Topical antimicrobial peptide omiganan recovers cutaneous dysbiosis but does not improve clinical symptoms in patients with mild to moderate atopic dermatitis in a phase 2 randomized controlled trial
| Autor: | Florencia, Edwin, Niemeyer-van der Kolk, Tessa, Buters, Thomas P., Krouwels, Lara, Boltjes, Jiry, de Kam, Marieke L, van der Wall, Hein, van Alewijk, DCJG (Dirk), van den Munckhof, EHA, Becker, MJ (Martin), Feiss, Gary, Prens, Errol, Moerland, Matthijs, Burggraaf, Jacobus, Rissmann, Robert, Doorn, Martijn BA van |
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| Přispěvatelé: | Rheumatology, Dermatology |
| Rok vydání: | 2022 |
| Předmět: |
Staphylococcus aureus
medicine.medical_specialty business.industry Dermatology Atopic dermatitis medicine.disease_cause Antimicrobial medicine.disease Dermatitis Atopic law.invention Randomized controlled trial Tolerability law Internal medicine Pharmacodynamics medicine Dysbiosis Humans business Staphylococcus Antimicrobial Peptides Antimicrobial Cationic Peptides Skin |
| Zdroj: | Journal of the American Academy of Dermatology, 86(4), 854-862 Journal of the American Academy of Dermatology, 86(4), 854-862. Mosby Inc. |
| ISSN: | 0190-9622 |
| Popis: | Background: Dysbiosis and colonization with Staphylococcus aureus is considered to play an important role in the pathogenesis of atopic dermatitis (AD). Recovering this dysbiosis may improve AD symptoms. Omiganan is a synthetic indolicidin analogue antimicrobial peptide with activity against S aureus and could be a viable new treatment option for AD.Objective: To explore the tolerability, clinical efficacy, and pharmacodynamics of omiganan in mild to moderate AD.Methods: Eighty patients were randomized to omiganan 1%, 1.75%, or 2.5% or vehicle twice daily for 28 days on all lesions. Weekly visits included clinical scores and microbiological and pharmacodynamic assessments of 1 target lesion.Results: In all omiganan treatment groups, dysbiosis was recovered by reducing Staphylococcus species abundance and increasing diversity. A reduction of cultured S aureus was observed in all omiganan treatment groups, with a significant reduction for omiganan 2.5% compared to vehicle (-93.5%; 95% CI, -99.2 to -28.5%; P = .02). No significant clinical improvement was observed.Conclusion: Topical administration of omiganan twice daily for up to 28 days in patients with mild to moderate AD led to a recovery of dysbiosis but without clinical improvement. Therefore, a monotreatment that selectively targets the microbiome does not appear to be a successful treatment strategy in mild to moderate AD. |
| Databáze: | OpenAIRE |
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