Old Drug Becomes An Effective New Treatment For Eczema

Following news earlier in the week that a British Skin Foundation (BSF) funded project in Dundee had achieved a breakthrough in eczema research, another BSF funded study has developed a new way to use a 40-year-old drug which has been found to be effective in the treatment of the commonest form of eczema.

The drug, called azathioprine, was originally developed in the 1960s for kidney transplant patients. A randomised clinical trial at Newcastle University involving 63 adult eczema patients found that by using a novel dosing technique, the drug worked as an eczema treatment in a significant number of cases when compared to a placebo.

Dr Simon Meggitt, a Consultant Dermatologist at the Royal Victoria Infirmary, who conducted the study with Professor Nick Reynolds at Newcastle University, said: "This trial was actually long over-due. Dermatologists had long suspected azathioprine was a useful treatment for atopic eczema, but when we planned the study, no-one had actually done a trial to determine whether or not it worked.

The new dosing technique works by calculating the amount of the drug to give according to how much of a certain enzyme the individual has in their body. Dr Meggitt explained: "What is interesting about azathioprine is that people have a genetically-determined way of eliminating the drug from the body, related to a drug-metabolising enzyme known as TPMT. By tailoring the dosage of the drug dependent upon the level of TPMT in each individual patient, for the first time we were able to minimise the side effects of the treatment, but without compromising its effectiveness."

Matthew Patey, Director of the British Skin Foundation (BSF), the charity that co-funded the research, said: "This is the second really promising breakthrough in eczema research this week – both of which were awarded grants by the British Skin Foundation. This kind of promising development illustrates why at the BSF we are so dedicated to raising funds for research into eczema and related skin disorders that blight so many people's lives. Achieving breakthroughs in the development of cures and treatments for skin disease can only be achieved through high quality research, and we hope to be able to continue funding this kind of valuable work."As many as 20% of children suffer from eczema. The physical and psychological impact that this can have on the sufferer's life cannot be underestimated.

And it isn't just the patients who suffer – the disease also affects their friends and family too. A good example is 18-month-old Josh, who has suffered from eczema for most of his life.

"His itchy and flaky skin keeps him awake and crying every night. His parents can't sleep either because they are desperately trying to ease his symptoms. The emolient creams they use while bathing Josh help, but the grease and mess have ruined his baby clothes and bed linen. This is exactly the kind of case that shows why the work of the BSF is so important in being able to fund vital research that can help eliminate patients' suffering."

"By dosing patients according to the levels of TPMT in their bodies, we didn't run into any major problems with side-effects, but the drug still worked even at a lower doses. So far, no other clinical trials have used TPMT levels in this way to individualise treatment", added Dr Meggitt. "We have shown for the first time that if we can get the dose right, the safety of the drug increases significantly.

"Azathioprine has applications in a number of diseases, including lupus and Crohn's disease, but the advantage of using a skin disease to assess the usefulness of tailored dosing, is that it is very easy to actually see the results, which are more difficult to measure in the case of other internal diseases", said Dr Meggitt.

All of the patients who took part in the three-month trial had previously had a number of different treatments, including ultraviolet radiation therapy. The results of the study showed a reduction in the expected side-effects of the drug, while at the same time maintaining its effectiveness. The study also suggested that the effects of treatment with azathioprine were relatively long-lasting, giving patients several months' reprieve from the symptoms of their condition.

The study was carried out by scientists at Newcastle University and funded by the British Skin Foundation and the Wellcome Trust.

SOURCE: British Skin Foundation