Skin and connective tissue diseases
Atopic dermatitis: emerging and current treatments
Dawn Connelly
Corresponding AuthorDawn Connelly is an award-winning features editor at the Pharmaceutical Journal. She has worked in both hospital and community pharmacy and has over 10 years of experience in pharmacy journalism. In 2015, Dawn took the Data Journalism prize for an impressive info-graphic charting The Ebola virus outbreak.
Atopic dermatitis affects up to 30% of children and 10% of adults, and is common in both developed and developing countries. Two new medicines on the brink of entering the market — dupilumab, a biologic for severe disease, and crisaborole, a topical small molecule drug for milder disease — could herald a new era in the management of this condition, which has seen no major changes to the way it has been treated for over 15 years.
Epidemiology of atopic dermatitis
Source: Journal of Clinical Immunology; Allergologia et Immunopathologia
There is a wide variation in the global prevalence of atopic dermatitis, but it is common in both developed and developing countries.
How dupilumab works
Source: Expert Opinion on Biological Therapy; Nature Reviews Drug Discovery; Immunotherapy
The arrival of the first monoclonal antibody for atopic dermatitis, dupilumab, marketed as Dupixent, is anticipated as a revolution for patients with the most severe form of the disease. Dupilumab targets the Th2 pathway that drives atopic dermatitis
How crisaborole works
Source: Expert Opinion on Biological Therapy; Nature Reviews Drug Discovery; Immunotherapy
For mild disease, topical ointment crisaborole secured US Food and Drug Administration approval in December 2016. Crisaborole works by inhibiting the enzyme phosphodiesterase 4 (PDE4), which has long been known to have a role in atopic dermatitis
Current stepped treatment options for atopic dermatitis
Treatment for atopic dermatitis can be stepped up or down depending on disease severity. Acute flares will often require a temporary increase in the intensity of treatment
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202373
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