Skip to main content
SpringerLink
Log in

Calcineurininhibitoren zur topischen Therapie der Psoriasis

Calcineurin inhibitors for topical therapy in psoriasis

  • Leitthema
  • Published:
Der Hautarzt Aims and scope Submit manuscript

Zusammenfassung

Die spezifische antientzündliche Therapie der Psoriasis bietet vielfältige Möglichkeiten. Eine Option ergibt sich aus der Anwendung von Calcineurininhibitoren. Bisher ist lediglich die systemische Applikation von Ciclosporin A für diese Indikation zugelassen. Grundsätzlich sind aber Ciclosporin A, Tacrolimus und Pimecrolimus als wirksame antiinflammatorische Substanzen zur Therapie der Psoriasis einzustufen. Leider sind die verfügbaren galenischen Systeme für eine topische Anwendung der genannten Wirkstoffe nicht oder nur sehr bedingt geeignet, um eine ausreichende lokale Bioverfügbarkeit der jeweiligen Wirksubstanzen im Zielkompartiment zu gewährleisten. Lediglich unter Nutzung zusätzlicher penetrationsfördernder Maßnahmen bzw. penetrationserleichternder Bedingungen ist eine klinische Wirksamkeit der Präparate nachweisbar. Weiterführende galenische Konzepte lassen einen größeren Stellenwert der Substanzgruppe bei der topischen Therapie der Psoriasis erwarten.

Abstract

There are numerous possibilities for specific antiinflammatory therapy of psoriasis. One option is the use of calcineurin inhibitors. To date, only systemic administration of cyclosporine A is approved for this indication. Nonetheless cyclosporine A, tacrolimus and pimecrolimus can all be classed as effective anti-inflammatory agents for the therapy of psoriasis. Unfortunately, the vehicles currently available do not insure adequate topical delivery of these substances. Clinical efficacy of the preparations can be proven only when additional penetration-promoting measures are used or penetration-facilitating conditions exist. The entire group can be expected to play a greater role in the topical therapy of psoriasis if advances in vehicles and delivery systems are made.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Amichai B (2004) Psoriasis of the glans penis in a child successfully treated with Elidel (pimecrolimus) cream. J Eur Acad Dermatol Venereol 18: 742–743

    Article  PubMed  Google Scholar 

  2. Bigby M (2005) Pimecrolimus and tacrolimus for the treatment of intertriginous and facial psoriasis: are they effective? Arch Dermatol 141: 1152–1153

    Article  PubMed  Google Scholar 

  3. Billich A, Vyplel H, Grassberger M et al. (2005) Novel cyclosporin derivates featuring enhanced skin penetration despite increased molecular weight. Bioorg Med Chem 13: 3157–3167

    Article  PubMed  Google Scholar 

  4. Bousema MT, Tank B, Heule F et al. (1990) Placebo-controlled study of psoriasis patients treated topically with a 10% cyclosporine gel. J Am Acad Dermatol 22:126–127

    PubMed  Google Scholar 

  5. bu-Elmagd K, van TD, Jegasothy BV, Ackerman CD et al. (1991) FK 506: a new therapeutic agent for severe recalcitrant psoriasis. Transplant Proc 23: 3322–3324

    PubMed  Google Scholar 

  6. Choi HK, Flynn GL, Amidon GL (1995) Percutaneous absorption and dermal delivery of cyclosporin A. J Pharm Sci 84: 581–583

    PubMed  Google Scholar 

  7. Erdogan M, Wright JR Jr, McAlister VC (2002) Liposomal tacrolimus lotion as a novel topical agent for treatment of immune-mediated skin disorders: experimental studies in a murine model. Br J Dermatol 146: 964–967

    Article  PubMed  Google Scholar 

  8. Freeman AK, Linowski GJ, Brady C et al. (2003) Tacrolimus ointment for the treatment of psoriasis on the face and intertriginous areas. J Am Acad Dermatol 48: 564–568

    Article  PubMed  Google Scholar 

  9. Gottlieb AB, Griffiths CE, Ho VC et al. (2005) Oral pimecrolimus in the treatment of moderate to severe chronic plaque-type psoriasis: a double-blind, multicentre, randomized, dose-finding trial. Br J Dermatol 152: 1219–1227

    Article  PubMed  Google Scholar 

  10. Grassberger M, Steinhoff M, Schneider D, Luger TA (2004) Pimecrolimus – an anti-inflammatory drug targeting the skin. Exp Dermatol 13: 721–730

    Article  PubMed  Google Scholar 

  11. Gribetz C, Ling M, Lebwohl M et al. (2004) Pimecrolimus cream 1% in the treatment of intertriginous psoriasis: a double-blind, randomized study. J Am Acad Dermatol 51: 731–738

    Article  PubMed  Google Scholar 

  12. Griffiths CE, Powles AV, Baker BS et al. (1987) Topical cyclosporin and psoriasis. Lancet 1: 806

    Article  Google Scholar 

  13. Gupta AK, Chow M (2003) Pimecrolimus: a review. J Eur Acad Dermatol Venereol 17: 493–503

    Article  PubMed  Google Scholar 

  14. Gupta AK, Fisher GJ, Elder JT et al. (1989) Topical cyclosporine A inhibits the phorbol ester induced hyperplastic inflammatory response but not protein kinase C activation in mouse epidermis. J Invest Dermatol 93: 379–386

    Article  PubMed  Google Scholar 

  15. Hermann RC, Taylor RS, Ellis CN et al. (1988) Topical ciclosporin for psoriasis: in vitro skin penetration and clinical study. Skin Pharmacol 1: 246–249

