Return to content in this issue


Updated Review on Treatment of Atopic Dermatitis

Armario-Hita JC1, Galán-Gutiérrez M2, Dodero-Anillo JM3, Carrascosa JM4,5, Ruiz-Villaverde R6

1Servicio de Dermatología, Hospital Universitario de Puerto Real, Universidad de Cádiz, Cadiz, Spain
2Servicio de Dermatología, Hospital Universitario Reina Sofía, Córdoba, Spain
3Servicio de Farmacología Clínica, Hospital Universitario de Puerto Real, Cádiz, Spain
4Servicio de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
5Universitat Autònoma de Barcelona, Badalona, Spain
6Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain

J Investig Allergol Clin Immunol 2023; Vol 33(3) : 158-167
doi: 10.18176/jiaci.0906

Atopic dermatitis (AD) is a chronic or chronically recurrent Inflammatory dermatosis associated with multiple triggers that has a complex pathophysiological mechanism. It is characterized by a heterogeneous clinical expression, signs, and symptoms. Its etiology and pathogenesis are complex and are influenced by multiple immune-mediated factors. Treatment of AD can also be complex, given the high number of available drugs and multiple therapeutic targets. In this review, we summarize current literature on the efficacy and safety of topical and systemic drugs to treat moderate-to-severe AD. We begin with topical treatments such as corticosteroids and calcineurin inhibitors and subsequently address the latest systemic treatments, such as Janus kinase inhibitors (upadacitinib, baricitinib, abrocitinib, gusacitinib) and interleukin (IL) inhibitors, which have proven efficacious in AD, namely, dupilumab (IL-4 and IL-13), tralokinumab (IL-13), lebrikizumab (IL-13), and nemolizumab (IL-31). Given the large number of drugs available, we summarize the pivotal clinical trials for each drug, evaluate recent real-world experience in terms of safety and efficacy for purposes of compilation, and provide evidence to guide the optimal choice of therapy.

Key words: Atopic dermatitis, JAK inhibitors, Interleukin, Biologics, Dermatology