February
12, 2005
FDA
Considers Warnings for Eczema Creams
~by Rob Stein, Washington Post Staff Writer, page A9
Government
scientists, concerned that two prescription creams used widely for a common
skin condition may increase the risk of certain cancers, especially among
children, will propose adding strong new warnings to the product labels.
A handful of cases of cancer have been reported among adults and children
using the creams, sold under brand names Elidel and Protopic, and animal
and laboratory studies suggest the drugs could be to blame, according
to a new Food and Drug Administration analysis.
"The
evidence raises serious safety concerns in children regarding the potential
for carcinogenicity in humans treated with these agents," wrote Jean Temeck
of the FDA's division of pediatric drug development in a recommendation
posted late yesterday on the agency's Web site. The
document was one of several posted in preparation for a meeting of an
expert panel next week to assess the safety of the creams and recommend
what action the agency should take. Protopic
and Elidel were approved in 2000 and 2001, respectively, to treat eczema,
a common, chronic skin condition that causes redness and itching. Before
the new creams, the only treatment had been steroid creams and ointments,
which can be used only for short periods and can have a variety of side
effects.
The
new creams, which were seen as effective and much safer, immediately became
popular. At least 5 million prescriptions have been written for the creams.
The creams were approved for short-term or intermittent use by adults
and children age 2 and older, but Novartis Pharmaceuticals Corp. has marketed
Elidel aggressively, and both creams are believed to be widely used for
longer periods and among babies. "These products are being
widely used to treat . . . a non-life-threatening disease, and heavily
advertised for use in young children without appreciation . . . regarding
the potential for carcinogenic risk," Temeck wrote. Both Novartis
and Fujisawa Healthcare Inc., which makes Protopic, defended the safety
of their products to the FDA. "Elidel is an effective, steroid-free
treatment for mild to moderate eczema and has a well-established safety
profile," Novartis spokesman Tom Jones added in an e-mail.
Because
the drugs work by suppressing the immune system, scientists had been concerned
that they could increase the risk of cancer. As a result, when the FDA
approved the creams the agency required both companies to monitor whether
any cancers were reported among users.
In
2003, the agency convened an expert panel to examine the evidence to date,
but at that time only seven possible cases had been reported, so the agency
decided to continue to monitor the situation.
Since
then, however, a study involving monkeys has suggested the creams might
cause lymphoma, a cancer of the immune system, and reports of a variety
of cancers in humans using the creams have continued to rise.
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, including an 8-month-old boy whose infection
was so severe he suffered a heart attack after Protopic was applied "over
his entire body for six months," she wrote.
While
it remains far from proven that the creams are causing the complications,
"there is a need for a stronger approach to the communication and minimization
of the potential risk of cancer," Dianne Murphy, director of the FDA's
office of pediatric therapeutics, wrote in another document.
"We
believe regulatory action is needed at this time since a definitive answer
to the carcinogenic risk of these products will not be known for years,"
Temeck wrote.
The
addition of a possible "black box" warning to the label is one of several
recommendations that the committee will consider, an agency spokesman
said. The concern comes as the FDA has come under intense criticism for
failing to protect the public from potentially dangerous drugs. The blockbuster
painkiller Vioxx was recently pulled from the market because of concerns
that it and similar agents may increase the risk of heart attacks and
strokes. The advisory committee will focus on children because exposure
to a potential cancer-causing agent poses a greater risk to the young,
but its recommendations would apply to adults as well, the spokesman said. Although
the FDA is not bound to follow the recommendations of its advisory panels,
it usually does.
~for
a safe alternative to prescription cremes that could cause cancer, try
Eczema Body Heal . Made by
Moon Valley, this 100% natural & wildcrafted topical ointment is specially
formulated to promote the healing of eczema by effectively soothing and
nourishing dry, weeping skin, as well as minimizing new outbreaks.