A recent study conducted by King’s College London has compared the safety and effectiveness of two commonly used drugs, ciclosporin and methotrexate, in the treatment of severe atopic dermatitis in children and young people. Atopic dermatitis is a debilitating skin condition that commonly affects children.
There has been a lack of robust clinical trial evidence regarding the safety and efficacy of these conventional systemic treatments for pediatric patients with atopic dermatitis. This study aimed to fill that gap and establish a gold standard for treatment using these therapies.
The trial involved 103 children with severe atopic dermatitis, aged 2 to 16 years, across multiple centers in the UK and Ireland. The patients were randomly assigned to receive either methotrexate or ciclosporin and were assessed over a period of nine months of treatment and six months after treatment completion.
The findings of the study revealed that ciclosporin demonstrated faster and more significant reductions in disease severity after 12 weeks of treatment. However, methotrexate was found to be significantly cheaper and led to better control of the disease both during and after treatment, with reduced instances of flares reported by the participants. Importantly, there were no concerning safety signals observed for either drug.
Based on these results, methotrexate is identified as a useful and safe treatment option for children and young people with severe atopic dermatitis. It can serve as a cost-effective alternative to ciclosporin, particularly in settings with limited healthcare resources.
This study is the largest clinical trial to date investigating the use of conventional immuno-modulatory treatments for severe atopic dermatitis in children. Its findings have the potential to significantly impact the treatment approach for this condition globally.
Sources:
– Carsten Flohr et al, “Efficacy and safety of ciclosporin versus methotrexate in the treatment of severe atopic dermatitis in children and young people (TREAT): a multicentre, parallel group, assessor-blinded clinical trial,” British Journal of Dermatology (2023).
– King’s College London
