Non-hormonal treatments for atopic dermatitis

2023-12-30

Atopic dermatitis (AD), also known as atopic eczema, is a specific type of eczema and one of the most common chronic inflammatory skin diseases, affecting people of all ages and genders worldwide. The symptoms of AD manifest as a rash (or recurrent skin lesions), causing itching, which may resolve or relapse or relapse over time, and may also lead to sleep disturbance, embarrassment, and difficulty concentrating.

In China, the prevalence of AD in adults is 4.6%, in children aged 1 to 7 years old it is 12.9%, and in infants aged 1 to 12 months the prevalence of AD is as high as 30.48%, and this number is still rising year by year.

Glucocorticoids are still the main treatment method in the current treatment of atopic dermatitis.

However, long-term and large-scale use of topical glucocorticoids can cause secondary bacterial and fungal infections. Acne, rosacea dermatitis, skin atrophy and telangiectasia may occur locally, and reactions such as itching, pigmentation, facial erythema, and wound healing disorders may occur. There are also certain dependencies.

Compared with glucocorticoids, calcineurin inhibitors are effective in treating atopic dermatitis and also have the advantage of improving skin barrier function.

Calcineurin inhibitors such as tacrolimus, pimecrolimus and phosphodiesterase 4 inhibitor criborole ointment have no side effects of glucocorticoids and are not only suitable for the face, but can also replace traditional methods for other parts of the body. of topical corticosteroids.

In addition, in 2021, the FDA approved the JAK inhibitor ruxolitinib cream (Opzelura) developed by Incyte for the short-term and non-continuous long-term treatment of non-immunocompromised patients 12 years old and above with mild to moderate atopic dermatitis. Opzelura became the FDA The first and only approved topical JAK inhibitor.

In addition, some oral or injectable preparations have recently made some progress in the treatment of atopic dermatitis. There are:

• IL-4/IL-13 inhibitor (Dupilumab)
• IL-13 inhibitor (Tralokinumab, or Lebrikizumab)
• IL-22 inhibitor (Fezakinumab)
• IL-31 receptor inhibitor (Nemolizumab)
• IL-33 inhibitor (Etokimab)
• TSLP inhibitor