[Novel therapies in the treatment of atopic dermatitis].

Pol Merkur Lekarski

Department of Histology and Embryology, Medical University of Warsaw, Poland.

Published: December 2021

AI Article Synopsis

  • Atopic dermatitis is a long-term skin condition caused by a mix of genetic and environmental factors that lead to inflammation and eczema-like rashes.
  • New treatments include Dupilumab, the first biologic approved for this condition, along with other promising monoclonal antibodies and JAK inhibitors that show significant improvements in symptoms.
  • Further research is needed to understand these treatments' long-term effects and to better categorize atopic dermatitis subtypes for personalized therapy.

Article Abstract

Atopic dermatitis is a chronic, inflammatory disease characterized by eczematous lesions in typical locations. It is caused by the complex interplay between genetic predisposition, environmental factors and altered skin barrier. A more precise understanding of the pathogenesis of atopic dermatitis revealed novel therapeutic options. Dupilumab, which long-term effectiveness and safety have been proven, is the first biologic available for atopic dermatitis. Other monoclonal antibodies such as nemolizumab, tralokinumab, lebrikizumab and fezakinumab demonstrated statistically significant clinical improvements in phase 2 and 3 trials. Further investigations are needed to evaluate their longterm efficacy. JAK inhibitors such as abrocitinib, baricitinib and upadacitinib showed promising effects in improvement of skin lesions and itch reduction. Beneficial immunomodulatory effect of JAK inhibitors dissipate relatively quickly with cessation of the drug, because as opposed to monoclonal antibodies, they have short half-lives. Thus, during SARS-CoV-2 infection it might be safer to use JAK inhibitors in case of necessity of a rapid immune response. There is a need to differentiate subtypes of atopic dermatitis, based on clinical symptoms and inflammatory mediators to choose an optimal therapeutic option for each patient.

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