Predictors of the success of proactive therapy with topical tacrolimus in atopic dermatitis patients

<b>BACKGROUND.</b> Topical calcineurin inhibitors (TCIs) are an important anti-inflammatory drug for treating atopic dermatitis (AD). However, those treatment responses are variable. <b>AIMS.</b> To explore biomarkers that predict the success of topical tacrolimus, a typical TCI, application in maintaining remission (proactive therapy) for AD patients. <b>METHODS. </b>31 patients were treated with topical corticosteroids to induce remission (remission induction period) followed by daily tacrolimus ointment application for 4 weeks (maintenance therapy period), and twice-weekly application for 12 weeks (proactive therapy period). Thereafter, we correlated the treatment outcomes and patients’ laboratory findings. <b>RESULTS.</b> At the beginning of maintenance therapy, serum IgE level was significantly higher in 21 patients who completed maintenance therapy (<i>p</i>=0.049). Among them, 8 failed proactive therapy. Disease activity of these patients correlated well with serum <em>lactate dehydrogenase</em> (LDH),<i> </i>Thymus and activation-regulated chemokine (TARC) levels and peripheral eosinophil count. Particularly, mean TARC level of the proactive-dropout group showed an increasing trend even in the remission induction period, suggesting being the most sensitive biomarker.