The value of pimecrolimus in improving quality of life of children with severe eczema – an open non-randomised study

Background: Atopic eczema is a common skin condition. It has the potential to severely impair quality of life in affected children. Pimecrolimus is currently registered for mild-moderate eczema but in clinical practice children with more severe disease are often treated with this therapy in an attempt to find a safe addition to long-term topical corticosteroid usage. The aim of this study was to test the value of pimecrolimus in improving quality of life in children with severe atopic eczema.Methods: This a single site, phase 4, non-randomised, open label trial of pimecrolimus use in children aged 4 months to 12 years living withmoderate to very severe atopic eczema. The study was conducted at Steve Biko Academic Hospital. Patients with unsatisfactorily controlled disease despite conventional topical therapy, adequate use of emollients, allergen avoidance and non-pharmacological skin hygiene were enrolled. A ParentIndex Quality of Life Questionnaire was completed by parents before and three months after using pimecrolimus.Results: A total of 24 patients were recruited, 20 of whom completed the study. Ninety per cent of patients had co-morbid asthma and allergicrhinitis. The Parent Index Quality of Life demonstrated a mean 33% score improvement after the use of pimecrolimus. There was an attendant reduction in cost of therapy to these patients.Conclusions: Pimecrolimus usage should be extended to patients with more severe atopic eczema as the improvement in quality of life is important and demonstrable.Keywords: severe eczema; topical steroids; calcineurin inhibitors; pimecrolimus; quality of lif