Non-biologic systemic treatments for atopic dermatitis: Current state of the art and future directions

Alexandra Paolino; Helen Alexander; Conor Broderick; Carsten Flohr

doi:10.1111/cea.14301

Non-biologic systemic treatments for atopic dermatitis: Current state of the art and future directions

Alexandra Paolino
, Helen Alexander
, Conor Broderick
, Carsten Flohr^*

^*Corresponding author for this work

Dermatology

GSTT Guy's and St Thomas' NHS Foundation Trust

Research output: Contribution to journal › Review article › peer-review

7 Citations (Scopus)

Abstract

Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with an unpredictable clinical course, associated with a significant impact on quality of life. The pathophysiology of AD involves a complex interplay between impaired skin barrier function, immune dysregulation, genetic susceptibility and environmental factors. Advances in understanding of the immunological mechanisms that underpin AD have heralded the recognition of multiple novel therapeutic targets to bolster the systemic treatment armamentarium for patients with severe AD. This review examines current and future directions of non-biologic systemic treatments for AD, with a focus on their mechanism of action, efficacy and safety, and the key considerations to help inform treatment decisions. We summarize new developments in small molecule systemic therapies which have the potential to further advance our management of AD in this new era of precision medicine.

Original language	English
Pages (from-to)	495-510
Number of pages	16
Journal	Clinical and Experimental Allergy
Volume	53
Issue number	5
DOIs	https://doi.org/10.1111/cea.14301
Publication status	Published - May 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

atopic dermatitis
Janus kinase inhibitors
small molecule inhibitors
systemic treatment

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10.1111/cea.14301

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title = "Non-biologic systemic treatments for atopic dermatitis: Current state of the art and future directions",

abstract = "Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with an unpredictable clinical course, associated with a significant impact on quality of life. The pathophysiology of AD involves a complex interplay between impaired skin barrier function, immune dysregulation, genetic susceptibility and environmental factors. Advances in understanding of the immunological mechanisms that underpin AD have heralded the recognition of multiple novel therapeutic targets to bolster the systemic treatment armamentarium for patients with severe AD. This review examines current and future directions of non-biologic systemic treatments for AD, with a focus on their mechanism of action, efficacy and safety, and the key considerations to help inform treatment decisions. We summarize new developments in small molecule systemic therapies which have the potential to further advance our management of AD in this new era of precision medicine.",

keywords = "atopic dermatitis, Janus kinase inhibitors, small molecule inhibitors, systemic treatment",

author = "Alexandra Paolino and Helen Alexander and Conor Broderick and Carsten Flohr",

note = "Funding Information: CF is the Chief Investigator of the UK National Institute for Health Research‐funded TREAT ( ISRCTN15837754 ) and SOFTER ( Clinicaltrials.gov : NCT03270566) trials as well as the UK‐Irish Atopic eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918) and a Principle Investigator in the European Union (EU) Horizon 2020‐funded BIOMAP Consortium ( http://www.biomap‐imi.eu/ ). He also leads the EU Trans‐Foods consortium. His department has received investigator‐led funding from Sanofi‐Genzyme and Pfizer for microbiome work. All other authors declare no conflict of interest. Publisher Copyright: {\textcopyright} 2023 The Authors. Clinical \& Experimental Allergy published by John Wiley \& Sons Ltd.",

year = "2023",

month = may,

doi = "10.1111/cea.14301",

language = "English",

volume = "53",

pages = "495--510",

journal = "Clinical and Experimental Allergy",

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T1 - Non-biologic systemic treatments for atopic dermatitis

T2 - Current state of the art and future directions

AU - Paolino, Alexandra

AU - Alexander, Helen

AU - Broderick, Conor

AU - Flohr, Carsten

N1 - Funding Information: CF is the Chief Investigator of the UK National Institute for Health Research‐funded TREAT ( ISRCTN15837754 ) and SOFTER ( Clinicaltrials.gov : NCT03270566) trials as well as the UK‐Irish Atopic eczema Systemic Therapy Register (A‐STAR; ISRCTN11210918) and a Principle Investigator in the European Union (EU) Horizon 2020‐funded BIOMAP Consortium ( http://www.biomap‐imi.eu/ ). He also leads the EU Trans‐Foods consortium. His department has received investigator‐led funding from Sanofi‐Genzyme and Pfizer for microbiome work. All other authors declare no conflict of interest. Publisher Copyright: © 2023 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

PY - 2023/5

Y1 - 2023/5

N2 - Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with an unpredictable clinical course, associated with a significant impact on quality of life. The pathophysiology of AD involves a complex interplay between impaired skin barrier function, immune dysregulation, genetic susceptibility and environmental factors. Advances in understanding of the immunological mechanisms that underpin AD have heralded the recognition of multiple novel therapeutic targets to bolster the systemic treatment armamentarium for patients with severe AD. This review examines current and future directions of non-biologic systemic treatments for AD, with a focus on their mechanism of action, efficacy and safety, and the key considerations to help inform treatment decisions. We summarize new developments in small molecule systemic therapies which have the potential to further advance our management of AD in this new era of precision medicine.

AB - Atopic dermatitis (AD) is a prevalent chronic inflammatory skin condition with an unpredictable clinical course, associated with a significant impact on quality of life. The pathophysiology of AD involves a complex interplay between impaired skin barrier function, immune dysregulation, genetic susceptibility and environmental factors. Advances in understanding of the immunological mechanisms that underpin AD have heralded the recognition of multiple novel therapeutic targets to bolster the systemic treatment armamentarium for patients with severe AD. This review examines current and future directions of non-biologic systemic treatments for AD, with a focus on their mechanism of action, efficacy and safety, and the key considerations to help inform treatment decisions. We summarize new developments in small molecule systemic therapies which have the potential to further advance our management of AD in this new era of precision medicine.

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KW - small molecule inhibitors

KW - systemic treatment

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SN - 0954-7894

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JO - Clinical and Experimental Allergy

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IS - 5

ER -

Non-biologic systemic treatments for atopic dermatitis: Current state of the art and future directions

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