trial of treatment of atopic dermatitis with concurrent altabax® and topical low-potency corticosteroids versus low-potency corticosteroid mono-therapy

Conditions: Atopic Dermatitis

Summary: this study is designed to determine whether the addition of topical altabax (r) to a treatment regimen of topical corticosteroid therapy speeds clearance of atopic dermatitis and improves quality of life.

background: atopic dermatitis is a pruritic skin disorder which affects more than 10% of the united states population, one-third of whom report sleep disturbance and a quarter with chronic unremitting disease. atopic dermatitis is a recurrent pruritic skin disorder which has a significant morbidity and extensive costs for the health care system. quality of life is often impaired for patients with atopic dermatitis due to sleep disturbance, pruritus and the physical impairment of visible skin lesions. the rapidity in which pruritus and lesional appearance are noted to resolve correlates strongly with improved patient satisfaction and improved quality of life. recently, a clinical trial of adding mupirocin into a regimen of topical corticosteroids has shown a significant enhancement in lesional clearance and symptom reduction with addition of mupirocin to the topical corticosteroid. these improvements were most notable within the first week of treatment. proposal: a 4-week clinical trial of 60 atopic dermatitis patients (ages 9 months to 17 years) would be conducted. all sixty patients would be given topical mid-potency corticosteroid (locoid lipocream®) to be mixed with a second product. half the patients would receive altabax® and the other half would receive vehicle (blinded to subject and investigator). patients would be advised to apply the topical randomized product first, let dry and then apply topical locoid lipocream ® to affected areas, and then apply the topical randomized ointment product to each of the sites of skin disease on top of the locoid lipocream ®. treatment of affected areas would continue for 4 weeks or until lesions have cleared, which ever comes first. parents of patients will be asked to maintain a written diary of drug application.

Eligibility criteria:
inclusion criteria: 1. diagnosis of atopic dermatitis 2. ages 9 months to 17 years 3. presence of at least one lesion of atopic dermatitis at the time of baseline enrollment 4. disease limited to less than 100 cm2 body surface area 5. easi score of at least 7, based on the gong, et al publication gong jq, lin l, lin t, hao f, zeng fq, bi zg, yi d, zhao b. skin colonization by staphylococcus aureus in patients with eczema and atopic dermatitis and relevant combined topical therapy: a double-blind multicentre randomized controlled trial. br j dermatol. 2006 oct;155(4):680-7. exclusion criteria: 1. allergy to any ingredient in altabax® or locoid lipocream ® 2. usage of oral corticosteroids within the 2 weeks prior to study initiation or during the study 3. usage of topical corticosteroid or other topical prescriptions for atopic dermatitis in the week prior to study initiation 4. inability to comply with the study protocol 5. presence of major medical illness requiring systemic therapy including cancers. 6. clinical diagnosis of bacterial infections of the skin, including impetigo or abscesses.

Keywords: atopic dermatitis pruritus quality of life