Emerging Treatment Options in Atopic Dermatitis: Systemic Therapies

Dermatology. 2017;233(5):344-357. doi: 10.1159/000484406. Epub 2018 Jan 11.

Abstract

The pathogenesis of atopic dermatitis (AD) is multifactorial and intricate, and the clinical presentation of the condition varies greatly. Symptoms and severity depend on individual trigger factors and stage of the disease. The majority of AD patients are sufficiently treated with emollients in combination with existing topical or systemic therapies. Yet treatment failure with existing drugs and treatment options can be a significant clinical problem. New treatments are under development, and the majority of these new drugs focus on targeting a skewed immune response in AD. Novel therapeutic approaches, which target the pathways involved in the pathogenesis of AD, may provide a potentially more effective and less harmful approach to systemic therapy. These pharmaceutical agents are designed to narrowly modify or directly block a specific cellular signal or pro-inflammatory pathway. We review systemic drugs in the pipeline for AD. To make the review as current and pertinent as possible, we selected to focus on AD-related therapies available in the clinicaltrials.gov database with a first received date after January 1, 2014, up until May 31, 2017. We excluded therapies that could be categorized as either traditional Chinese medicine, herbal medicine, probiotics, histamine/leukotriene blockers, immuno-adsorption, or immunostimulants.

Keywords: Anti-IgE therapy; Apremilast; Atopic dermatitis; Baricitinib; Dupilumab; Janus kinase inhibitors; Lebrikizumab; Nemolizumab; OX40 ligand antagonist; Phosphodiesterase-4 inhibitors; SH2-containing inositol-5′-phosphatase 1 activators; Systemic treatment; Tezepelumab; Tofacitinib; Tralokinumab; Ustekinumab.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Dermatitis, Atopic / drug therapy*
  • Dermatitis, Atopic / immunology
  • Disease Management*
  • Humans
  • Immunologic Factors / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Immunologic Factors