Atopic dermatitis: emerging and current treatments

The Pharmaceutical Journal23 FEB 2017By Dawn Connelly

Dawn Connelly

Dawn 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.

Map showing the epidemiology of atopic dermatitis around the world

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.

Infographic showing how dupilumab works

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

Infographic showing how crisaborole works

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

Pathway showing treatment options for 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

References:

Editorial advisers: Tess McPherson, a consultant dermatologist at the Churchill Hospital in Oxford; Amy Paller, director of Northwestern University’s Skin Disease Research Center in Chicago, Illinois.

Graphics: alisdairmacdonald.co.uk

Citation: The Pharmaceutical Journal, February 2017, Vol 298, No 7898, online | DOI: 10.1211/PJ.2017.20202373

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