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Atopic Dermatitis: Current Guidelines for Diagnosis and Treatment. Part II


Authors: A. Machovcová 1;  P. Cetkovská 2;  J. Fialová 3;  S. Gkalpakiotis 4;  M. Kojanová 3
Authors place of work: Dermatovenerologické oddělení FN v Motole, Praha, primář MUDr. Alena Machovcová, Ph. D., MBA 1;  Dermatovenerologická klinika UK LF a FN Plzeň, Plzeň, přednosta MUDr. Jan Říčař, Ph. D. 2;  Dermatovenerologická klinika UK 1. LF a VFN Praha, Praha, přednosta prof. MUDr. Jiří Štork, CSc. 3;  Dermatovenerologická klinika UK 3. LF a FNKV, Praha, přednosta prof. MUDr. Petr Arenberger, DrSc., MBA 4
Published in the journal: Čes-slov Derm, 98, 2023, No. 3, p. 123-149
Category: Reviews (Continuing Medical Education)

Summary

Atopic dermatitis is a chronic, very itching disease of children and adults that requires intensive local and often systemic treatment. The choice of treatment depends on the age, severity of the disease and associated diseases. Current recommendations in part II contain indications for systemic treatment; summarize the latest available knowledge on conventional systemic, biological and targeted treatment of atopic dermatitis. At the same time, treatment goals (initial, rational, optimal), evaluation of treatment response and treatment failure are defined.

Keywords:

atopic dermatitis – indications for systemic treatment – treatment evaluation – treatment goals – conventional systemic treatment – biological and targeted treatment


Zdroje

1. ADTRALZA. https://www.ema.europa.eu/en/documents/product-information/adtralza-epar-product-information_cs.pdf, dostupné 1. 1. 2022.

2. AGACHE, I., AKDIS, CA., AKDIS, M. et al. EAACI Biologicals Guidelines – dupilumab for children and adults with moderate-to-severe atopic dermatitis. Allergy, 2021, 4, p. 988–1009.

3. AKINLADE, B., GUTTMAN-YASSKY, E., BRUIN-WELLER, M. et al. Conjunctivitis in dupilumab clinical trials. Br J Dermatol, 2019, 3, p. 459–473.

4. ASZODI, N., THURAU, S., SEEGRABER, M. et al. Management of dupilumab-associated conjunctivitis in atopic dermatitis. J Dtsch Dermatol Ges, 2019, 17, p. 488–491.

5. BECK, LA., THACI, D., DELEURAN, M. et al. Laboratory safety of dupilumab for up to 3 years in adults with moderate-to-severe atopic dermatitis: results from an open-label extension study. J Dermatolog Treat, 2021, 8, p. 1–9.

6. BERTH-JONES, J., EXTON, L. S., LADOYANNI, E. et al. British Association of Dermatologists guidelines for the safe and effective prescribing of oral ciclosporin in dermatology 2018. Br J Dermatol, 2019, 180, p. 1312–1338.

7. BIEBER, T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov, 2022, 21, p. 21–40.

8. BILSBOROUGH, J., LEUNG, DY., MAURER, M. et al. IL-31 is associated with cutaneous lymphocyte antigen positive skin homing T cells in patients with atopic dermatitis. J Allergy Clin Immunol, 2006, 2, p. 418–425.

9. BLAUVELT, A., DE BRUIN-WELLER, M., GOODERHAM, M. et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet, 2017, 10086, p. 2287–2303.

10. BOGUNIEWICZ, M., FONACIER, L., GUTTMAN-YASSKY, E. et al. Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape. Ann Allergy Asthma Immunol, 2018, 20(1), p. 10–22.

11. CALLEWAETR, C., NAKATSUJI, T., KNIGHT, R. et al. IL-4Rα blockade by dupilumab decreases Staphylococcus aureus colonization and increases microbial diversity in atopic dermatitis. J Invest Dermatol, 2020, 1, p. 191–202.

12. CARTRON, AM., NGUYEN, MH., ROH, YS. et al. Janus kinase inhibitors for atopic dermatitis: a promising treatment modality. Clin Exp Dermatol, 2021, 46 (5), p. 820–824.

13. CELLCEPT. https://www.ema.europa.eu/en/documents/product-information/cellcept-epar-product-information_cs.pdf.

14. CETKOVSKÁ, P., KOJANOVÁ, M., ARENBERGER, P. et al. Přehled současných doporučených postupů pro systémovou „nebiologickou“ léčbu psoriázy. Čes-slov Derm, 2017, roč. 92, s. 3–17.

