ArticleJournal of the American Academy of Dermatology2013
Oral azathioprine for recalcitrant pediatric atopic dermatitis: clinical response and thiopurine monitoring.
Article in Journal of the American Academy of Dermatology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.
- Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents.Journal of the American Academy of Dermatology · 2014Guideline
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- Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis.Current allergy and asthma reports · 2024Review
- Shedding light on key pharmacological knowledge and strategies for pediatric atopic dermatitis.Expert review of clinical pharmacology · 2023Review
- Improving Psychological Health Outcomes in Children with Atopic Dermatitis.Clinical, cosmetic and investigational dermatology · 2023Review
- Anti-inflammatory and biologic drugs for atopic dermatitis: a therapeutic approach in children and adolescents.Frontiers in medicine · 2023Review
- Narrative review on the management of moderate-severe atopic dermatitis in pediatric age of the Italian Society of Pediatric Allergology and Immunology (SIAIP), of the Italian Society of Pediatric Dermatology (SIDerP) and of the Italian Society of Pediatrics (SIP).Italian journal of pediatrics · 2022Review
- Recent insights into the management of treatment-resistant pediatric atopic dermatitis.International journal of women's dermatology · 2022Review
- Consensus Update for Systemic Treatment of Atopic Dermatitis.Annals of dermatology · 2021Article
- [Recommendations when switching therapy from immunosuppressive drugs to dupilumab in patients with atopic dermatitis].Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2021Review
- Current Perspectives on the Systemic Management of Atopic Dermatitis.Journal of asthma and allergy · 2021Review
- Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during the COVID-19 pandemic.Dermatologic therapy · 2020Review
- Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part II. Systemic treatment and new therapeutic methods.Postepy dermatologii i alergologii · 2020Article
- Drugs for the Treatment of Chronic Hand Eczema: Successes and Key Challenges.Therapeutics and clinical risk management · 2020Review
- Topical and Oral Therapies for Childhood Atopic Dermatitis and Plaque Psoriasis.Children (Basel, Switzerland) · 2019Article
- Understanding the Burden of Atopic Dermatitis in Africa and the Middle East.Dermatology and therapy · 2019Review
- A Systematic Scoping Literature Review of Publications Supporting Treatment Guidelines for Pediatric Atopic Dermatitis in Contrast to Clinical Practice Patterns.Dermatology and therapy · 2018Article
- Translating translation into patient benefit for atopic eczema.The British journal of dermatology · 2016Review
- Consensus Conference on Clinical Management of pediatric Atopic Dermatitis.Italian journal of pediatrics · 2016Review
- Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment.Annals of dermatology · 2015Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAzathioprine is prescribed as a corticosteroid-sparing agent for many inflammatory conditions, including refractory atopic dermatitis (AD). There are limited prospective data on its appropriate use and monitoring for children with AD.
objectivesThis study was designed to assess clinical response to azathioprine, determine the necessity for repeated measurement of thiopurine methyltransferase (TPMT) activity during treatment, and test the utility of measuring levels of the metabolites 6-thioguanine nucleotide and 6-methylmercaptopurine.
methodsTwelve children with severe, recalcitrant AD were treated with oral azathioprine and followed prospectively. Disease severity was determined by the SCORing AD index. Baseline TPMT activity was measured and this was repeated along with 6-thioguanine nucleotide and 6-methylmercaptopurine measurement at times of stable improvement, inadequate response, or change in response.
resultsAzathioprine therapy was associated with clinical improvement in all but 1 patient. There were few adverse effects. Three patients showed a significant change in TPMT activity during treatment: 2 had a mild decrease and 1 demonstrated enzyme inducibility with an increase from the intermediate to the normal activity range. These changes, but not 6-thioguanine nucleotide or 6-methylmercaptopurine levels, inversely correlated with the clinical response to therapy. LIMITATIONS: Small sample size is a limitation.
conclusionsAzathioprine can be of benefit in the treatment of recalcitrant pediatric AD. Repeat assessment of TPMT activity may be helpful for evaluation of nonresponse or change in response and warrants further study. In contrast, measurement of thiopurine metabolites during treatment was not clinically useful.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.