A study on the knowledge, attitudes, and practices of Asian dermatologists in the management of atopic dermatitis

Chan, Yuin‐Chew; Tay, Yong–Kwang; Sugito, Titi Lestari; Boediardja, Siti Aisah; Chau, Duong-Dinh; Nguyen, Khac-Vien; Yee, Kim-Chye; Alias, Mardziah; Hussein, Suraiya H.; Dizon, Ma Victoria; Roa, Francisca; Chan, Yiong‐Huak; Wananukul, Siriwan; Kullavanijaya, Preya; Singalavanija, Srisupalak; Cheong, Wai-Kwong

doi:10.4103/ds.ds_31_19

Cited by 12 publications

(3 citation statements)

References 18 publications

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“…Atopic dermatitis (AD) is a prevalent inflammatory dermatosis with increasing worldwide prevalence . Symptoms, such as relapsing pruritus and visible lesions, may last for a few years and even persist throughout life, necessitating effective treatments . Janus kinase (JAK) inhibitors have become a promising treatment option for patients with AD because they have been associated with favorable clinical outcomes in clinical trials …”

Section: Introductionmentioning

confidence: 99%

“…1,2 Symptoms, such as relapsing pruritus and visible lesions, may last for a few years and even persist throughout life, necessitating effective treatments. 3,4 Janus kinase (JAK) inhibitors have become a promising treatment option for patients with AD because they have been associated with favorable clinical outcomes in clinical trials. 5 Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a potentially life-threatening illness associated with high recurrence rates and mortality.…”

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confidence: 99%

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Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors

et al. 2022

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ImportanceThe risk of venous thromboembolism (VTE) among patients with atopic dermatitis (AD), especially when receiving treatment with Janus kinase (JAK) inhibitors, is unclear.ObjectiveTo determine the association of AD with incident VTE and evaluate the risk of incident VTE among patients with AD who were receiving treatment with JAK inhibitors.Data SourcesThe MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched with no restrictions on language nor geographic locations from their respective inception to February 5, 2022.Study SelectionCohort studies examining the association of AD with incident VTE and randomized clinical trials (RCTs) reporting VTE events in participants with AD receiving JAK inhibitors were included. Around 0.7% of initially identified articles met the selection criteria.Data Extraction and SynthesisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The risk of bias of included cohort studies and RCTs was assessed by the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool 2, respectively. A random-effects model meta-analysis was conducted to calculate the pooled hazard ratio (HR) and risk difference for incident VTE.Main Outcomes and MeasuresThe HRs for incident VTE associated with AD and risk difference for incident VTE between participants with AD who were receiving treatment with JAK inhibitors and controls receiving placebo or dupilumab.ResultsTwo cohort studies and 15 RCTs with a total of 466 993 participants were included. The meta-analysis found no significant association of AD with incident VTE (HR, 0.95; 95% CI 0.62-1.45; incidence rate of VTE, 0.23 events/100 patient-years). Overall, 3 of 5722 patients with AD (0.05%) who were receiving treatment with JAK inhibitors experienced VTE compared with 1 of 3065 patients with AD (0.03%) receiving placebo or dupilumab (Mantel-Haenszel risk difference, 0; 95% CI, 0-0). The incidence rate of VTE was 0.15 and 0.12 events per 100 patient-years in participants with AD receiving JAK inhibitors and placebo, respectively. The findings were similar in 4 unique JAK inhibitors (abrocitinib, baricitinib, upadacitinib, and SHR0302).Conclusions and RelevanceThe results of this systematic review and meta-analysis suggest that the currently available evidence does not detect an increased risk of VTE associated with AD or treatment with JAK inhibitors. These findings may provide a reference for clinicians in prescribing JAK inhibitors for patients with AD.

