University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Department of Dermatology, University of Cincinnati, Cincinnati, OH, USA.
J Dermatolog Treat. 2022 May;33(3):1274-1278. doi: 10.1080/09546634.2020.1837721. Epub 2020 Nov 3.
Until recently, treatment of atopic dermatitis has been limited to topical corticosteroids, calcineurin inhibitors, phototherapy, and systemic immunomodulatory agents. With improved understanding of the pathogenesis underlying atopic dermatitis, targeted oral small molecules and topical agents are being developed.
Discuss efficacy and safety profiles of emerging oral small molecules and targeted topical agents in phase 2 and 3 clinical trials.
A systemic literature review was conducted to identify results of randomized, placebo-controlled trials of oral small molecules and topical Janus kinase inhibitors up to March 1 2020 for the treatment of atopic dermatitis.
Three novel oral small molecules, abrocitinib, upadacitinib, and baricitinib, demonstrated improvement of clinical severity, pruritus, and quality of life with acceptable safety profiles. Apremilast, a phosphodiesterase inhibitor, was less efficacious with use limited by adverse effects. Two novel topical agents, ruxolitinib and delgocitinib, were effective and well-tolerated.
Targeted therapeutics including oral small molecules and topical agents show promise for the treatment of atopic dermatitis. The use of validated core measures is necessary for future trials in order to adequately compare agents and progress evidence-based medicine.
直到最近，特应性皮炎的治疗还局限于局部皮质类固醇、钙调神经磷酸酶抑制剂、光疗和全身免疫调节剂。随着对特应性皮炎发病机制认识的提高，靶向口服小分子药物和局部药物正在开发中。
讨论在 2 期和 3 期临床试验中新兴的口服小分子和靶向局部制剂的疗效和安全性。
系统检索了截至 2020 年 3 月 1 日用于治疗特应性皮炎的口服小分子和 Janus 激酶抑制剂的随机、安慰剂对照试验的结果。
三种新型口服小分子药物阿布昔替尼、乌帕替尼和巴瑞替尼均显示出改善临床严重程度、瘙痒和生活质量的效果，且安全性可接受。磷酸二酯酶抑制剂阿普司特疗效较差，因不良反应而受限。两种新型局部制剂罗氟司特和德谷替尼有效且耐受性良好。
包括口服小分子和局部制剂在内的靶向治疗方法为特应性皮炎的治疗带来了希望。未来的试验需要使用经过验证的核心措施，以便充分比较药物并推进循证医学。
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