Biedermann T, Werfel T
Klinik und Poliklinik für Dermatologie und Allergologie, Biedersteinerstraße 29, 80802, München, Deutschland.
Hautarzt. 2015 Feb;66(2):108-13. doi: 10.1007/s00105-014-3575-8.
Currently the only approved drug available for the systemic therapy of atopic dermatitis is cyclosporine; however, based on current data from published studies, azathioprine, methotrexate, and mycophenolate mofetil or mycophenolic acid can be administered off-label. Some biologics on the market that have been approved for other indications (ustekinumab, rituximab, tocilizumab) have been successfully used in a few patients with atopic dermatitis. The world's first prospective controlled studies with the biologic human anti-IL4R antibody dupilumab for the indication "atopic dermatitis" were published in 2014. These motivated (1) to extend the studies to dupilumab and (2) to clinically test antagonization of other target molecules of TH2 polarized, atopic inflammation, e.g., IL-13, IL-31, IL-22, TSLP, and CRTH2. A number of clinical trials are currently recruiting in this area and will provide interesting new insights for future therapeutic approaches in atopic dermatitis.
目前,唯一被批准用于特应性皮炎全身治疗的药物是环孢素;然而,根据已发表研究的现有数据,硫唑嘌呤、甲氨蝶呤以及霉酚酸酯或霉酚酸可在无获批适应症的情况下使用。市场上一些已被批准用于其他适应症的生物制剂(乌司奴单抗、利妥昔单抗、托珠单抗)已成功用于少数特应性皮炎患者。2014年发表了世界上首例关于生物制剂人抗IL4R抗体度普利尤单抗用于“特应性皮炎”适应症的前瞻性对照研究。这些研究促使(1)将研究扩展至度普利尤单抗,以及(2)对TH2极化的特应性炎症的其他靶分子(如IL-13、IL-31、IL-22、TSLP和CRTH2)的拮抗作用进行临床试验。目前该领域有多项临床试验正在招募受试者,这将为特应性皮炎未来的治疗方法提供有趣的新见解。