Current treatments for atopic dermatitis in Japan

Abstract

The goal of a treatment regimen for atopic dermatitis is to reach and maintain a state where the patient exhibits mild symptoms or an absence of symptoms, and the patient should not experience disturbance during daily activities. The basis of a treatment regimen for atopic dermatitis is topical therapy, and currently there exist topical corticosteroids, tacrolimus and delgocitinib. Using these, proactive therapy is performed as maintenance therapy after remission induction therapy. However, in cases of moderate to severe atopic dermatitis, topical drugs alone cannot induce remission and systemic therapies such as cyclosporin, ultraviolet therapy, and dupilumab should be used in combination. In particular, dupilumab has many advantages such as high efficacy, relatively few adverse reactions, and ease of use in elderly patients with severe atopic dermatitis. In this review, we present a treatment algorithm for atopic dermatitis that emphasizes the importance of maintaining remission after induction of remission, and summarizes the characteristics of current medication therapy for atopic dermatitis in Japan.

Dupilumab With Concomitant JAK Inhibitor：A Novel Strategy For Atopic Dermatitis With Poor Response To Dupilumab

“…We hypothesized a combination of Dupilumab and JAK inhibitors treatment in patients with severe AD could achieve inhibition of type 2 system signaling and block a range of cytokine, growth factor, and hormone receptor signaling pathway. [30,31] Combination therapy could better regulate the immune imbalance, and may ameliorate chronic dermatitis by reducing itching and improving skin barrier function. In most chronic skin lesions, Th1-mediated and Th17-mediated responses are activated, in particular in children and people of Asian descent.…”

Refractory nummular eczema in child successfully treated with NB‐UVB and topical delgocitinib

“…4 It is available for children with AD with ages more than 2 years old. 5 It inhibits IL-4, IL-13, and IL-31, 6 resulting in the relief of pruritus.…”

Evaluation of standard treatments for managing adult Japanese patients with inadequately controlled moderate‐to‐severe atopic dermatitis: Two‐year data from the ADDRESS‐J disease registry

“…5 However, a substantial proportion of Japanese patients with AD suffer from inadequate disease control due to insufficient therapeutic response to TCS and TCI, poor treatment compliance attributable to self-perceived improvement of disease, forgetfulness, and treatment inconvenience. 6,7 Thus far, several retrospective analyses or chart reviews have been performed to determine the long-term outcomes in adult Japanese patients with AD. 4,8 Due to the emergence of novel therapies, 9 the current real-life practices for the long-term management of AD should be assessed prior to positioning new treatment modalities.…”

“…According to the current treatment guidelines, the standard treatments for AD in Japan include TCS and topical calcineurin inhibitors (TCI) for controlling inflammation, emollients for skin care, and adjunctive therapies such as antihistamines for reducing pruritus; furthermore, treatment for severe refractory disease only includes higher‐potency TCS or TCS in combination with phototherapy, cyclosporine, or psychosomatic therapy 5 . However, a substantial proportion of Japanese patients with AD suffer from inadequate disease control due to insufficient therapeutic response to TCS and TCI, poor treatment compliance attributable to self‐perceived improvement of disease, forgetfulness, and treatment inconvenience 6,7 …”