    PubMed  Google Scholar 

  16. Jahn K (2002) Moderne galenische Zubereitungen zur dermalen Anwendung von Ciclosporin A und Mycophenolatmofetil. Shaker, Aachen

  17. Kroft EB, Erceg A, Maimets K et al. (2005) Tacrolimus ointment for the treatment of severe facial plaque psoriasis. J Eur Acad Dermatol Venereol 19: 249–251

    Article  PubMed  Google Scholar 

  18. Lebwohl M, Freeman A, Chapman MS et al. (2005) Proven efficacy of tacrolimus for facial and intertriginous psoriasis. Arch Dermatol 141: 1154

    Article  PubMed  Google Scholar 

  19. Lebwohl M, Freeman AK, Chapman MS et al. (2004) Tacrolimus ointment is effective for facial and intertriginous psoriasis. J Am Acad Dermatol 51: 723–730

    Article  PubMed  Google Scholar 

  20. Liu H, Li S, Wang Y et al. (2006) Effect of vehicles and enhancers on the topical delivery of cyclosporin A. Int J Pharm 311: 182–186

    Article  PubMed  Google Scholar 

  21. Mansouri P, Farshi S (2006) Pimecrolimus 1 percent cream in the treatment of psoriasis in a child. Dermatol Online J 12: 7

    Google Scholar 

  22. Marsland AM, Griffiths CE (2002) The macrolide immunosuppressants in dermatology: mechanisms of action. Eur J Dermatol 12: 618–622

    PubMed  Google Scholar 

  23. Mrowietz U, Graeber M, Brautigam M et al. (1998) The novel ascomycin derivative SDZ ASM 981 is effective for psoriasis when used topically under occlusion. Br J Dermatol 139: 992–996

    Article  PubMed  Google Scholar 

  24. Mrowietz U, Wustlich S, Hoexter G et al. (2003) An experimental ointment formulation of pimecrolimus is effective in psoriasis without occlusion. Acta Derm Venereol 83: 351–353

    Article  PubMed  Google Scholar 

  25. Ortonne JP, van de Kerkhof PC, Prinz JC et al. (2006) 0.3% Tacrolimus gel and 0.5% Tacrolimus cream show efficacy in mild to moderate plaque psoriasis: results of a randomized, open-label, observer-blinded study. Acta Derm Venereol 86: 29–33

    PubMed  Google Scholar 

  26. Pharmazeutisches Laboratorium des „Neuen Rezeptur-Formularium“ (2004) Standardisierte Rezepturen. Govi, Eschborn

  27. Rallis E, Nasiopoulou A, Kouskoukis C et al. (2005) Successful treatment of genital and facial psoriasis with tacrolimus ointment 0.1%. Drugs Exp Clin Res 31: 141–145

    PubMed  Google Scholar 

  28. Rappersberger K, Komar M, Ebelin ME et al. (2002) Pimecrolimus identifies a common genomic anti-inflammatory profile, is clinically highly effective in psoriasis and is well tolerated. J Invest Dermatol 119: 876–887

    Article  PubMed  Google Scholar 

  29. Scheinfeld N (2004) The use of topical tacrolimus and pimecrolimus to treat psoriasis: a review. Dermatol Online J 10: 3

    Google Scholar 

  30. Schulze HJ, Mahrle G, Steigleder GK (1990) Topical cyclosporin A in psoriasis. Br J Dermatol 122: 113–114

    PubMed  Google Scholar 

  31. Steele JA, Choi C, Kwong PC (2005) Topical tacrolimus in the treatment of inverse psoriasis in children. J Am Acad Dermatol 53: 713–716

    Article  PubMed  Google Scholar 

  32. The European FK 506 Multicentre Psoriasis Study Group (1996) Systemic tacrolimus (FK 506) is effective for the treatment of psoriasis in a double-blind, placebo-controlled study. Arch Dermatol 132: 419–423

    Article  PubMed  Google Scholar 

  33. Tosti A, Guerra L, Bardazzi F, Lanzarini M (1990) Topical ciclosporin in nail psoriasis. Dermatologica 180: 110

    Google Scholar 

  34. Wolff K (2004) Current concepts and review of pimecrolimus in the treatment of psoriasis. Dermatol Clin 22: 461–465

    PubMed  Google Scholar 

  35. Yamamoto T, Nishioka K (2000) Topical tacrolimus is effective for facial lesions of psoriasis. Acta Derm Venereol 80: 451

    PubMed  Google Scholar 

  36. Yocum DE (1996) Cyclosporine, FK-506, rapamycin, and other immunomodulators. Rheum Dis Clin North Am 22: 133–154

    Article  PubMed  Google Scholar 

  37. Zonneveld IM, Rubins A, Jablonska S et al. (1998) Topical tacrolimus is not effective in chronic plaque psoriasis. A pilot study. Arch Dermatol 134: 1101–1102

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der Autor hat als Prüfarzt an klinischen Studien mit den genannten Präparaten und Wirkstoffen teilgenommen und war als Projektleiter in klinisch-experimentellen Untersuchungen tätig, die von den betroffenen Firmen in Auftrag gegeben und bezahlt wurden.

Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

Author information

Authors and Affiliations

  1. Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Institut für angewandte Dermatopharmazie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Kromayer-Straße 5, 06097 , Halle

    J. Wohlrab

Authors
  1. J. Wohlrab
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Wohlrab.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wohlrab, J. Calcineurininhibitoren zur topischen Therapie der Psoriasis. Hautarzt 57, 685–689 (2006). https://doi.org/10.1007/s00105-006-1185-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-006-1185-9

Schlüsselwörter

Keywords

Search

Navigation