15. CIBINQO. https://www.ema.europa.eu/en/documents/product-information/cibinqo-epar-product-information_en.pdf, dostupné 1. 1. 2022.

16. CIBINQO. https://www.sukl.cz/modules/medication/detail.php_kod=0255385.

17. COTTER, DG., SCHAIRER, D., EICHENFIELD, L. Emerging therapies for atopic dermatitis: JAK inhibitors. J Am Acad Dermatol, 2018, 78(3 Suppl 1), S53–S62.

18. D´ERME, AM., ROMANELLI, M., CHIRICOZZI, A. Spotlight on dupilumab in the treatment of atopic dermatitis: design, development, and potential place in therapy. Drug Des Devel Ther, 2017, 11, p. 1473–1480.

19. DE BRUIN-WELLER, M., THACI, D., SMITH, C. et al. Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFE). Br J Dermatol, 2018, 178(5), p. 1083–1101.

20. DE BRUIN-WELLER, M., BIEDERMANN, T., BISSONNETTE, R. et al. Treat-to-target in atopic dermatitis: an international consensus on a set of core decision points for systemic therapies. Acta Derm Venereol, 2021, 101(2), adv00402. doi: 10.2340/00015555-3751.

21. DE WIJS, LEM., BOSMA, AL., ERLER, NS. et al. Effectiveness of dupilumab treatment in 95 patients with atopic dermatitis: daily practice data. Br J Dermatol, 2019, 182(2), p. 418–426.

22. DE WIJS, LEM., NGUYEN, NT., KUNKELER, ACM. et al. Clinical and histopathological characterization of paradoxical head and neck erythema in patients with atopic dermatitis treated with dupilumab: a case series. Br J Dermatol, 2020, 183 (4), p. 745–749.

23. DUGGAN, S. Tralokinumab: first approval. Drugs, 2021, 81(14), p. 1657–1663.

24. DUPIXENT. https://www.ema.europa.eu/en/documents/product-information/dupixent-epar-product-information_cs.pdf, dostupné 1. 1. 2022.

25. DUPIXENT. https://www.sukl.cz/modules/medication/detail.php?code=0238479&tab=prices.

26. EICHENFIELD, LF., BIEBER, T., BECK, LA. et al. Infections in dupilumab clinical trials in atopic dermatitis: a comprehensive pooled analysis. Am J Clin Dermatol, 2019, 20(3), p. 443–456.

27. FERREIRA, S., GUTTMAN-YASSKY, E., TORRES, T. Selective JAK1 inhibitors for the treatment of atopic dermatitis: focus on upadacitinib and abrocitinib. Am J Clin Dermatol, 2020, 21(6), p. 783–798.

28. FUTAMURA, M., LESHEM, YA., THOMAS, KS. et al. A systematic review of Investigator Global Assessment (IGA) in atopic dermatitis (AD) trials: Many options, no standards. J Am Acad Dermatol, 2016, 74(2), p. 288–294.

29. GERBENS, LAA., HAMANN, SAS., BROUWER, MWD. et al. Methotrexate and azathioprine for severe atopic dermatitis: a 5year follow-up study of a randomized controlled trial. Br J Dermatol, 2018, 178 (6), p. 1288–96.

30. GITTLER, JK., SHEMER, A., SUÁREZ-FARINAS, M. et al. Progressive activation of T(H)2/T(H)22 cytokines and selective epidermal proteins characterizes acute and chronic atopic dermatitis. J Allergy Clin Immunol, 2012; 130(6), p. 1344–1354.

31. GONCALVES, F., FREITAS, E., TORRES, T. Selective IL-13 inhibitors for the treatment of atopic dermatitis. Drugs Context, 2021; 10, p. 2021–1–7.

32. GOODERHAM, MJ., HONG, HC., ESHTIAGHI, P. et al. Dupilumab: A review of its use in the treatment of atopic dermatitis. J Am Acad Dermatol, 2018; 78(3 Suppl. 1), p. S28–36.

33. GUTTMAN-YASSKY, E., BRUNNER, PM., NEUANN, AU. et al. Efficacy and safety of fezakinumab (an IL-22 monoclonal antibody) in adults with moderate-to-severe atopic dermatitis inadequately controlled by conventional treatments: a randomized, double-blind, phase 2a trial. J Am Acad Dermatol, 2018; 78(5), p. 872–881.

34. GUTTMAN-YASSKY, E., BISSONNETTE, R., UNGAR, B. et al. Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis. J Allergy Clin Immunol, 2019; 143(1), p. 155–172.

