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TCI Not Associated With Cancer in Children

Tacrolimus, a topical calcineurin inhibitor, does not appear to increase the risk of cancer among pediatric patients with atopic dermatitis (AD), according to the findings of a recent study.

Using data from APPLES (A Prospective Pediatric Longitudinal Evaluation to Assess the Long-term Safety of Tacrolimus Ointment for the Treatment of AD), the researchers assessed the incidence of malignancies over 10 years among children with AD treated with topical tacrolimus for 6 weeks or more.

The researchers calculated standardized incidence ratios (SIRs) for cancer events compared with sex-, age-, and race-matched controls using data from national cancer registries. A total of 7954 patients enrolled at 314 sites were included in the study.
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Six confirmed cancer cases occurred over 44,629 person-years, the researchers said, with no cases of lymphoma diagnosed.

“This finding provides no support for the hypothesis that topical tacrolimus increases long-term cancer risk in children with AD,” the researchers concluded.


Paller AS, Fölster-Holst R, No Chen SC, et al. Evidence of increased cancer incidence in children using topical tacrolimus for atopic dermatitis [published online April 1, 2020]. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.03.075

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