揭示儿科特应性皮炎的关键药理学知识和策略。

Shedding light on key pharmacological knowledge and strategies for pediatric atopic dermatitis.

机构信息

Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA.

Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

Expert Rev Clin Pharmacol. 2023 Feb;16(2):119-131. doi: 10.1080/17512433.2023.2173172. Epub 2023 Feb 6.

Abstract

INTRODUCTION

Atopic dermatitis (AD) is an inflammatory disease affecting over 20% of the pediatric population, with 85% of cases presenting before the age of five. Recently, therapeutic options in pediatric patients have evolved rapidly, following extensive development in adult treatments.

AREAS COVERED

This review will encompass relevant molecular drivers, along with an overlook on treatment modalities in pediatric AD, as well as a summary of pipeline treatments in clinical trials for pediatric patients from PubMed, Google Scholar, and Clinicaltrials.gov up to July 2022. Topical corticosteroids are the mainstay for AD flares in adults and children. Topical approved agents in pediatric AD are calcineurin inhibitors, crisaborolecrisaborole, and ruxolitinib. Dupilumab is the only FDA approved biologic for patients with AD from six months of age. A Janus kinase inhibitor, upadacitinib, is a systemic treatment approved for pediatric AD patients (age >12 years). Systemic immunosuppressants used in pediatric AD include methotrexate, azathioprine, cyclosporinecyclosporine, and mycophenolate mofetil.

EXPERT OPINION

Data regarding disease prevention are conflicting, however, an abundance of research has transpired regarding amelioration of symptoms and induction of disease clearance by targeting numerous pathological mechanisms. Understanding the pediatric AD phenotype will further advance the field and the development of improved therapeutics.

摘要

简介

特应性皮炎(AD)是一种影响超过 20%儿童人群的炎症性疾病,其中 85%的病例发生在五岁之前。最近,随着成人治疗方法的广泛发展,儿科患者的治疗选择迅速发展。

涵盖领域

本综述将包括相关的分子驱动因素,以及儿科 AD 的治疗方式概述,以及截至 2022 年 7 月,来自 PubMed、Google Scholar 和 Clinicaltrials.gov 的儿科患者临床试验中正在研发的治疗方法的总结。局部皮质类固醇是成人和儿童 AD 发作的主要治疗方法。儿科 AD 中批准的局部制剂包括钙调神经磷酸酶抑制剂、克立硼罗和芦可替尼。度普利尤单抗是唯一一种 FDA 批准用于六个月以上 AD 患者的生物制剂。Janus 激酶抑制剂乌帕替尼是一种被批准用于治疗 12 岁以上 AD 患者的系统性治疗药物。在儿科 AD 中使用的系统性免疫抑制剂包括甲氨蝶呤、硫唑嘌呤、环孢素和霉酚酸酯。

专家意见

关于疾病预防的数据存在矛盾,但是,已经有大量的研究致力于通过针对多种病理机制来改善症状和诱导疾病清除。了解儿科 AD 的表型将进一步推进该领域和改善治疗方法的发展。

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