35. GUTTMAN-YASSKY, E., PAVEL, AB., ZHOU, L. et al. GBR 830, an anti-OX40, improves skin gene signatures and clinical scores in patients with atopic dermatitis. J Allergy Clin Immunol, 2019; 144(2), p. 482–493.

36. GUTTMAN-YASSKY, E., TEIXEIRA, H. D., SIMPSON, E. L. et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet, 2021, 397(10290), p. 2151–2168.

37. HAECK, IM., KNOL, MJ., TEN BERGE, O. et al. Enteric-coated mycophenolate sodium versus cyclosporin A as long-term treatment in adult patients with severe atopic dermatitis: A randomized controlled trial. J Am Acad Dermatol, 2011, 64(6), p. 1074–1084.

38. HALLING, AS., LOFT, N., SILVERBERG, JI. et al. Real-world evidence of dupilumab efficacy and risk of adverse events: A systematic review and meta-analysis. J Am Acad Dermatol, 2021, 84(1), p. 139–147.

39. HAMILTON, JD., SUÁREZ-FARINAS, M., DHINGRA, N. et al. Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol, 2014, 134(6), p. 1293–1300.

40. HE, H., GUTTMAN-YASSKY, E. JAK inhibitors for atopic dermatitis: an update. Am J Clin Dermatol, 2018, 20(2), p. 181–192.

41. HOWE W, DELLAVALLE RP., LEVY ML., FOWLER J. Treatment of atopic dermatitis (eczema). https://www.uptodate.com/contents/treatment-of-atopic-dermatitis eczema.

42. HOWELL, MD., KUO, FI., SMITH, PA. Targeting the Janus kinase family in autoimmune skin diseases. Front Immunol, 2019, 10, 2342–2342.

43. CHEN, YL., GUTOWSKA-OWSIAK, D., HARDMAN, CS. et al. Proof-of-concept clinical trial of etokimab shows a key role for IL-33 in atopic dermatitis pathogenesis. Sci Transl Med, 2019, 11(515), eaax2945.

44. IMURAN. https://www.ema.europa.eu/en/documents/product-information/cellcept-epar-product-information_cs.pdf.

45. KABASHIMA, K., FURUE, M., HANIFIN, JM. et al. Nemolizumab in patients with moderate-to-severe atopic dermatitis: randomized, phase II, long-term extension study. J Allergy Clin Immunol, 2018, 142(4), p. 1121–1130.

46. KABASHIMA, K., MATSUMURA, T., KOMAZAKI, H. et al. Nemolizumab-JP01 Study Group. Trial of nemolizumab and topical agents for atopic dermatitis with pruritus. N Engl J Med, 2020, 383(2), p. 141–150.

47. KOJANOVÁ, M., FIALOVÁ, J., CETKOVSKÁ, P. et al. Účinnost biologické léčby středně těžké až těžké psoriázy – analýza z registru BIOREP. Čes-slov Derm, 2021, roč. 2, s. 73–79.

48. KOJANOVÁ, M., FIALOVÁ, J., CETKOVSKÁ, P. et al. Atopická dermatitida v registru BIOREP. Čes-slov Derm, 2021, roč. 3, s. 134–141.

49. LAW PING MAN, S., BOUZILLÉ, G., BENETON, N. et al. Drug survival and post-drug survival of first-line immunosuppressive treatments for atopic dermatitis: comparison between methotrexate and cyclosporine. J Eur Acad Dermatol Venereol, 2018, 32(8), p. 1327–1335.

50. LEUNG, DY., GUTTMAN-YASSKY, E. Deciphering the complexities of atopic dermatitis: shifting paradigms in treatment approaches. J Allergy Clin Immunol, 2014, 134(4), p. 769–779.

51. METHOTREXAT. https://www.sukl.cz. trexan-neospc.pdf.

52. NEWSOM, M., BASHYAM, AM., BALOGH, EA. et al. New and emerging systemic treatments for atopic dermatitis. Drugs, 2020, 80(11), p. 1041–1052.

53. NEZAMOLOLAMA, N., FIELDHOUSE, K., METZGER, K. et al. Emerging systemic JAK inhibitors in the treatment of atopic dermatitis: a review of abrocitinib, baricitinib, and upadacitinib. Drugs Context, 2020, 9, 2020-8-5.

54. OLUMIANT. https://www.ema.europa.eu/en/documents/product-information/olumiant-epar-product-information_cs.pdf, dostupné 1. 1. 2022.