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Section: Introductionmentioning

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Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors

et al. 2022

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“…Long-term inflammation could result in lichenification and has been linked to frequent cutaneous infection, particularly Staphylococcus aureus colonization ( 5 , 6 ). AD affects up to 20% of children, especially in families with atopic history, and it affects 10% of adults, although the rate varies by region ( 7 – 9 ). The interaction between genetic, environmental, and immunological factors was implicated in the pathogenesis of AD ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

JAK–STAT signaling pathway in the pathogenesis of atopic dermatitis: An updated review

Huang

Hung

et al. 2022

Front. Immunol.

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Atopic dermatitis (AD) is a chronic, inflammatory, pruritic form of dermatosis with heterogeneous manifestations that can substantially affect patients' quality of life. AD has a complex pathogenesis, making treatment challenging for dermatologists. The Janus kinase (JAK)–signal transducer and activator of transcription (STAT) pathway plays a central role in modulating multiple immune axes involved in the immunopathogenesis of AD. In particular, Th2 cytokines, including interleukin (IL)-4, IL-5, IL-13, IL-31, and thymic stromal lymphopoietin, which contribute to the symptoms of chronic inflammation and pruritus in AD, are mediated by JAK–STAT signal transduction. Furthermore, JAK–STAT is involved in the regulation of the epidermal barrier and the modulation of peripheral nerves related to the transduction of pruritus. Targeting the JAK–STAT pathway may attenuate these signals and show clinical efficacy through the suppression of various immune pathways associated with AD. Topical and oral JAK inhibitors with variable selectivity have emerged as promising therapeutic options for AD. Notably, topical ruxolitinib, oral upadacitinib, and oral abrocitinib were approved by the U.S. Food and Drug Administration for treating patients with AD. Accordingly, the present study reviewed the role of JAK–STAT pathways in the pathogenesis of AD and explored updated applications of JAK inhibitors in treating AD.

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Epidemiology, Diagnosis, and Treatment of Atopic Dermatitis in the Developing Countries of Asia, Africa, Latin America, and the Middle East: A Review

Carrera¹,

Hammadi

Huang

et al. 2019

Dermatol Ther (Heidelb)

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Atopic dermatitis (AD), the leading cause of skin-related burden of disease worldwide, is increasing in prevalence in developing countries of Asia, Africa, Latin America, and the Middle East. Although AD presents similarly across racial and ethnic groups as chronic and relapsing pruritic eczematous lesions, some features of the disease may be more or less prominent in patients with darker skin. Despite a similar presentation, consistent diagnostic criteria and consistent treatment guidelines are lacking. Because of these and other challenges, adherence to treatment guidelines is difficult or impossible. Previous studies have stated that many patients with AD receive ineffective or inappropriate care, such as oral antihistamines, oral corticosteroids, or traditional medicines, if they are treated at all; one study showed that approximately one-third of patients received medical care for their dermatologic condition; of those, almost three-quarters received inappropriate or ineffective treatment. In addition, other challenges endemic to developing countries include cost, access to care, and lack of specialists in AD. Furthermore, most of the available diagnostic criteria and treatment guidelines are based on European and North American populations and few clinical trials report the racial or ethnic makeup of the study population. Drug pharmacokinetics in varying ethnicities and adverse effects in different skin physiologies are areas yet to be explored. The objective of this review is to describe the diagnosis, treatment, and management of AD in developing countries in Asia, Africa, Latin America, and the Middle East; to discuss the differences among the countries; and to establish the unmet needs of patients with AD in them. The unmet medical need for treatment of AD in developing countries can be addressed by continuing to train medical specialists, improve Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9918782.

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A study on the knowledge, attitudes, and practices of Asian dermatologists in the management of atopic dermatitis

Cited by 12 publications

References 18 publications

Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors

Association of Risk of Incident Venous Thromboembolism With Atopic Dermatitis and Treatment With Janus Kinase Inhibitors

JAK–STAT signaling pathway in the pathogenesis of atopic dermatitis: An updated review

Epidemiology, Diagnosis, and Treatment of Atopic Dermatitis in the Developing Countries of Asia, Africa, Latin America, and the Middle East: A Review

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