Washington University School of Medicine, St. Louis, MO, USA.
Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Br J Dermatol. 2023 May 24;188(6):698-708. doi: 10.1093/bjd/ljac016.
Atopic dermatitis (AD) is a common inflammatory skin disease characterized by scaly, oozing skin and itch. In moderate-to-severe AD, treatment options have been historically very limited and off-label use has been a common method for disease management. For decades, ciclosporin A was the only systemic immunosuppressive drug approved in most European countries to address this major unmet medical need. However, increased understanding of the pathophysiology of AD has led to a revolution in the treatment of this potentially debilitating disease. Following the approval of the first biological therapy for AD in 2017, there has been a rapid expansion of compounds under development and four additional systemic therapies have been approved in Europe and the USA within the past 3 years alone. In this review, we underscore how key breakthroughs have transformed the therapeutic landscape of AD, leading to a major expansion of type 2 immunity-targeted biological therapies, exploration of neuroimmune modulatory agents, and interest in Janus kinase inhibition.
特应性皮炎(AD)是一种常见的炎症性皮肤病,其特征为鳞屑、渗出和瘙痒。在中重度 AD 中,治疗选择历来非常有限,超适应证使用是疾病管理的常见方法。几十年来,环孢素 A 是大多数欧洲国家批准的唯一一种用于解决这一重大未满足医疗需求的全身性免疫抑制剂。然而,对 AD 病理生理学的深入了解导致了这种潜在使人衰弱的疾病治疗的革命性变化。自 2017 年批准第一种 AD 生物疗法以来,开发中的化合物数量迅速增加,仅在过去 3 年内,欧洲和美国就批准了另外 4 种全身性治疗药物。在这篇综述中,我们强调了关键突破如何改变 AD 的治疗格局,导致 2 型免疫靶向生物疗法的大幅扩展、神经免疫调节剂的探索以及对 Janus 激酶抑制的关注。