What is the recommended treatment and dosage for atopic dermatitis using pimercrolimus?

From the Guidelines

Pimecrolimus 1% cream is recommended for adults with mild-to-moderate atopic dermatitis, as evidenced by recent guidelines 1. The treatment should be applied thinly to affected areas twice daily until symptoms resolve, and it is particularly useful for sensitive areas like the face, neck, and skin folds where topical steroids may cause side effects. Key points to consider when prescribing pimecrolimus 1% cream include:

• It works by inhibiting T-cell activation and inflammatory cytokine production, reducing the inflammation and itching associated with atopic dermatitis 1.
• Treatment can continue as needed for flare-ups, though it should not be used continuously long-term.
• Patients should avoid sun exposure during treatment and should not use pimecrolimus on infected skin.
• Improvement is usually seen within 2-6 weeks of starting treatment.
• This medication is typically prescribed as a second-line treatment when conventional therapies like moisturizers and topical corticosteroids have failed or aren't appropriate, as per the guidelines 1. Some important considerations for the use of pimecrolimus 1% cream in adults with atopic dermatitis include:
• The recommendation for its use is based on high certainty of evidence, as stated in the guidelines 1.
• It is approved for patients 2 years and older, though off-label use in younger patients may occur under dermatologist supervision.
• Recent studies, such as those cited in the guidelines 1, support the safety and efficacy of pimecrolimus 1% cream for the treatment of mild-to-moderate atopic dermatitis in adults.

From the FDA Drug Label

The patient or care giver should apply a thin layer of ELIDEL (pimecrolimus) Cream 1% to the affected skin twice daily. The safety of ELIDEL Cream under occlusion, which may promote systemic exposure, has not been evaluated. ELIDEL Cream should not be used with occlusive dressings. ELIDEL ® (pimecrolimus) Cream 1% is indicated as second-line therapy for the short-term and non-continuous chronic treatment of mild to moderate atopic dermatitis in non-immunocompromised adults and children 2 years of age and older, who have failed to respond adequately to other topical prescription treatments, or when those treatments are not advisable.

The recommended treatment and dosage for atopic dermatitis using pimercrolimus is to apply a thin layer of ELIDEL Cream 1% to the affected skin twice daily 2. Key points to consider:

• Application should be limited to areas of involvement with atopic dermatitis.
• Continuous long-term use of ELIDEL Cream should be avoided.
• ELIDEL Cream is indicated as second-line therapy for the short-term and non-continuous chronic treatment of mild to moderate atopic dermatitis in non-immunocompromised adults and children 2 years of age and older 2.

From the Research

Treatment Overview

• Pimecrolimus is a topically active, nonsteroid, calcineurin inhibitor used to control symptoms of atopic dermatitis in adult and pediatric patients 3.
• Topical pimecrolimus 1% cream is approved for the short-term and intermittent long-term treatment of mild-to-moderate atopic dermatitis in non-immunocompromised patients aged ≥2 years who do not respond well to, or may have adverse effects with, conventional treatments 3.

Dosage and Administration

• The recommended dosage of pimecrolimus is 1% cream, applied topically to the affected areas 4, 5.
• Pimecrolimus can be used as a first-line therapy for patients with established mild atopic dermatitis at the first signs and symptoms of disease 4.
• Maintenance treatment with pimecrolimus may effectively prevent subsequent disease flares after resolution of lesions 4.

Efficacy and Safety

• Pimecrolimus has been shown to be effective in reducing the incidence of disease flares and improving health-related quality of life (HR-QOL) in children and adolescents with atopic dermatitis 3, 5.
• The most common adverse events associated with pimecrolimus are application-site reactions, nasopharyngitis, headache, cough, pyrexia, influenza, and bronchitis 5.
• Pimecrolimus does not cause skin atrophy, a common side effect of topical corticosteroids, and is not associated with clinically relevant systemic adverse events 3, 6.