Update of systemic treatments in severe/recalcitrant atopic dermatitis:Consensus document of the KAAACI working group on atopic dermatitis
10.4168/aard.2024.12.2.58
- Author:
Myongsoon SUNG
1
;
Young-Il KOH
;
Mi-Ae KIM
;
Hyunjung KIM
;
Jung Im NA
;
Dong-Ho NAHM
;
Taek Ki MIN
;
Yang PARK
;
Dong Hun LEE
;
Mi-Hee LEE
;
So-Yeon LEE
;
Youngsoo LEE
;
Chong Hyun WON
;
Hye Yung YUM
;
Mira CHOI
;
Eung Ho CHOI
;
Woo Kyung KIM
;
Author Information
1. Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Korea
- Publication Type:REVIEW
- From:Allergy, Asthma & Respiratory Disease
2024;12(2):58-71
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Atopic dermatitis (AD) is the most prevalent inflammatory skin condition, with approximately 80% of cases originating in childhood and some emerging in adulthood. In South Korea, the estimated prevalence of AD ranges between 10% and 20% in children and 1% and 3% in adults. Severe/recalcitrant AD manifests as a chronic, relapsing skin disorder, persisting with uncontrolled symptoms even after topical steroid treatment. Corticosteroids and systemic immunosuppression, conventionally the standard care for difficult-to-treat diseases, cause numerous undesirable side effects. When AD persists despite topical steroid application, systemic therapies like cyclosporine or systemic steroids become the second treatment strategy. The desire for targeted treatments, along with an enhanced understanding of AD’s pathophysiology, has spurred novel therapeutic development. Recent advances introduce novel systemic options, such as biological agents and small-molecule therapy, tailored to treat severe or recalcitrant AD. Notably, dupilumab, a monoclonal antibody inhibiting interleukin 4 and 13, marked a transformative breakthrough upon gaining approval from the U.S. Food and Drug Administration (FDA) in 2017, leading to a paradigm shift in the systemic treatment of AD. Furthermore, both dupilumab and Janus kinase inhibitors, including baricitinib, abrocitinib, and tofacitinib, now approved by the Korean FDA, have established their applicability in clinical practice. These innovative therapeutic agents have demonstrated favorable clinical outcomes, effectively addressing moderate to severe AD with fewer side reactions than those associated with previous systemic immunosuppressants. This review summarizes the latest advancements and evidence regarding systemic treatments for AD, including newly approved drugs in Korea.
