Alexander Helen, Patton Thomas, Jabbar-Lopez Zarif K, Manca Andrea, Flohr Carsten
Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
Centre for Health Economics, University of York, York, UK.
F1000Res. 2019 Jan 31;8. doi: 10.12688/f1000research.17039.1. eCollection 2019.
Patients with atopic dermatitis (AD) who do not adequately respond to topical therapy and phototherapy often need systemic immunomodulatory treatment to control their symptoms. Conventional systemic agents, such as ciclosporin, azathioprine, and methotrexate, have been used for decades, but there are concerns about their safety profile. There are now many novel systemic agents emerging through clinical trials, which may have great potential in the treatment of AD. Despite this, there are very few data comparing the performance of these drugs against each other. The purpose of this article is to review the current systemic therapies in AD and present an indirect comparison of systemic AD treatments using effectiveness and safety data from published randomised controlled trials, highlighting important remaining gaps in knowledge. Although the latest developments in systemic AD treatments are exciting and dearly needed, further work is required before the promise of a therapeutic revolution becomes reality.
对局部治疗和光疗反应不佳的特应性皮炎（AD）患者通常需要进行全身免疫调节治疗来控制症状。传统的全身用药，如环孢素、硫唑嘌呤和甲氨蝶呤，已经使用了几十年，但人们对其安全性存在担忧。目前有许多新型全身用药正在通过临床试验涌现出来，它们在AD治疗中可能具有巨大潜力。尽管如此，比较这些药物相互之间疗效的数据却非常少。本文的目的是回顾AD目前的全身治疗方法，并利用已发表的随机对照试验的有效性和安全性数据对AD全身治疗进行间接比较，突出知识方面仍然存在的重要差距。尽管AD全身治疗的最新进展令人兴奋且迫切需要，但在治疗革命的前景成为现实之前，还需要进一步开展工作。
