Combining basic therapy and immunotherapy led to significant clinico-immunological improvement in children with exacerbation of moderate atopic dermatitis, according to research presented at the European Academy of Allergy and Clinical Immunology-World Allergy Organization World Allergy and Asthma Congress in Milan.
Russian researchers studied 61 children (aged 5 to17 years) with exacerbation of moderate atopic dermatitis (EMAD) and 30 healthy, matched controls. Children with EMAD were randomly divided into two groups; 31 received basic therapy and 20 mg immunomodulator (BT+IM), and 30 treated with BT only. IM administration was sublingual 30 minutes before mealtime at 1 mg once daily for 10 days, followed by 1 mg once daily every other day.
Treated groups had a basic Scoring Atopic Dermatitis (SCORAD) index of 41.86 ± 2.56, and treatment effectiveness was assessed at 1 and 3 months.
At 1 month, inflammation was reduced by 2.5 times in the BT+IM cohort, compared with 1.4 times among BT patients. At 3 months, the BT+IM group experienced twice the reduction of 1 month, with 30% of patients showing no skin lesions.
SCORAD index showed 2.2-fold and 3.5-fold reductions at 1 and 3 months, respectively, among the BT+IM cohort, compared with 1.5-fold and 2.4-fold reductions, respectively, for BT patients.
Children with EMAD presented with lower phagocytic index (PI; from 2.87 ± 0.02 to 2.17 ± 0.12; P<.05) and phagocytic number (PN; from 6.35 ± 0.42 to 4.64 ± 0.17; P<.05) than controls.
“Addition of IM to BT resulted in normalization of PI and PN at 1 month, with no significant changes of serum cytokine IL-4, IL-13, interferon-gamma [IFN-y] levels (P>.05),” the researchers reported. After 3 months, BT+IM patients exhibited elevated IFN-y from 20.3 ± 2 pg/mL to 41.5 ± 3.5 pg/mL (P<.05), but remained below normal levels found in controls. BT patients failed to achieve normal levels of PI, PN and cytokine.
“The addition of BT+IM in children with EMAD … helped to take more control under the course of disease,” the researchers concluded.
For more information:
Slavyanskaya TA. Abstract 344: Immunotherapy Rationale in Children with Exacerbation of Moderate Atopic Dermatitis. Presented at: EAACI-WAO World Allergy and Asthma Congress 2013; June 23-26, Milan.