Consensus Update for Systemic Treatment of Atopic Dermatitis

Lee, Ji Hyun; Kim, Jung Eun; Park, Gyeong-Hun; Bae, Jung Min; Byun, Ji Yeon; Shin, Min Kyung; Han, Tae Young; Hong, Seung‐Phil; Jang, Yong Hyun; Kim, Hye One; Na, Chan Ho; Lew, Bark‐Lynn; Ahn, Jong Woong; Park, Chang Ook; Seo, Young‐Joon; Lee, Yang Won; Son, Sang Wook; Choi, Eung Ho; Park, Young Lip; Roh, Joo Young

doi:10.5021/ad.2021.33.6.497

Cited by 24 publications

(33 citation statements)

References 134 publications

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“…Other immune suppressors which can be used are as follows: azathioprine (selective use; it is considered to be a second-line medication for adults, after cyclosporine, having the risk of bone marrow suppression), methotrexate (selective use, having similar efficacy to azathioprine; it is considered a second-line treatment in pediatric and adult cases of moderate-to severe AD, after cyclosporine), mycophenolate mofetil (it has low recommendation evidence levels; prolonged treatment presents the risk of herpes infection). 12 , 14 Dupilumab, an anti–IL-4–receptor α mono-clonal antibody which is approved by both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for use in moderate-to-severe cases of AD in adolescents and adults, has the capacity to bind to the shared α-chain receptor of both IL-4 and IL-13, having a partial limiting effect on the inflammation driven by the Th2 activity. 11–13 Thus being said, although many patients benefitted from it (with total response and/or no side effects), it might have limited use because not all patients respond to this treatment, they can present a partial response to it, they can develop tolerance or might not even want it due to its administering pathway (subcutaneous injections); it also determines injection site adverse reactions, neck and/or face erythema, conjunctivitis.…”

Section: Resultsmentioning

confidence: 99%

Once-Daily Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults and Adolescents Aged 12 Years and Over: A Short Review of Current Clinical Perspectives

Niculeț¹,

Bobeică²,

Ștefanopol³

et al. 2022

TCRM

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Atopic dermatitis (AD) is a chronic inflammatory skin disorder with high prevalence and a complex pathophysiology. This relapsing and remitting skin disorder has many negative consequences on the patient’s quality of life and that of his family. Until now, moderate-to-severe AD treatment was a symptomatic one, using skin emollients, topical corticosteroids, phototherapy, antihistamines and systemic drugs – immune suppressants and other systemic treatments (dupilumab). Starting from 2021, abrocitinib, a Janus kinase-1 inhibitor, was approved for the treatment of moderate-to-severe cases of AD in Europe, in adults. Multiple phase three studies (JADE MONO-1 [NCT03349060]; JADE MONO-2 [NCT03575871]; JADE TEEN [NCT03796676]; JADE COMPARE; GOODERHAM; JADE EXTEND) have yielded positive results in adults and adolescents suffering from this disease, with efficacy, a good tolerance, safe profile, and with generally mild side effects. The positive results were obtained even starting from the first stages of the oral drug administration. The low frequency of side effects and the advantage of having an orally administered medication makes abrocitinib an important additional tool for the treatment of moderate-to-severe forms of AD.

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Section: Resultsmentioning

confidence: 99%

Once-Daily Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults and Adolescents Aged 12 Years and Over: A Short Review of Current Clinical Perspectives

Niculeț¹,

Bobeică²,

Ștefanopol³

et al. 2022

TCRM

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“…The most notable change in guidelines for the treatment of AD in South Korea is the recommendation of dupilumab as an important treatment option for patients with moderate-to-severe AD 29 , 30 . Likewise, a recent study based on German AD registry reported dupilumab to be the leading treatment among the patients with moderate-to-severe AD 31 .…”

Section: Discussionmentioning

confidence: 99%

Real-world treatment patterns for atopic dermatitis in South Korea

Lee

Choi

Noh

et al. 2022

Sci Rep

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The phenotypes of atopic dermatitis (AD) are diverse, and ethnic differences have been suggested. To date, few studies have explored large-scale national data on the treatment patterns of AD in Asians. Therefore, we aimed to examine real-world treatment patterns for AD, including the probability of discontinuation of AD treatment and restart after discontinuation. A retrospective observational study was conducted using the nationwide healthcare database in South Korea between January 1, 2016 to July 31, 2020. We identified 944,559 pediatric patients and 1,066,453 adults with AD. Topical corticosteroids and antihistamines were the most commonly prescribed medications in all age groups. The frequency of topical corticosteroid prescription decreased as the age increased. Although immunosuppressive drugs were not widely used in both children and adults, cyclosporine was the most frequently prescribed immunosuppressant, particularly among those aged 12 years or more (1–2%). Pediatric patients were more likely to discontinue treatment than adult patients. Treatment restart for moderate-to-severe AD was earlier than that for overall AD. In conclusion, significant differences were observed in the treatment patterns of AD between pediatric and adult patients. These findings will improve our understanding of the latest treatment patterns for AD, which may contribute to decision-making in clinical practice.

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“…Conventional systemic management of AD consists of corticosteroids and immunosuppressants such as cyclosporine A and methotrexate ( 44 ). Topical treatment of AD includes corticosteroids and calcineurin inhibitors ( 26 ).…”

Section: Atopic Dermatitismentioning

confidence: 99%

Immunopathology and Immunotherapy of Inflammatory Skin Diseases

2022

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Recently, there have been impressive advancements in understanding of the immune mechanisms underlying cutaneous inflammatory diseases. To understand these diseases on a deeper level and clarify the therapeutic targets more precisely, numerous studies including in vitro experiments, animal models, and clinical trials have been conducted. This has resulted in a paradigm shift from non-specific suppression of the immune system to selective, targeted immunotherapies. These approaches target the molecular pathways and cytokines responsible for generating inflammatory conditions and reinforcing feedback mechanisms to aggravate inflammation. Among the numerous types of skin inflammation, psoriasis and atopic dermatitis (AD) are common chronic cutaneous inflammatory diseases. Psoriasis is a IL-17–mediated disease driven by IL-23, while AD is predominantly mediated by Th2 immunity. Autoimmune bullous diseases are autoantibody-mediated blistering disorders, including pemphigus and bullous pemphigoid. Alopecia areata is an organ-specific autoimmune disease mediated by CD8 + T-cells that targets hair follicles. This review will give an updated, comprehensive summary of the pathophysiology and immune mechanisms of inflammatory skin diseases. Moreover, the therapeutic potential of current and upcoming immunotherapies will be discussed.

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Consensus Update for Systemic Treatment of Atopic Dermatitis

Cited by 24 publications

References 134 publications

Once-Daily Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults and Adolescents Aged 12 Years and Over: A Short Review of Current Clinical Perspectives

Once-Daily Abrocitinib for the Treatment of Moderate-to-Severe Atopic Dermatitis in Adults and Adolescents Aged 12 Years and Over: A Short Review of Current Clinical Perspectives

Real-world treatment patterns for atopic dermatitis in South Korea

Immunopathology and Immunotherapy of Inflammatory Skin Diseases

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