Expert consensus on the systemic treatment of atopic dermatitis in special populations.

J Eur Acad Dermatol Venereol

Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Published: June 2023

AI Article Synopsis

  • There is a growing number of treatment options for moderate-to-severe atopic dermatitis, prompting the need for clear guidance on how to choose the right systemic agent for different patient groups.
  • An expert panel, consisting of 12 members, conducted a thorough literature review focusing on six key clinical scenarios: asthma, eye conditions, cancer history, infections, pregnancy/lactation, and elderly patients.
  • The panel analyzed three categories of systemic treatments—traditional systemics, Janus kinase inhibitors, and biologics—resulting in 25 expert consensus statements to help clinicians make informed treatment decisions.

Article Abstract

With the increasing number of options for the treatment of moderate-to-severe atopic dermatitis, clinicians need guidance on a practical approach to selecting a systemic agent for specific patient populations. We convened an expert panel consisting of 12 members to conduct a literature review and summarize relevant data related to six scenarios of clinical interest: comorbid asthma, ocular surface disease, history of cancer, past and ongoing infections of interest (including herpes simplex virus, herpes zoster, hepatitis B, and tuberculosis), pregnancy and lactation, and the elderly. We performed a literature search and examined each clinical scenario with respect to three major categories of available systemic agents: traditional systemics (azathioprine, cyclosporine A, methotrexate, and mycophenolate mofetil), Janus kinase inhibitors (abrocitinib, baricitinib, and upadacitinib), and biologics (dupilumab, lebrikizumab, and tralokinumab). The expert panel and steering committee met virtually to review the data and discuss the drafted consensus statements. A modified Delphi process was used to arrive at a set of final consensus statements related to the systemic treatment of AD in these specific patient populations. To provide practical guidance on the choice of systemic therapy for atopic dermatitis in these six topics of clinical interest, 25 expert consensus statements and a summary of the supporting data are presented herein.

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Source
http://dx.doi.org/10.1111/jdv.18922DOI Listing

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