An Overview of Atopic Dermatitis Disease Burden, Pathogenesis, and the Current Treatment Landscape: Recommendations for Appropriate Utilization of Systemic Therapies.

Abstract

Objective: To review the disease impact, immunopathogenesis, and treatment landscape of atopic dermatitis (AD), including recommendations for appropriate utilization of systemic treatments.

Methods: A PubMed search for relevant articles on AD and the treatment landscape was conducted using the key words "atopic dermatitis," "biologic," "therapeutic inertia," "Janus kinase (JAK) inhibitor," and "systemic treatment."

Results: AD is a common, chronic inflammatory skin disease that can have a profound negative impact on quality of life. With recent advancements and approvals of systemic treatments, it is now possible to offer targeted therapy to patients with moderate-to-severe AD. When topical treatments are no longer sufficient for managing AD, recently published AD management guidelines recommend that providers consider/offer advanced systemic treatments.

Limitations: More data are needed on the use of systemic treatments in special populations, including head-to-head comparisons of available systemic treatments in these populations.

Conclusion: An increased awareness of the immunopathogenesis, diagnosis, and treatment landscape of AD is needed amongst healthcare providers (HCPs). Special consideration of diagnosis and treatment options should be given to certain populations, including patients of different ages, those who may be pregnant or become pregnant, are biologic-experienced, and/or have comorbidities. Of note, HCPs should be aware of the clinical presentation in patients with skin of color. Therapeutic inertia can prevent HCPs from intensifying treatment when needed, and HCPs should know when it is appropriate to offer systemic treatments, including biologics and JAK inhibitors.