How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema?
We sought to explore the architecture of trials of calcineurin inhibitors for atopic eczema to document the extent to which comparisons with active treatments such as topical corticosteroids (TCS) might have been included or avoided. We identified all eligible randomized controlled trials (RCTs) usi...
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| Format: | Article |
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Elsevier
2016
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| Online Access: | https://eprints.nottingham.ac.uk/33835/ |
| _version_ | 1848794714886635520 |
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| author | Wilkes, Sally R. Nankervis, Helen Tavernier, Elsa Maruani, Annabel Williams, Hywel C. |
| author_facet | Wilkes, Sally R. Nankervis, Helen Tavernier, Elsa Maruani, Annabel Williams, Hywel C. |
| author_sort | Wilkes, Sally R. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | We sought to explore the architecture of trials of calcineurin inhibitors for atopic eczema to document the extent to which comparisons with active treatments such as topical corticosteroids (TCS) might have been included or avoided. We identified all eligible randomized controlled trials (RCTs) using the Global Resource for EczemA Trials database. Network plots were produced where the nodes represented a treatment type and the lines between the nodes represented the number of trials or participants that were involved in the various treatment comparisons. A total of 174 RCTs for atopic eczema treatments were identified where pimecrolimus, tacrolimus or topical corticosteroids were compared with another intervention or a vehicle/emollient. Of 39 trials involving pimecrolimus and of 41 trials involving tacrolimus, 8 (20.5%) and 13 (31.7%) respectively made comparisons with topical corticosteroids, and 25 (64.1%) and 15 (36.6%) respectively were vehicle-controlled studies. The high rate of comparisons with vehicle controls in RCTs assessing the efficacy of pimecrolimus or tacrolimus long after efficacy had been established is a matter of concern. Active comparators (mild TCS for pimecrolimus and moderate to potent TCS for tacrolimus) are best placed to inform how topical calcineurin inhibitors compare to established clinical practice. |
| first_indexed | 2025-11-14T19:20:35Z |
| format | Article |
| id | nottingham-33835 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:20:35Z |
| publishDate | 2016 |
| publisher | Elsevier |
| recordtype | eprints |
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| spelling | nottingham-338352020-05-04T18:00:32Z https://eprints.nottingham.ac.uk/33835/ How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? Wilkes, Sally R. Nankervis, Helen Tavernier, Elsa Maruani, Annabel Williams, Hywel C. We sought to explore the architecture of trials of calcineurin inhibitors for atopic eczema to document the extent to which comparisons with active treatments such as topical corticosteroids (TCS) might have been included or avoided. We identified all eligible randomized controlled trials (RCTs) using the Global Resource for EczemA Trials database. Network plots were produced where the nodes represented a treatment type and the lines between the nodes represented the number of trials or participants that were involved in the various treatment comparisons. A total of 174 RCTs for atopic eczema treatments were identified where pimecrolimus, tacrolimus or topical corticosteroids were compared with another intervention or a vehicle/emollient. Of 39 trials involving pimecrolimus and of 41 trials involving tacrolimus, 8 (20.5%) and 13 (31.7%) respectively made comparisons with topical corticosteroids, and 25 (64.1%) and 15 (36.6%) respectively were vehicle-controlled studies. The high rate of comparisons with vehicle controls in RCTs assessing the efficacy of pimecrolimus or tacrolimus long after efficacy had been established is a matter of concern. Active comparators (mild TCS for pimecrolimus and moderate to potent TCS for tacrolimus) are best placed to inform how topical calcineurin inhibitors compare to established clinical practice. Elsevier 2016-07-20 Article PeerReviewed Wilkes, Sally R., Nankervis, Helen, Tavernier, Elsa, Maruani, Annabel and Williams, Hywel C. (2016) How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? Journal of Investigative Dermatology, 136 (10). pp. 1944-1949. ISSN 1523-1747 Atopic eczema; Topical corticosteroids; Calcineurin inhibitors; Randomised clinical trial; Network geometry http://www.sciencedirect.com/science/article/pii/S0022202X16313331 doi:10.1016/j.jid.2016.05.104 doi:10.1016/j.jid.2016.05.104 |
| spellingShingle | Atopic eczema; Topical corticosteroids; Calcineurin inhibitors; Randomised clinical trial; Network geometry Wilkes, Sally R. Nankervis, Helen Tavernier, Elsa Maruani, Annabel Williams, Hywel C. How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title | How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title_full | How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title_fullStr | How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title_full_unstemmed | How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title_short | How clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| title_sort | how clinically relevant are treatment comparisons of topical calcineurin inhibitor trials for atopic eczema? |
| topic | Atopic eczema; Topical corticosteroids; Calcineurin inhibitors; Randomised clinical trial; Network geometry |
| url | https://eprints.nottingham.ac.uk/33835/ https://eprints.nottingham.ac.uk/33835/ https://eprints.nottingham.ac.uk/33835/ |