Department of Dermatology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55902, USA.
Paediatr Drugs. 2019 Aug;21(4):239-260. doi: 10.1007/s40272-019-00342-w.
Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by pruritus, inflammatory erythematous skin lesions, and skin-barrier defect. Current mainstay treatments of emollients, steroids, calcineurin inhibitors, and immunosuppressants have limited efficacy and potentially serious side effects. Recent advances and understanding of the pathogenesis of AD have resulted in new therapies that target specific pathways with increased efficacy and the potential for less systemic side effects. New FDA-approved therapies for AD are crisaborole and dupilumab. The JAK-STAT inhibitors (baricitinib, upadacitinib, PF-04965842, ASN002, tofacitinib, ruxolitinib, and delgocitinib) have the most promising results of the emerging therapies. Other drugs with potential include the aryl hydrocarbon receptor modulating agent tapinarof, the IL-4/IL-13 antagonists lebrikizumab and tralokinumab, and the IL-31Rα antagonist nemolizumab. In this review, new and emerging AD therapies will be discussed along with their mechanisms of action and their potential based on clinical study data.
特应性皮炎(AD)是一种慢性炎症性皮肤病,其特征为瘙痒、炎症性红斑性皮损和皮肤屏障缺陷。目前,保湿剂、类固醇、钙调磷酸酶抑制剂和免疫抑制剂等主要治疗方法疗效有限,且可能存在严重的副作用。最近对 AD 发病机制的深入了解和研究进展,产生了一些新的治疗方法,这些方法针对特定的途径,具有更高的疗效和潜在的较少的全身副作用。新获得 FDA 批准的 AD 治疗药物为 crisaborole 和 dupilumab。JAK-STAT 抑制剂(baricitinib、upadacitinib、PF-04965842、ASN002、tofacitinib、ruxolitinib 和 delgocitinib)是新兴疗法中最有前途的。其他具有潜力的药物包括芳香烃受体调节剂 tapinarof、IL-4/IL-13 拮抗剂 lebrikizumab 和 tralokinumab 以及 IL-31Rα拮抗剂 nemolizumab。在本文综述中,将讨论 AD 的新型和新兴治疗方法,包括它们的作用机制和基于临床研究数据的潜在应用。