Advanced Therapies for Moderate-to-Severe Atopic Dermatitis: Marathon or Sprint?
Abstract
Atopic dermatitis (AD) is a chronic, relapsing and remitting disease that has a substantial impact on the lives of patients and caregivers. While mild AD can be adequately managed with topical therapies, patients with moderate-to-severe AD may require systemic treatment which has traditionally consisted of off-label use of immunosuppressants such as methotrexate, cyclosporine, and azathioprine.
Several advanced therapies that target specific components of the pathophysiological pathway in AD are now available for patients with moderate-to-severe disease. Agents approved in Canada include an anti–interleukin (IL)-4 receptor inhibitor that blocks signalling of both IL-4 and IL-13 (dupilumab), a selective anti–IL-13 monoclonal antibody (tralokinumab), and selective Janus kinase (JAK) inhibitors (abrocitinib and upadacitinib). The introduction of these therapies has greatly improved dermatologists’ ability to tailor treatment strategies based on individual clinical profiles and patient preferences.
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