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Proactive treatment of atopic eczema with topical corticosteroids and calcineurin inhibitors: a systematic review and meta-analysis

A systematic review was conducted of nine randomized controlled trials reporting the efficacy and tolerability of topical corticosteroids and/or topical calcineurin inhibitors (TCIs) for flare prevention in atopic eczema. The trials, dating from 1999-2009, were double-blind, randomized, vehicle-controlled and included active therapy with tacrolimus, fluticasone propionate or methylprednisolone aceponate. All the active agents were more effective than vehicle in treating acute flares. A meta-analysis revealed that topical fluticasone may be more effective (relative risk [RR]: 0.46) than tacrolimus (RR: 0.78). However, head to head studies comparing fluticasone versus tacrolimus are needed to confirm these results and evaluate safety aspects. Further work is also required to allow conclusions on long-term safety (Schmitt, J. et ...