PMID- 18157526
OWN - NLM
STAT- MEDLINE
DCOM- 20080825
LR  - 20181113
IS  - 0031-6970 (Print)
IS  - 0031-6970 (Linking)
VI  - 64
IP  - 4
DP  - 2008 Apr
TI  - Topical tacrolimus and pimecrolimus in the treatment of cutaneous lupus 
      erythematosus: an evidence-based evaluation.
PG  - 337-41
AB  - BACKGROUND: Lesions of cutaneous lupus erythematosus (CLE) are refractory to a 
      wide range of topical or systemic therapies. The pathogenesis of CLE is 
      multifactorial and polygenic, and many of its details remain unclear. However, 
      immunologic evidence suggests the possible therapeutic use of tacrolimus and 
      pimecrolimus. CLE is one of the most common dermatological autoimmune disorders 
      worldwide, which includes systemic lupus erythematosus (SLE) with malar rash, 
      subacute cutaneous lupus erythematosus (SCLE) and discoid lupus erythematosus 
      (DLE). OBJECTIVE: Our aim was to determine the efficacy of topical pimecrolimus 
      and tacrolimus in the treatment of cutaneous lupus erythematosus. METHODS: The 
      literature was systematically reviewed. Medline, Embase, and the Cochrane 
      Database were searched for systemic reviews, randomised controlled trials and 
      nonrandomised clinical trials using the search terms "pimecrolimus", "Elidel", 
      "SDZ ASM 981", "tacrolimus", "Protopic", "FK506" and "cutaneous lupus 
      erythematosus". Studies were assessed independently by two authors. RESULTS: Five 
      studies were eligible for inclusion in this review. Only one of them was a 
      randomised controlled trial (RCT). There was no significant difference between 
      tacrolimus and clobetasol; however, evidence indicates the highest tolerability 
      of tacrolimus compared with corticosteroids. This review indicates the efficacy 
      of tacrolimus and pimecrolimus in, at least initial, cutaneous lesions of SLE. 
      However, in SCLE and DLE lesions, the efficacy appears to be lower, perhaps due 
      to the chronicity of those lesions. CONCLUSION: The lack of RCTs is 
      characteristic. Future studies should focus on efficacy, short- and long-term 
      effects and cost-effectiveness. However, tacrolimus and pimecrolimus show 
      efficacy, and such effort is worthwhile.
FAU - Tzellos, Thrasivoulos George
AU  - Tzellos TG
AD  - Department of Pharmacology, School of Medicine, Aristotle University of 
      Thessaloniki, Thessaloniki, Greece.
FAU - Kouvelas, Dimitrios
AU  - Kouvelas D
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20071220
PL  - Germany
TA  - Eur J Clin Pharmacol
JT  - European journal of clinical pharmacology
JID - 1256165
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunosuppressive Agents)
RN  - 7KYV510875 (pimecrolimus)
RN  - ADN79D536H (Clobetasol)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Administration, Topical
MH  - Clobetasol/administration & dosage/therapeutic use
MH  - Databases, Factual
MH  - Glucocorticoids/administration & dosage/therapeutic use
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage/*therapeutic use
MH  - Lupus Erythematosus, Cutaneous/*drug therapy/pathology
MH  - Randomized Controlled Trials as Topic
MH  - Skin/pathology
MH  - Tacrolimus/administration & dosage/*analogs & derivatives/therapeutic use
RF  - 30
EDAT- 2007/12/25 09:00
MHDA- 2008/08/30 09:00
CRDT- 2007/12/25 09:00
PHST- 2007/09/27 00:00 [received]
PHST- 2007/11/16 00:00 [accepted]
PHST- 2007/12/25 09:00 [pubmed]
PHST- 2008/08/30 09:00 [medline]
PHST- 2007/12/25 09:00 [entrez]
AID - 10.1007/s00228-007-0421-2 [doi]
PST - ppublish
SO  - Eur J Clin Pharmacol. 2008 Apr;64(4):337-41. doi: 10.1007/s00228-007-0421-2. Epub 
      2007 Dec 20.