled trials that included 1869 patients with mild to moderate AD were subjected to meta-analysis.
  • Funding: None disclosed.

Limitations

  • Measurement tools used do not measure patient experience.

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