55. OLUMIANT. https://www.sukl.cz/modules/medication/detail.php?code=0219354&tab=prices.

56. PALLER, AS., SIEGFRIED, EC., THACI, D. et. al. Efficacy and safety of dupilumab with concomitant topical corticosteroids in children 6 to 11 years old with severe atopic dermatitis: a randomized, double-blinded, placebo-controlled phase 3 trial. J Am Acad Dermatol, 2020, 83(5), p. 1282–1293.

57. PREDNISON. https://www. sukl.cz, prednison-leciva-spc.pdf.

58. REICH, K., TEIXEIRA, HD., DE BRUIN-WELLER, M. et al. Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet, 2021, 397(10290), p. 2169–2181.

59. RICARDO, JW., LIPNER, SR. Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during the COVID-19 pandemic. Dermatol Ther, 2020, 33(5), p. e13687.

60. RINVOQ. https://www.ema.europa.eu/en/documents/product-information/rinvoq-epar-product-information_cs.pdf, dostupné 1. 1. 2022.

61. RINVOQ. https://www.sukl.cz/Rozhodnutí_Rinvoq_SUKLS311431_2021.pdf.

62. RUZICKA, T., HANIFIN, JM., FURUE, M. et al. Anti-interleukin-31 receptor a antibody for atopic dermatitis. N Engl J Med, 2017, 37(9), p. 826–835.

63. SANDIMMUN NEORAL. https://www.sukl.cz, sandimmun-neoral-spc-4.pdf.

64. SCHNEEWEISS, MC., PEREZ-CHADA, L., MEROLA, JF. Comparative safety of systemic immuno-modulatory medications in adults with atopic dermatitis. J Am Acad Dermatol, 2021, 85(2), p. 321–329.

65. SIDBURY, R., DAVIS, DM., COHEN, DE. et al. Guidelines of care for the management of atopic dermatitis: section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol, 2014, 71(2), p. 327–349.

66. SILVERBERG, JI., TOTH, D., BIEBER, T. et al. Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial. Br J Dermatol, 2021, 184(3), p. 450–463.

67. SIMPSON, EL., BIEBER, T., GUTTMAN-YASSKY E. et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med, 2016, 375(24), p. 2335–2348.

68. SIMPSON, EL., FLOHR, C., EICHENFIELD, LF. et al. Efficacy and safety of lebrikizumab (an anti-IL-13 monoclonal antibody) in adults with moderateto-severe atopic dermatitis inadequately controlled by topical corticosteroids: a randomized, placebo-controlled phase II trial (TREBLE). J Am Acad Dermatol, 2018, 78(5), p. 863–871.

69. SIMPSON, EL., PALLER, AS., SIEGFRIED, EC. et al. Efficacy and safety of dupilumab in adolescents with uncontrolled moderate to severe atopic dermatitis: a phase 3 randomized clinical trial. JAMA Dermatol, 2020, 156(1), p. 44–56.

70. SIMSPON, EL., PARNES, JR., SHE, D. et al. Tezepelumab, an anti-thymic stromal lymphopoietin monoclonal antibody, in the treatment of moderate to severe atopic dermatitis: A randomized phase 2a clinical trial. J Am Acad Dermatol, 2019, 80(4), p. 1013–1021.

71. SIMPSON, EL., LACOUR, JP., SPELMAN, L. et al. Baricitinib in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: results from two randomized monotherapy phase III trials. British J Dermatol, 2020, 183(2), p. 242–255.

72. SIMPSON, EL., MEROLA, JF., SILVERBERG, JI. et al. Safety of tralokinumab in adult patients with moderate-to-severe atopic dermatitis: pooled analysis of five randomized, double-blind, placebo-controlled phase II and phase III trials. Br J Dermatol, 2022, 187(6), p. 888–899.

73. SIMPSON, EL., SINCLAIR, R., FORMAN, S. et al. Efficacy and safety of abrocitinib in adults and adolescents with moderate-to-severe atopic dermatitis (JADE MONO-1): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet, 2020, 396(10246), p. 255–266.

74. SNAST, I., REITER, O., HODAK, E. et al. Are biologics efficacious in atopic dermatitis? A systematic review and meta-analysis. Am J Clin Dermatol, 2018, 19(2), p. 145–165.

75. SONG, CH., LEE, JK. Lebrikizumab treatment in adults with asthma. N Engl J Med, 2011, 365(25), p. 2432–2434.

76. SORIA, A., DU-THANH, A., SENESCHAL, J. et al. Development or exacerbation of head and neck dermatitis in patients treated for atopic dermatitis with dupilumab. JAMA Dermatol, 2019, 155(11), p. 1312–1315.

