New strategies for atopic dermatitis treatment
Dr. Virginia Sanz
Hospital Manises, Valencia, Spain
DOI: https://doi.org/10.35466/RA2021n6378
Keywords: Atopic Dermatitis; Type 2 Immune Response; Dupilumab; Baricitinib
Abstract
Atopic Dermatitis (AD) is an inflammatory and chronic disease with a growing prevalence worldwide, high in the child population (20-25%) and lower, but also important, in the adult population (1-3%).
The disease in its moderate and severe forms emerges with a strong systemic inflammatory load, which on multiple occasions associates comorbidities at the level of other organs and systems different to the skin, and has a strong impact on the quality of life of patients, affecting to all spheres of an individual's life.
Nowadays, the etiopathogenesis is not known, but it is postulated that there is a genetic basis, a dysfunction at the level of the epidermal barrier, an alteration of the microbiota, with a greatly increased presence of Staphylococcus aureus, and finally, a dysregulation of the immune system, specifically, an over-activation of the type 2 immune response.
Fortunately, most patients present mild forms of the disease that are controlled with emollients and topical treatments, but around 10% of them present severe forms and require systemic treatments.
Until recently, treatment for moderate or severe forms comprised only phototherapy and classical immunosuppressive systemic therapy (oral corticosteroids and corticosteroid-sparing agents, such as oral Cyclosporine). Today there are approved new molecules such as the monoclonal antibody against the interleukin 4 and 13 receptor, Dupilumab, and the JAK 1 and 2 inhibitor, Baricitinib, among others. However, there are many other drugs in development that are presenting good efficacy and safety data in clinical trials. Therfore, a promising therapeutic future for patients with atopic dermatitis is coming.
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