Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis

IF 5.4 2区医学 Q1 ALLERGY Current Allergy and Asthma Reports Pub Date : 2024-04-18 DOI:10.1007/s11882-024-01145-x

Hyun J. Yim, Tiffany Jean, Peck Y. Ong

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Abstract

Purpose of Review

Historically, systemic treatments for atopic dermatitis (AD) primarily consisted of immunosuppressive agents such as corticosteroids and Disease Modifying Antirheumatic Drugs (DMARDS), which provided symptomatic relief but often had long-term adverse effects. Newer treatments have shown significant efficacy with less side effects in clinical trials. This review discusses and compares conventional and newer systemic treatments for AD.

Recent Findings

Newer medications for AD including dupilumab, tralokinumab, lebrikizumab, and oral JAK inhibitors have been shown to be safe and efficacious. High dose cyclosporine and dupilumab were more effective than methotrexate and azathioprine in improving clinical signs of AD. High-dose upadacitinib was shown in another meta-analysis to be most effective in the measured outcomes but had the highest frequency of adverse events.

Summary

Targeted biologic treatments are increasingly favored over traditional immunosuppressive treatments of AD. Treatment can be individualized based on potency, adverse side effects, mechanism of action, and administration preference. Ongoing research continues to expand treatment options for AD.

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中重度特应性皮炎新旧系统疗法的比较

综述目的在过去，特应性皮炎（AD）的系统治疗主要包括免疫抑制剂，如皮质类固醇激素和疾病修饰抗风湿药（DMARDS），这些药物可缓解症状，但往往会产生长期不良反应。新的治疗方法在临床试验中显示出显著疗效，且副作用较小。本综述讨论并比较了AD的传统治疗方法和较新的系统治疗方法。最新研究结果较新的AD治疗药物包括杜比鲁单抗、曲妥珠单抗、来布利珠单抗和口服JAK抑制剂，已被证明安全有效。在改善 AD 临床症状方面，大剂量环孢素和杜比卢单抗比甲氨蝶呤和硫唑嘌呤更有效。另一项荟萃分析表明，大剂量达帕替尼对测量结果最有效，但不良反应发生频率最高。治疗可根据药效、不良副作用、作用机制和用药偏好进行个体化。正在进行的研究将继续扩大 AD 的治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.

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