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Severe atopic dermatitis: Therapeutic update

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Atopic dermatitis (AD) is a common inflammatory skin disorder with a multitude of highly characterized comorbidities that affect infants, children, and adults worldwide. Despite its high prevalence and health burden, our armamentarium to treat AD in its severe form has remained lacking. For decades, the only Food and Drug Administration approved systemic treatment options for AD had been limited to corticosteroids.


We conducted a nonsystematic review of the new and emerging drugs for the treatment of AD.


The recent emergence of dupilumab, a monoclonal antibody that selectively inhibits the type 2 cytokines that are integral to the pathogenesis of AD has provided dermatologists and allergists with a safe and effective targeted therapy to manage patients with moderate-to-severe disease. Numerous other drugs, both topical and systemic, are currently in development for the treatment of AD and have shown promise in their early phase trials. These agents include monoclonal antibodies that target various mediators relevant for a type 2 immune response, small-molecule inhibitors that block signaling through the Janus kinase pathway, and other agents that are aimed at addressing the symptomatology of itch.


When anticipating the successful development and release of these drugs in the near future, it will be imperative for providers to review the available data, including the efficacy and adverse effects profile of each agent to determine the best treatment approach for each individual patient with AD.
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Keywords: Atopic dermatitis; biologics; eczema; jakinibs; treatment phosphodiesterase 4; type 2 immunity

Document Type: Research Article

Publication date: November 1, 2018

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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