Frontiers in Pediatrics (Apr 2023)

Observational study of pimecrolimus 1% cream for prevention of transcutaneous sensitization in children with atopic dermatitis during their first year of life

  • Nikolay N. Murashkin,
  • Nikolay N. Murashkin,
  • Nikolay N. Murashkin,
  • Nikolay N. Murashkin,
  • Leyla S. Namazova-Baranova,
  • Leyla S. Namazova-Baranova,
  • Svetlana G. Makarova,
  • Roman A. Ivanov,
  • Stepan G. Grigorev,
  • Stepan G. Grigorev,
  • Dmitri V. Fedorov,
  • Eduard T. Ambarchian,
  • Eduard T. Ambarchian,
  • Roman V. Epishev,
  • Roman V. Epishev,
  • Alexander I. Materikin,
  • Leonid A. Opryatin,
  • Alena A. Savelova

DOI
https://doi.org/10.3389/fped.2023.1102354
Journal volume & issue
Vol. 11

Abstract

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IntroductionEpidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants.MethodThis was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 “baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy”; patients who sought medical attention later were group 2 “baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus”. Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age.ResultsFifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred.DiscussionThe pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants.Trial registrationhttps://clinicaltrials.gov/NCT04900948, retrospectively registered, 25 May 2021.

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