Published online September 5, 2006
PEDIATRICS Vol. 118 Supplement August 2006, pp. S15-S16 (doi:10.1542/peds.2006-0900Z)
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Long-term Treatment of Atopic Dermatitis With Pimecrolimus Cream 1% in Infants Does Not Interfere With the Development of Protective Antibodies After Vaccination

Jonathan M. Spergel, MD, PhD

Philadelphia, PA

ABSTRACT

PURPOSE OF THE STUDY.: To examine if pimecrolimus 1% cream in the treatment of atopic dermatitis would have any effect on vaccinations.

STUDY POPULATION.: A total of 91 children with mild-to-severe atopic dermatitis (AD), aged 3 to 23 months at enrollment.

METHODS.: Children were enrolled in a 1-year double-blind study (76 children received pimecrolimus, and 15 children received placebo). All 91 children were enrolled in a 1-year open-label extension study of pimecrolimus 1% cream. Patients were treated with either pimecrolimus 1% cream or placebo for initial symptoms, and more potent topical corticosteroids were used for flares not prevented by pimecrolimus 1% cream. Patients were vaccinated at normal scheduled times (4 doses of tetanus and diphtheria and 1 or 2 doses of measles and rubella). Response was evaluated at months 18 and 24 of the 2-year period.

RESULTS.: The seropositivity rates of 93.6% for tetanus, 88.6% for diphtheria, 88.5% for measles, and 84.4% for rubella were comparable with those reported in the literature. Seropositivity was not significantly affected by the use of pimecrolimus at the time of vaccinations (±28 days). These seropositivity rates were within the ranges of 87% to 100% for tetanus, 83.3% to 99.3 for diphtheria, 60.5% to 97.1% for measles, and 55.6% to 88.1% for rubella, similar to those reported in age-matched pediatric populations.

CONCLUSION.: Topical pimecrolimus in the treatment of atopic dermatitis had no effect on the response to routine childhood vaccination.

REVIEWER COMMENTS.: Topical pimecrolimus, similar to topical tacrolimus (J Am Acad Dermatol. 2005;53[2 suppl 2]:S206–S213), had no effect on routine childhood vaccination. These topical calcineurin inhibitors did not affect basic B-cell function as measured by postvaccination titers.

Papp KA, Breuer K, Meurer M, et al. J Am Acad Dermatol. 2005;52:247–253[CrossRef][ISI][Medline]