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

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 (relative risk [RR], 1.50; P<.001) 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.