Wohlrab Johannes, Mrowietz Ulrich, Weidinger Stephan, Werfel Thomas, Wollenberg Andreas
Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06097, Halle (Saale), Deutschland.
An-Institut für angewandte Dermatopharmazie, Martin-Luther-Universität Halle-Wittenberg, Halle-Wittenberg, Deutschland.
Hautarzt. 2021 Apr;72(4):321-327. doi: 10.1007/s00105-020-04720-1.
Based on new insights into the molecular pathogenesis of atopic dermatitis, a targeted anti-inflammatory therapy-dupilumab-has recently been approved as treatment alongside glucocorticoids and ciclosporin. Due to their pharmacology, neither glucocorticoids nor ciclosporin nor the off label used substances methotrexate, azathioprine and mycophenolic acid derivatives are suitable for long-term therapy. When switching therapy from small molecular substances to dupilumab, various factors should be considered. Both the specific cause of the change (ineffectiveness, adverse effects or contraindications) as well as the pharmacological conditions should be taken into account. Since there have been no specific clinical studies on this subject so far, the authors relied mainly on a literature search to draw up recommendations for practical everyday use.
基于对特应性皮炎分子发病机制的新认识,一种靶向抗炎疗法——度普利尤单抗——最近已被批准与糖皮质激素和环孢素一起作为治疗药物。由于其药理学特性,糖皮质激素、环孢素以及非标签使用的甲氨蝶呤、硫唑嘌呤和霉酚酸衍生物都不适合长期治疗。当从小分子物质转换为度普利尤单抗治疗时,应考虑多种因素。既要考虑换药的具体原因(无效、不良反应或禁忌症),也要考虑药理学情况。由于目前尚无关于该主题的具体临床研究,作者主要依靠文献检索来制定实际日常使用的建议。