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. 2023 May 22;85(7):3563-3573.
doi: 10.1097/MS9.0000000000000844. eCollection 2023 Jul.

Safety and efficacy of pimecrolimus versus vehicle for the treatment of atopic dermatitis in adults and paediatric population: a systematic review and meta-analysis

Sareema E Akhtar  1 , Saad Shakil  1 , Sabeeh K Farooqui  1 , Tarek Khedro  2 , Ahmad L Alzufairi  2 , Muhammad A Niaz  2 , Saifullah Syed  2 , Riaz Jiffry  2 , Abdulla K Alsubai  2 , Abdullah Almesri  2 , Hebatalla Ismail  2 , Kashif A Khan  3 , Ahmed Al-Hindawi  4 , Hussein K Ali  2 , Timothy Falodun  2 , Aysa Tabassi  2 , Aylin Tabassi  2 , Talal Almas  2
Affiliations

Safety and efficacy of pimecrolimus versus vehicle for the treatment of atopic dermatitis in adults and paediatric population: a systematic review and meta-analysis

Sareema E Akhtar et al. Ann Med Surg (Lond). .

Abstract

Atopic dermatitis remains a widespread problem affecting various populations globally. While numerous treatment options have been employed, pimecrolimus remains a potent and viable option. Recently, there has been increasing interest in comparing the safety and efficacy of pimecrolimus with its vehicle.

Methods: The authors conducted a comprehensive search of several databases, including PubMed, COCHRANE, MEDLINE, and Cochrane Central, from inception to May 2022, using a wide search strategy with Boolean operators. The authors also employed backward snowballing to identify any studies missed in the initial search. The authors included randomized controlled trials in our meta-analysis and extracted data from the identified studies. The authors used Review Manager (RevMan) Version 5.4 to analyze the data, selecting a random-effects model due to observed differences in study populations and settings. The authors considered a P-value of 0.05 or lower to be statistically significant.

Results: The authors initially identified 211 studies, of which 13 randomized controlled trials involving 4180 participants were selected for analysis. Our pooled analysis revealed that pimecrolimus 1% was more effective at reducing the severity of atopic dermatitis than its vehicles. However, no significant difference was observed in adverse effects between pimecrolimus and vehicle, except for pyrexia, nasopharyngitis, and headache, which were increased with pimecrolimus.

Conclusion: Our meta-analysis showed that pimecrolimus 1% is more effective than vehicle, although the safety profile remains inconclusive. Pimecrolimus reduced the Investigator's Global Assessment score, Eczema Area and Severity Index score, and severity of pruritus when compared to its vehicle, indicating a higher efficacy profile. This is one of the first meta-analyses to assess the efficacy and safety profile of pimecrolimus 1% against a vehicle and may assist physicians in making informed decisions.

Keywords: atopic dermatitis; eczema and dermatology; elidel; pimecrolimus.

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Conflict of interest statement

NA.

Figures

Figure 1
Figure 1
Forest plot of IGA score (0 or 1) of pimecrolimus versus vehicle.
Figure 2
Figure 2
Forest plots evaluating pruritus score (0 or 1) of pimecrolimus versus vehicle.
Figure 3
Figure 3
Forest plots evaluating EASI of pimecrolimus versus vehicle.
Figure 4
Figure 4
Forest plots evaluating the safety outcomes of pyrexia of pimecrolimus versus vehicle.
Figure 5
Figure 5
Forest plots evaluating the safety outcomes of nasopharyngitis of pimecrolimus versus vehicle.
Figure 6
Figure 6
Forest plots evaluating the safety outcomes of headache of pimecrolimus versus vehicle.
Figure 7
Figure 7
Forest plots evaluating the safety outcomes of pimecrolimus versus vehicle for respiratory symptoms.
Figure 8
Figure 8
Forest plots evaluating the safety outcomes of pimecrolimus versus vehicle for gastrointestinal symptoms.
Figure 9
Figure 9
Forest plots evaluating the safety outcomes of pimecrolimus versus vehicle for dermatological manifestations.
Figure 10
Figure 10
Forest plots evaluating the other safety outcomes of pimecrolimus versus vehicle.
See this image and copyright information in PMC

References

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