Clinical Efficacy Of 0.1% Tacrolimus Ointment Combined With 0.1% Mometasone Furoate Cream In The Treatment Of Moderate To Severe Atopic Dermatitis In Adults

Objective: To evaluate the clinical efficacy and safety of topical 0.1% tacrolimus ointment combined with 0.1% mometasone furoate cream sequential therapy in the treatment of moderate to severe atopic dermatitis in adults.Methods: A total of 30 adult patients with moderate to severe atopic dermatitis were included in this study,including 13 males and 17 females,aged between 18 and 75 years.Topical 0.1% tacrolimus ointment combined with 0.1% mometasone furoate cream was sequential treatment.The research program consists of three phases.Stage 1: 0.1%tacrolimus ointment twice daily,morning and evening,and 0.1% mometasone furoate cream once daily in the evening for 2 weeks.Stage 2: 0.1% tacrolimus ointment twice daily,morning and evening,0.1% mometasone furoate cream once every other day,three times a week,for 2 weeks.Stage 3: stop using 0.1% mometasone furoate cream and 0.1% tacrolimus cream twice daily,once in the morning and once in the evening.Using a before and after self-controlled study,respectively before the treatment and after treatment for 2 weeks,4weeks and 6 weeks is analyzed the eczema area and severity index score(ESAI score),the scoring atopic dermatitis(SCORAD)scale,the investigator global assessment(IGA score),the pruritus numerical rating scale(P-NRS score),the dermatology life quality index(DLQI score),the patient-oriented eczema measure(POEM score),the pittsburgh sleep quality index(PSQI score),the hospital anxiety and depression scale(HADS score),etc.,and the occurrence of adverse drug reactions were recorded in detail.The scores before and after treatment were analyzed by Chi-square test for counting data,t-test for measurement data conforming to normal distribution,and Wilcoxon signed rank sum test for nonparametric analysis for those not conforming to normal distribution.Results: All the 30 patients were treated and observed strictly according to the experimental protocol.The effective rates at the 2nd,4th and 6th week of treatment were50%(15/30),87%(26/30)and 93.3%(28/30)(P < 0.05),respectively.EASI score decreased from baseline(13.35±8.58)to baseline(1.45±1.31)after 6 weeks of treatment(p < 0.001).The SCORAD score decreased from 42.73±10.67 to 5.85±3.16(p < 0.001).The number of patients with IGA score 0/1 and IGA improvement ≥2 was 93.33%.Among the subjective evaluation indicators of patients,the improvement degree of pruritch and sleep was analyzed,and the results showed that after 6 weeks of treatment,80% of patients improved their P-NRS score ≥4 points;PSQI score decreased from baseline(3.90±1.30)to(1.23±0.43)(P < 0.001).After 6 weeks of sequential treatment with 0.1% tacrolimus ointment and 0.1%mometasone furoate cream,DLQI score,POEM score and HADS score were significantly improved compared with those before treatment,with improvement rates of 84%,89% and71%,respectively.One patient developed folliculitis and received symptomatic treatment with fusidic acid,which improved after 1 week of medication.Pruritus was found in 3patients and skin burning in 1 patient,which was mild and lasted for several minutes and gradually resolved on its own.Conclusion: Sequential therapy of 0.1% tacrolimus cream combined with 0.1%mometasone furoate cream is safe and effective in the treatment of moderate to severe atopic dermatitis in adults.The combination of sequential treatment regiments resulted in effective control of skin lesions and pruritus in the short term,and significant improvement in sleep and quality of life.It can reduce the adverse reactions caused by long-term external use of glucocorticoids and provide an important basis for standardizing the use of external drugs for moderate and severe atopic dermatitis in adults.