Melinda Gooderham1, Charles W Lynde2, Kim Papp3, Marc Bourcier4, Lyn Guenther5, Wayne Gulliver6, Chih-Ho Hong7, Yves Poulin8, Gordon Sussman9, Ronald Vender10. 1. 1 Queen's University, SKiN Centre for Dermatology, and Probity Medical Research, Peterborough, ON, Canada. 2. 2 Lynde Dermatology, Probity Medical Research, Markham Ontario, and Department of Medicine, University of Toronto, Toronto, ON, Canada. 3. 3 K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada. 4. 4 University of Sherbrooke, QC, Canada. 5. 5 University of Western Ontario, London ON, Canada. 6. 6 Memorial University of Newfoundland St. John's, NL, Canada. 7. 7 Department of Dermatology and Skin Science, University of British Columbia, and Probity Medical Research, Surrey, BC, Canada. 8. 8 Laval University and CDQM and CRDQ, Quebec, QC, Canada. 9. 9 Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada. 10. 10 Dermatrials Research Inc., Hamilton, ON, Canada.
Abstract
BACKGROUND: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. OBJECTIVE: To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. METHODS: A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. RESULTS: Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. CONCLUSION: Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.
BACKGROUND:Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. OBJECTIVE: To review the treatment options for adult ADpatients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. METHODS: A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult ADpatients. This review is based on the best available evidence from a published systematic review and an additional literature search. RESULTS: Current treatments for AD are reviewed, including options for adult ADpatients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. CONCLUSION: Many ADpatients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.