Comparison of effectiveness of topical tacrolimus 0.1% vs topical halobetasol propionate 0.05% as an add-on to oral hydroxychloroquine in discoid lupus erythematosus.
connective tissue disorders
discoid lupus erythematosus
halobetasol propionate
ointment
tacrolimus
therapy-topical
Journal
Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
03
11
2020
revised:
02
12
2020
accepted:
10
12
2020
pubmed:
16
12
2020
medline:
25
5
2021
entrez:
15
12
2020
Statut:
ppublish
Résumé
In recent years, calcineurin inhibitors have been used as the first line alternative to topical corticosteroids in the treatment of discoid lupus erythematosus (DLE). We aim to evaluate the efficacy and safety of topical tacrolimus 0.1% vs topical halobetasol propionate 0.05% in patients with DLE. This comparative study was carried out in the Department of Dermatology and Venereology, Chittagong Medical College Hospital (CMCH), Bangladesh between the period of July 2018 and June 2019. The change of DLE activity assessed with the cutaneous lupus erythematosus disease area and severity index was used as a primary outcome measure. The effective sample was 40 patients in each group. Both groups were similar in terms of baseline demographic and clinical characteristics. After 8 weeks of treatment, the mean total erythema score decreased significantly in both groups (in tacrolimus treated group [TTG] from 12.53 ± 8.05 to 8.03 ± 5.69, [P < .001] and in halobetasol propionate treated group [HTG] from 11.83 ± 7.17 to 7.30 ± 4.56 [P < .001]), as well as the mean total scale/hypertrophy score (in TTG from 8.08 ± 5.30 to 4.33 ± 3.21; [P < .001] and in HTG from 7.40 ± 4.73 to 3.68 ± 2.01, [P < .001]. The magnitude of reduction was significantly better in HTG [P = .032]). The mean total activity score decreased significantly in both groups (in TTG from 22.95 ± 13.40 to 14.33 ± 8.89, [P < .001] and in HTG from 22.15 ± 11.95 to 13.7 ± 7.22, [P < .001]). The present study demonstrated that tacrolimus 0.1% ointment and halobetasol propionate 0.05% ointment had a comparable efficacy in DLE patients; however, halobetasol showed significantly better improvement regarding scaly, hypertrophic lesions.
Substances chimiques
Hydroxychloroquine
4QWG6N8QKH
halobetasol
9P6159HM7T
Clobetasol
ADN79D536H
Tacrolimus
WM0HAQ4WNM
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14675Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Mowla M, Alam M, Hoque M, et al. The spectrum of cutaneous manifestations in lupus erythematosus: the tertiary hospital experience. JCMCTA. 2010;21:34-39.
Werth VP. Clinical manifestations of cutaneous lupus erythematosus. Autoimmun Rev. 2005;4:296-302.
Tebbe B, Orfanos CE. Epidemiology and socioeconomic impact of skin disease in lupus erythematosus. Lupus. 1997;6:96-104.
Kuhn A, Ruland V, Bonsmann G. Cutaneous lupus erythematosus: update of therapeutic options. JAAD. 2011;65:179-193.
Gisondi P, Ellis CN, Girolomoni G. Pimecrolimus in dermatology: atopic dermatitis and beyond. Int J Clin Pract. 2005;59:969-974.
Sticherling M. Update on the use of topical calcineurin inhibitors in cutaneous lupus erythematosus. Biol Targets Ther. 2011;5:21-31.
Walker SL, Kirby B, Chalmers RJG. The effect of topical tacrolimus on severe recalcitrant chronic discoid lupus erythematosus. Br J Dermatol. 2002;147:405-406.
Graf J, Webb A, Davis J. The use of topical tacrolimus (FK506/protopic) in cutaneous manifestations of autoimmune diseases. J Clin Rheumatol. 2003;9:310-315.
Lampropoulos CE, Sangle S, Harrison P, Hughes GRV, D'Cruz DP. Topical tacrolimus therapy of resistant cutaneous lesions in lupus erythematosus: a possible alternative. Rheumatology. 2004;43:1383-1385.
Tlacuilo-Parra A, Guevara-Gutiérrez E, Gutiérrez-Murillo F, Soto-Ortiz A, Barba-Gómez F, Hernández-Torres M. Pimecrolimus 1% cream for the treatment of discoid lupus erythematosus. Rheumatology. 2005;44:1564-1568.
Drake LA, Dinehart SM, Farmer ER, et al. Guidelines/outcomes committee, & task force. Guidelines of care for the use of topical glucocorticosteroids. JAAD. 1996;35:615-619.
Jessop S, Whitelaw DA, Grainge MJ, Jayasekera P. Drugs for discoid lupus erythematosus. Cochrane Database Syst Rev. 2017;5(5):CD002954.
Dhurat R, Kanwar AJ, Vishalakshi V, et al. Evaluation of the erricact and safety of 0.05% helobetasol propionate ointment and 0.5% clobetasol propionate ointment in chronic, localized plaque psoriasis. Asian J Pharm Clin Res. 2016;9:288-291.
Tzung T-Y, Liu Y-S, Chang H-W. Tacrolimus vs clobetasol propionate in the treatment of facial cutaneous lupus erythematosus: a randomized, double-blind, bilateral comparison study. BJD. 2007;156:191-192.
Pothinamthong P, Janjumratsang PA. Comparative study in efficacy and safety of 0.1% tacrolimus and 0.05% clobetasol propionate ointment in discoid lupus erythematosus by modified cutaneous lupus erythematosus disease area and severity index. J Med Assoc Thai. 2012;95:933-940.
Barikbin B, Givrad S, Yousefi M, Eskandari F. Pimecrolimus 1% cream versus betamethasone 17-valerate 0.1% cream in the treatment of facial discoid lupus erythematosus: a double-blind, randomized pilot study. CED. 2009;34:776-780.
Madan V, August PJ, Chalmers RJG. Efficacy of topical tacrolimus 0.3% in clobetasol propionate 0.05% ointment in therapy-resistant cutaneous lupus erythematosus: a cohort study. CED. 2010;35:27-30.
Annegret Kuhn A, Kristina Gensch K, Merle Haust M, et al. Efficacy of tacrolimus 0.1% ointment in cutaneous lupus erythematosus: a multicenter, randomized, double-blind, vehicle-controlled trial. JAAD. 2010;65:54-64.
Wahie S, Meggitt SJ. Long-term response to hydroxychloroquine in patients with discoid lupus erythematosus. BJD. 2013;169:653-659.
Bhat YJ, Manzoor S, Qayoom S. Steroid-induced rosacea: a clinical study of 200 patients. Indian J Dermatol. 2011;56(1):30-32.