Elidel (pimecrolimus) cream for dermatitis

I was prescribed this medication in May and it was very effective for my eczema. I had it for more than 10 years and it was away in two weeks with the use of this cream. However, I was told not to use long term as it can cause cancer. I had two flares and used only for a day or two and that again cleared it. I'm absolutely over the moon with this. It made a huge improvement in my life.

Has anybody else use this?

Apparently, the ingredient is an immune suppressive, calcineurin inhibitor. It is discovered for organ transplantation. This makes me think again my immune system attacks my own body. I also have Hashimoto's and I have never suffered any form of allergy before I had ME.

 

I used Elidel to treat my psoriasis for years before I got on an anti IL-23 biologic this year. It worked well though not for itching so I had to combine it with a topical steroid sometimes. It significantly improved my patches and made a couple go away but they would always come back within a couple days from the last application, so for years I was constantly managing my psoriasis with continual application of topicals.

My dermatologist said the data showing increased skin cancer risk were from older studies that were eventually refuted by newer longitudinal studies. E.g. https://www.cancertherapyadvisor.co...idel-eczema-cream-cancer-risk/article/399079/

 

Thank you @leokitten, good to know that Elidel is not as risky as I thought.

I've heard about Stelara (anti IL23?) is next stage if the eczema comes back. I hope it doesn't, as this medicine is so expensive.

 

I don't know how one would be able to afford a biologic without insurance, at least in the U.S. Stelara costs $10,000 1st 0.45mg starter injection + $10,000 2nd 0.45mg starter injection 4weeks later + $21,000 each 0.90mg maintenance injection every 12 weeks after.

Stelara (ustekinumab) is a biologic approved only for psoriasis and psoriatic arthritis. I believe that atopic dermatitis (eczema) is driven by different inflammatory cytokines and pathways, so I wonder why a doctor would want to prescribe Stelara for atopic dermatitis.

There are two biologics out (or coming out) for atopic dermatitis:

First Biologic Approved for Moderate to Severe Atopic Dermatitis

Dupixent (dupilumab) is an anti IL-4 and IL-13 (already FDA approved)

A Second Biologic Drug for Atopic Dermatitis Makes Its Way to Market

Nemolizumab is an anti IL-31 (finished phase II trials)

Psoriasis is driven by different cytokines, namely IL-17 and IL-23. The somewhat older drug Stelara targeted the p40 subunits of both IL-12 and IL-23, but because the broad array of important immune activities of IL-12p40, has higher risk of infections, cancer, and adverse effects.

More recently developed biologics all have been targeting IL-17 or IL-23, which is more upstream and relevant to psoriasis. I take Tremfya (guselkumab) which is the newest psoriasis biologic and specifically blocks the p19 subunit of IL-23, so its very targeted and has currently the lowest risk of adverse effects. If I didn't have the biologic paid for Tremfya would cost me $10,000 per injection (so $80,000 first year with two extra starter doses, and $60,000 every year after).

 

@leokitten the dr who prescribed Elidel did not mention Stelera to me. I'm not sure what my diagnosis either. A friend of mine who suffers from a severe skin condition had mentioned Stelara. You seem to be experienced and have detailed information about both condition. I have heard about dupilumab but I'm sure my friend is going to use Stelera so she must have psoriasis.

I have not tested for anything before given Elidel, not so sure about my diagnosis either. I never knew the difference between psoriasis and eczema. Thank you for clarifying this.

 

I went to my records (online) and got my diagnosis; it is atopic dermatitis not psoriasis.