tacrolimus in psoriasis

Last edited 04/2023 and last reviewed 05/2023

Tacrolimus in psoriasis

Tacrolimus

• is a macrolide calcineurin inhibitor that is produced by Streptomyces tsukubaensis
  • although tacrolimus and ciclosporin inhibit calcineurin leading to suppression of T-cell activation, tacrolimus has been found to have a more potent immunological effect with a diminished vasoconstrictive and fibrinogenic effect (1)

Topical and oral administration of tacrolimus has demonstrated considerable efficacy in the treatment of psoriasis (1)

• with regard to topical tacrolimus therapy, particular utility has been observed in cases of inverse psoriasis and psoriasis affecting the face, genitalia, and nails
  • topical tacrolimus appears to have a role as a corticosteroid-sparing agent and may be associated with fewer side effects than other topical preparations
  • a systematic review stated that ".. studies demonstrated a considerable efficacy of topical administration of tacrolimus and pimecrolimus in the treatment of psoriasis, especially for facial, genital, and intertriginous areas.." (2)

Reference:

• Malecic N, Young H. Tacrolimus for the management of psoriasis: clinical utility and place in therapy. Psoriasis (Auckl). 2016 Dec 7;6:153-163. doi: 10.2147/PTT.S101233. PMID: 29387602; PMCID: PMC5683124.
• Dattola A, Silvestri M, Bennardo L, Del Duca E, Longo C, Bianchi L, Nisticò S. Update of calcineurin inhibitors to treat inverse psoriasis: A systematic review. Dermatol Ther. 2018 Nov;31(6):e12728. doi: 10.1111/dth.12728. Epub 2018 Oct 8. PMID: 30295379.