A recent study conducted by researchers from Trinity College and King’s College has compared the two main conventional systemic treatments, methotrexate and ciclosporin, for children with atopic dermatitis. Atopic dermatitis is the most common skin condition in children, and these immuno-modulatory drugs modify the immune system’s response.
This trial, published in the British Journal of Dermatology, aimed to provide evidence on the safety and treatment success of these therapies, as well as establish a gold standard for treatment in severe atopic dermatitis. The study involved 103 children aged 2-16 years across 13 centers in the UK and Ireland.
The results of the trial showed that ciclosporin had a faster onset of action and reduced disease severity more at 12 weeks. However, it was also more expensive compared to methotrexate. On the other hand, methotrexate was significantly cheaper and led to better long-term disease control after 12 weeks, with fewer flares reported by the participants after treatment cessation. Importantly, there were no safety concerns observed for either drug.
Atopic dermatitis affects more than one in five Irish children and has a significant impact on their quality of life. While creams are initially effective, severe cases often require systemic treatments. Many European countries, including Ireland, require children to try unlicensed therapies before providing more advanced treatments, making it crucial to establish the efficacy and safety of conventional therapies like methotrexate and ciclosporin.
These findings will likely change the treatment approach for children with severe atopic dermatitis, not only in the UK but also internationally. It provides valuable evidence for healthcare providers and informs the decision-making process when choosing between methotrexate and ciclosporin for pediatric patients.
Overall, both methotrexate and ciclosporin were found to be effective and well-tolerated treatments for severe atopic dermatitis in children. Methotrexate demonstrated more sustained benefit after treatment discontinuation, making it a favorable choice for long-term disease control.
– British Journal of Dermatology
– Trinity College
– King’s College London