Advances in systemic treatment for adults with moderate-to-severe atopic dermatitis

Background: Atopic dermatitis (AD) is a common and chronic inflammatory skin disease. Approximately 10% of adults with AD do not respond adequately to topical therapies and require phototherapy and/or systemic therapy. Objective: To provide a patient-focused approach to the identification and management of adults with AD who require systemic treatment. Methods: A working group of clinicians experienced in managing AD was convened to review and discuss current evidence on the identification and clinical management of adults with moderate to severe AD. Results: We propose a set of simple and practical clinical criteria for selecting candidates for systemic treatment of AD based on their response to first-line topical therapy and 4 clinical measures that are easily incorporated into routine practice. We also suggest a framework for evaluating systemic treatments according to attributes that are important from both a clinician’s and a patient’s perspective. An algorithm was developed proposing a pathway for treatment of moderate to severe AD in adults. Conclusion: Adults with moderate to severe AD that does not respond adequately to topical therapies currently have few safe and effective treatment options. A clinical algorithm could help guide treatment decisions.

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Systemic treatment for severe atopic dermatitis

Journal of Dermatological Treatment ◽

10.3109/09546639609097189 ◽

1996 ◽

Vol 7 (sup3) ◽

pp. S13-S15 ◽

Cited By ~ 1

Author(s):

Ronald Marks

Keyword(s):

Atopic Dermatitis ◽

Systemic Treatment ◽

Severe Atopic Dermatitis

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Systemic Treatment for Severe Atopic Dermatitis

Archivum Immunologiae et Therapiae Experimentalis ◽

10.1007/s00005-018-0521-y ◽

2018 ◽

Vol 67 (2) ◽

pp. 69-78 ◽

Cited By ~ 4

Author(s):

Mara Giavina-Bianchi ◽

Pedro Giavina-Bianchi

Keyword(s):

Atopic Dermatitis ◽

Systemic Treatment ◽

Severe Atopic Dermatitis

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A Retrospective Analysis of Real Life Medication Regimens for Adults with Atopic Dermatitis on Immunosuppressive Medication (Ramadil) In a Single Third Line Center in Belgium

International Journal of Clinical & Experimental Dermatology ◽

10.33140/ijced.02.01.10 ◽

2017 ◽

Vol 2 (1) ◽

Keyword(s):

Atopic Dermatitis ◽

Side Effects ◽

Systemic Treatment ◽

Real Life ◽

Immunosuppressive Drugs ◽

Line Center ◽

Severe Atopic Dermatitis ◽

Therapeutic Effects ◽

Immunosuppressive Medication ◽

Third Line

Few Belgian data are available on the treatment of severe atopic dermatitis in adults. As in most other countries, only cyclosporine A is registered for the systemic treatment of atopic dermatitis. Although treatment periods are restricted, side effects may occur, and response failure is possible. Small trials with other immunosuppressive drugs (azathioprine, mofetylmycophenolate, and methotrexate) have indicated they may improve atopic dermatitis, although their effect is slower than with cyclosporine. In the future, treatment of atopic dermatitis may drastically change as the therapeutic effects of new biologicals are promising. This RAMADIL study, from a third line referral center in Belgium, was conducted in order to collect information about the way AD is treated in this pre-biological era.

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