Features - Forty year old drug offers hope for eczema sufferers

Scientists at Newcastle University have developed a new and safe way to use a 40-year-old drug which has been found to be effective in the treatment of the commonest form of eczema.

A randomised clinical trial involving 63 adult patients with atopic eczema, and published in the current edition of the Lancet (published 11 March) found that the drug, azathioprine, developed in the 1960s for kidney transplant patients, worked in a significant number of cases when compared to a placebo. The study was carried out by scientists at Newcastle University and funded by the British Skin Foundation and the Wellcome Trust.

Young mother Lindsay Dodds, of Blakelaw, Newcastle, was among those who took part in the clinical trials of azathioprine. She said: 'My eczema disappeared within a couple of months. It was the first time I have been clear of eczema since I was a child.' Lindsay, who has a four-and-a-half month old son, stopped taking eczema drugs during pregnancy and is now on different medication.

Dr Simon Meggitt, a Consultant Dermatologist at the Royal Victoria Infirmary in Newcastle, 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'.

Atopic eczema affects about 10 to 15 per cent of people in childhood, and around one third carry the symptoms into adulthood. Eczema can have a large impact on quality of life, especially when eczema fails to respond to strong steroid creams, at which point there is no one established alternative treatment.

Matthew Patey, Director of the British Skin Foundation, the charity that funded the research, said: 'This kind of promising development illustrates why at the British Skin Foundation 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.'

Dr Meggitt continued: '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'.

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.

'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.

Page Created: 28 March 2006