14 Aug Atopic Dermatitis: No Link Found Between Topical Calcineurin Inhibitor Use and Non-Melanoma Skin Cancer

MedicalResearch.com Interview with:

Dr. Asgari

Maryam M. Asgari, MD MPH
Professor
Department of Dermatology, Massachusetts General Hospital
Department of Population Medicine, Harvard Medical School

MedicalResearch.com: What is the background for this study? What are Topical Calcineurin Inhibitors used for? 

Response: Topical calcineurin inhibitors (TCIs) are FDA approved for the treatment of atopic dermatitis (though they are used off-label to treat a wide range of inflammatory conditions of the skin, including psoriasis, seborrheic dermatitis, and contact dermatitis).  There are currently two drugs available – tacrolimus and pimecrolimus – both of which carry a black box label warning users about the potential for increased skin cancer risk.  The risk associated with keratinocyte carcinoma, the most common cancer (defined as basal cell carcinoma and squamous cell carcinoma), remains poorly defined because findings from large-scale post-marketing surveillance studies are lacking. 

MedicalResearch.com: What are the main findings? 

Response: In this large cohort study of 93,746 adults in an integrated healthcare delivery system diagnosed with atopic dermatitis, there was no increased risk of keratinocyte carcinoma overall, or by subtype (basal cell carcinoma or squamous cell carcinoma) among topical calcineurin inhibitors -exposed patients as compared to topical corticosteroid-exposed patients or patients unexposed to topical calcineurin inhibitors or topical corticosteroids.

MedicalResearch.com: What should readers take away from your report?

Response: Our findings provide some reassurance about the safety profile of topical calcineurin inhibitors with respect to keratinocyte carcinoma risk among adult patients with atopic dermatitis.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Our study focused on risk of keratinocyte carcinoma, the most common form of skin cancer, and found no associated increased risk with exposure. Future studies that examine other forms of skin cancer, such as melanoma or cutaneous T-cell lymphoma, could be future research directions.

Disclosures: This study was funded by Valeant Pharmaceuticals (sponsor).  The sponsor provided feedback in study design and protocol development, but had no role in the conduct of the study including collection, management, analysis, and interpretation of the data or preparation of the findings.  The sponsor reviewed and approved the manuscript and supported the decision to submit the manuscript for publication. 

Citation:

Asgari MM, Tsai A, Avalos L, Sokil M, Quesenberry CP. Association Between Topical Calcineurin Inhibitor Use and Keratinocyte Carcinoma Risk Among Adults With Atopic Dermatitis. JAMA Dermatol. Published online August 12, 2020. doi:10.1001/jamadermatol.2020.2240

https://jamanetwork.com/journals/jamadermatology/article-abstract/2768937

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Last Updated on August 14, 2020 by Marie Benz MD FAAD