77. SPERGEL JM, LIO PA. Management of severe atopic dermatitis (eczema) in children. https://www.uptodate. com/contents/management-of-severe-atopic-dermatitis-eczema-in children?

78. STANDER, S., YOSIPOVITCH, G., LEGAT, FJ. et al. Trial of nemolizumab in moderate-to-severe prurigo nodularis. N Engl J Med, 2020, 382(8), p. 706–716.

79. THACI, D., SIMPSON, E., DELEURAN, M. et al. Efficacy and safety of dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis: a pooled analysis of two phase 3 randomized trials (LIBERTY AD SOLO 1 and LIBERTY AD SOLO 2). J Dermatol Sci, 2019, 94(2), p. 266–275.

80. THYSSEN, JP., DE BRUIN-WELLER, MS., PALLER, AS. et al. Conjunctivitis in atopic dermatitis patients with and without dupilumab therapy – international eczema council survey and opinion. J Eur Acad Dermatol Venereol, 2019, 33(7), p. 1224–1231.

81. TORRES, T., GONÇALO, M., PAIVA LOPES, MJ. et al. Portuguese recommendations for the treatment of atopic dermatitis with biologic therapy and JAK inhibitors in adult patients. Drugs Context, 2021, 10, p. 2021-9-5.

82. ULTSCH, M., BEVERS, J., NAKAMURA, G. et al. Structural basis of signaling blockade by anti-IL-13 antibody lebrikizumab. J Mol Biol, 2013, 425(8), p. 1330–1339.

83. WEIDINGER, S., BECK, LA., BIEBER, T. et al. Atopic dermatitis. Nat Rev Dis Primers, 2018; 4(1), p. 1.

84. WERFEL, T., HERATIZADEH, A., ABERER, W. et al. S2k guideline on diagnosis and treatment of atopic dermatitis – short version. J Dtsch Dermatol Ges, 2016, 14(1), p. 92–106.

85. WERFEL, T., HERATIZADEH, A., ABERER, W. et al. Update „Systemic treatment of atopic dermatitis“ of the S2k-guideline on atopic dermatitis. J Dtsch Dermatol Ges, 2021, 19(1), p. 151–168.

86. WESTON, WL., HOWE, W. Treatment of atopic dermatitis (eczema). https://www.uptodate.com/contents/treatment-of-atopic-dermatitis-eczema.

87. WOLLENBERG, A., ARIENS, L., THURAU, S. et al. Conjunctivitis occurring in atopic dermatitis patients treated with dupilumab-clinical characteristics and treatment. J Allergy Clin Immunol Pract, 2018, 6(5), p. 1778–1780.

88. WOLLENBERG, A., BARBAROT, S., BIEBER, T., et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: Part II. J Eur Acad Dermatol Venereol, 2018, 32(6), p. 850–878.

89. WOLLENBERG, A., BECK, LA., BLAUVELT, A. et al. Laboratory safety of dupilumab in moderate-to-severe atopic dermatitis: results from three phase III trials (LIBERTY AD SOLO 1, LIBERTY AD SOLO 2, LIBERTY AD CHRONOS). Br J Dermatol, 2020, 182(5), p. 1120–1135.

90. WOLLENBERG, A., CHRISTEN-ZACH, S., TAIEB, A. et al. European Task Force on Atopic Dermatitis/EADV Eczema Task Force. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol, 2020, 34(12), p. 2717–2744.

91. WOLLENBERG, A., BLAUVELT, A., GUTTMAN-YASSKY, E. et al. Tralokinumab for moderate-to-severe atopic dermatitis: results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2). Br J Dermatol, 2021, 184(3), p. 437–449.

92. WOLLENBERG, A., KINBERGER, M., ARENTS, B. et al. European guideline (EuroGuiDerm) on atopic eczema: part I – systemic therapy. J Eur Acad Dermatol Venereol. 2022 Sep;36(9):1409–1431.

93. WORM, M., SIMPSON, EL., THACI, D. et al. Efficacy and safety of multiple dupilumab dose regimens after initial successful treatment in patients with atopic dermatitis: a randomized clinical trial. JAMA Dermatol, 2020, 156(2), p. 131–143.

94. www.sukl.cz/inhibitory-janus-kinaz-zaverecna-doporuceni-z-evropskeho?highlightWords=JAK+inhibitory, 1. 11. 2022.

95. YTTERBERG, SR., BHATT, DL., MIKULS, TR. et al. ORAL Surveillance Investigators. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med, 2022, 386(4), p. 316–326.

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