The evolving atopic dermatitis management landscape

Expert Opin Pharmacother. 2022 Mar;23(4):517-526. doi: 10.1080/14656566.2021.1999412. Epub 2021 Nov 10.

Abstract

Introduction: Atopic dermatitis is a common dermatologic condition that affects millions of people worldwide, and a standardized approach to treatment was published by the American Academy of Dermatology (AAD) in 2013-14. Since 2014, new FDA-approved treatment options such as dupilumab and crisaborole have changed the landscape of AD management, and future therapies such as JAK inhibitors and anti-interleukin 13 and 31 antibodies appear effective, emphasizing the need for a comprehensive review to give clinicians an updated toolbox to aid in pharmacologic management.

Areas covered: In this review, the authors explore the updated efficacy and safety data on established therapeutic options for AD including topical corticosteroids, topical calcineurin inhibitors, cyclosporine, azathioprine, methotrexate, and mycophenolate mofetil. In addition, the authors also explore trial data and studies on dupilumab, crisaborole, omalizumab, tofacitinib, ruxolinitib, abrocitinib, baricitinib, upadacitinib, delgocitinib, nemoliuzumab, and tralokinumab.

Expert opinion: The AAD guidelines must be updated in the future to include several new treatment modalities that have revolutionized the pharmacologic management of patients with AD, including dupilumab and crisaborole. The future of AD treatment is also extremely bright, as JAK inhibitors and Il-13/31 antibodies have shown convincing results in the improvement of AD patients' lives in various trials and studies that have been examined in this paper.

Keywords: AAD guidelines; Atopic dermatitis; JAK inhibitor; crisaborole; dupilumab; eczema; omalizumab; pharmacotherapy; treatment; update.

Publication types

  • Review

MeSH terms

  • Cyclosporine / therapeutic use
  • Dermatitis, Atopic* / drug therapy
  • Dermatologic Agents* / therapeutic use
  • Eczema* / drug therapy
  • Humans
  • Janus Kinase Inhibitors* / therapeutic use

Substances

  • Dermatologic Agents
  • Janus Kinase Inhibitors
  • Cyclosporine