where are the dead rats?
FYI ping
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When since steroid creams and ointments can cause problems also, I think this is was writen by a lawyer waiting to cash in on a lawsuit.
My name is Mark, and I don't know why doctors don't have this, but I'm telling you they don't;)
"At least 5 million prescriptions have been written for the creams .... At least seven cases of lymphoma have been reported, as well as at least seven cases of skin cancer and a handful of others, Temeck wrote. Several children reported infections..So what do we have here - that is besides the authors obvious hangup with the number seven. If we add allllll the sevens, 'severals' and ' handfuls we get approximately the number 28 - out of FIVE MILLION prescriptions. That result is .0000056%!! Now if that isn't 'safe', I don't know what the heck is.
oops, gotta go, my ear itches - time to apply my Elidel
Bump.
This is hearbreaking.
This was the one concern we Dermatologists had when these two topicals came out. Experience from using Protopic's ingredient, tacrolimlus, orally as well as an older oral drug, cyclosporine, with the same mechanism of action gave us plenty of information on their potential side effects. Orally there were many side effects, but since they were used to prevent organ transplant rejection or for severe auto-immune diseases they were an acceptable risk for those indications. Besides they were often safer and more effective than prior treatments. Most of the side effects resulted from either direct internal effects of the drugs or were secondary to the immunosuppression they produced. As the topicals were shown to have insignificant systemic absorption, with a few rare caveats, the topicals were predicted to be free of those side effects. Time has confirmed that.
Two cancers, specifically squamous cell carcinoma of the skin and lymphomas, were problems with the oral drugs. Both cancers in such cases usually respond to treatment. Lymphomas were thought to be secondary to the immunosuppression and thus probably not a problem with the topicals. SCC is more common in many forms of immunosuppression, so could be similarly explained, but some kind of direct carcinogenic effect in the skin couldn't be ruled out without long term topical experience. Thus the topical's labelling, and we Dermatologists, have been recommending sunblock to patients using lots of these drugs. Until this piece everything I've read says the data so far showed no evidence of a cancer link. SCC and lymphoma are common cancers. Children with eczema are prone to skin infections. Useful denominators, relative risks and consideration of other possible causes in these cases would help determine whether the topicals were at fault. So far I'm underwhelmed. I suspect I'll hear more on this at our national meetings next week.
The FDA dismissal of eczema as "a non-life-threatening disease" and thus by implication as a disease unworthy of accepting any treatment related risk is worthy of contempt. As doubtless many Freepers can recall, bad eczema is a miserable condition that can ruin one's life. It can even ruin a country. Just look at how Marat, confined to his bath to obtain minimal relief from his severe eczema, shared his misery during the French revolution. For that matter eczema used to be a common cause of death via widespread secondary skin infections in the pre-antibiotic era.
Over the past couple years I believe several FDA decisions denying new drugs or restricting old ones have harmed many more Dermatology patients than these two very useful creams. Since they have become available my many eczema patients have been getting under better control and staying under better control compared to the past. Further advances, ideally a cure, are still needed. Further drugs in their class, to bid down their high prices - their real main side effect, would be nice. Generics are at least a decade away. It's hard to see how the proposed FDA actions will reduce costs.