Advagraf® for the treatment of adults with atopic dermatitis

Advagraf® is potentially an alternative treatment option in patients with severe atopic dermatitis (AD) and nonresponsiveness and/or side effects to commonly used immunosuppressive drugs, such as cyclosporine A (CsA), azathioprine, mycophenolic acid and methotrexate. In healthy subjects, Advagraf® exerts a more favourable safety profile especially on blood pressure and renal function. In this study the results of nine patients with severe recalcitrant AD treated with Advagraf® for 6 months are described. Disease activity was monitored using the Six Area, Six Sign Atopic Dermatitis (SASSAD), BSA (Body Surface Area) and (modified) SCORAD (Scoring Atopic Dermatitis). Serum TARC (thymus and activationregulated chemokine) was determined as an objective measure for disease activity. POEM (Patient-Oriented Eczema Measure) was used to monitor disease impact experienced by the patient. All outcome measures were significantly decreased after 2 weeks of treatment compared to pre-treatment. The outcome measures were still significantly decreased after 12 weeks and 6 months compared to pre-treatment with Advagraf®. Two out of 9 patients had to discontinue Advagraf® within 6 months due to an increase in serum creatinine and gastrointestinal complaints. Advagraf® can be a good alternative in patients with severe recalcitrant atopic dermatitis, in which treatment options are very limited. Future studies comparing Advagraf® with CsA as first choice drug in severe AD patients are needed.© 2014 De Nederlandse Vereniging voor Dermatologie en Venereologie.