Saeki Hidehisa, Ohya Yukihiro, Arakawa Hirokazu, Ichiyama Susumu, Katsunuma Toshio, Katoh Norito, Tanaka Akio, Tanizaki Hideaki, Tsunemi Yuichiro, Nakahara Takeshi, Nagao Mizuho, Narita Masami, Hide Michihiro, Fujisawa Takao, Futamura Masaki, Masuda Koji, Matsubara Tomoyo, Murota Hiroyuki, Yamamoto-Hanada Kiwako, Furuta Junichi
Department of Dermatology, Nippon Medical School, Tokyo, Japan.
Department of Occupational and Environmental Health, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan.
J Dermatol. 2025 Feb;52(2):e70-e142. doi: 10.1111/1346-8138.17544. Epub 2024 Dec 20.
This is the English version of the 2024 clinical practice guidelines for the management of atopic dermatitis (AD). AD is a disease characterized by relapsing eczema with pruritus as a primary lesion. A crucial aspect of AD treatment is the prompt induction of remission via the suppression of existing skin inflammation and pruritus. To achieve this, topical anti-inflammatory drugs, such as topical corticosteroids, tacrolimus ointment, delgocitinib ointment, and difamilast ointment, have been used. However, the following treatments should be considered in addition to topical therapy for patients with refractory moderate-to-severe AD: oral cyclosporine, subcutaneous injections of biologics (dupilumab, nemolizumab, tralokinumab), oral Janus kinase inhibitors (baricitinib, upadacitinib, abrocitinib), and phototherapy. In these revised guidelines, descriptions of five new drugs, namely, difamilast, nemolizumab, tralokinumab, upadacitinib, and abrocitinib, have been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.
这是2024年特应性皮炎(AD)管理临床实践指南的英文版本。AD是一种以复发性湿疹为特征、瘙痒为主要皮损的疾病。AD治疗的一个关键方面是通过抑制现有的皮肤炎症和瘙痒迅速诱导缓解。为实现这一目标,已使用局部抗炎药物,如局部糖皮质激素、他克莫司软膏、度普利尤单抗软膏和地法米司特软膏。然而,对于难治性中重度AD患者,除局部治疗外,还应考虑以下治疗方法:口服环孢素、皮下注射生物制剂(度普利尤单抗、奈莫利珠单抗、曲洛珠单抗)、口服Janus激酶抑制剂(巴瑞替尼、乌帕替尼、阿布昔替尼)和光疗。在这些修订指南中,增加了五种新药的描述,即地法米司特、奈莫利珠单抗、曲洛珠单抗、乌帕替尼和阿布昔替尼。本指南提出了相关建议,以审查临床研究文章,评估医疗活动利弊之间的平衡,并针对临床实践中几个需要决策的要点优化与医疗活动相关的患者结局。