Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, 1001 Main Street, Buffalo, NY, 14203, USA.
Clin Rev Allergy Immunol. 2020 Oct;59(2):208-219. doi: 10.1007/s12016-020-08802-9.
Atopic dermatitis is a common immunologic skin disease. Mild atopic dermatitis can be managed with emollients and topical therapies such as low potency topical steroids, which have a favorable safety profile. Severe atopic dermatitis, in contrast, is a challenging disease to treat. Topical therapies are typically inadequate for control of severe atopic dermatitis. When topical therapies fail, the mainstay of therapy for severe atopic dermatitis has traditionally been phototherapy or off-label use of systemic immunosuppressant treatment, yet systemic immunosuppressants all have significant potential toxicities, drug interactions, and contraindications, requiring close monitoring. Targeted biologics are therefore attractive treatment options for topical therapy-refractory cases of atopic dermatitis, with the potential to offer effective, safer treatment of uncontrolled atopic dermatitis. Dupilumab, as the only biologic therapy currently FDA-approved for atopic dermatitis, is effective for many patients, but there is need for continuing study of additional biologic therapies to address the needs of diverse patients with uncontrolled atopic dermatitis.
特应性皮炎是一种常见的免疫性皮肤疾病。轻度特应性皮炎可以通过保湿剂和局部治疗（如低效能外用类固醇）来控制，这些治疗方法具有良好的安全性。相比之下，重度特应性皮炎是一种具有挑战性的疾病。局部治疗通常不足以控制重度特应性皮炎。当局部治疗失败时，重度特应性皮炎的主要治疗方法传统上是光疗或外用免疫抑制剂治疗，但所有系统性免疫抑制剂都具有显著的潜在毒性、药物相互作用和禁忌症，需要密切监测。因此，对于局部治疗抵抗的特应性皮炎病例，靶向生物制剂是一种有吸引力的治疗选择，有可能为未控制的特应性皮炎提供有效、更安全的治疗。度普利尤单抗是目前唯一被 FDA 批准用于特应性皮炎的生物制剂，对许多患者有效，但需要继续研究其他生物制剂，以满足不同特应性皮炎患者的需求。
