Topical pimecrolimus is less effective for treating eczema than moderate and potent corticosteroids and tacrolimus

Clinical question: 
How effective is topical pimecrolimus for treating eczema?
Bottom line: 
Three weeks’ treatment with topical pimecrolimus was less effective than a moderate (triamcinolone acetonide) and a potent topical corticosteroid (betamethasone valerate). Six weeks’ treatment with pimecromlimus was less effective and caused more participants to ‘drop out’ of treatment due to lack of efficacy than tacrolimus. Pimecrolimus had higher drop out rates and caused more ‘skin burning’ (sensation of warmth) than topical corticosteroids. It caused a similar rate of adverse effects to tacrolimus (3% of participants).
Caveat: 
None of the trials reported on key adverse effects, such as thinning of the skin. The therapeutic role of topical pimecrolimus is uncertain due to the absence of key comparisons with mild corticosteroids.
Context: 
Pimecrolimus was developed as an alternative to topical corticosteroids for treating eczema but it’s efficacy and safety compared with existing treatments remain unclear. It is much more expensive than corticosteroids.
Review CD#: 
CD000550
PEARLS No: 
45
Date: 
February, 2008
Authored by: 
Brian R McAvoy