Expert Consensus on the Systemic Treatment of Atopic Dermatitis in Special Populations.
D N AdamM J GooderhamJ R BeeckerC H HongC S JackV JainP LansangC W LyndeKim A PappV H PrajapatiI TurchinJ YeungPublished in: Journal of the European Academy of Dermatology and Venereology : JEADV (2023)
With the increasing number of options for the treatment of moderate-to-severe atopic dermatitis, clinicians need guidance on a practical approach to selecting a systemic agent for specific patient populations. We convened an expert panel consisting of 12 members to conduct a literature review and summarize relevant data related to six scenarios of clinical interest: comorbid asthma, ocular surface disease, history of cancer, past and ongoing infections of interest (including herpes simplex virus, herpes zoster, hepatitis B, and tuberculosis), pregnancy and lactation, and the elderly. We performed a literature search and examined each clinical scenario with respect to three major categories of available systemic agents: traditional systemics (azathioprine, cyclosporine A, methotrexate, and mycophenolate mofetil), Janus kinase inhibitors (abrocitinib, baricitinib, and upadacitinib), and biologics (dupilumab, lebrikizumab, and tralokinumab). The expert panel and steering committee met virtually to review the data and discuss the drafted consensus statements. A modified Delphi process was used to arrive at a set of final consensus statements related to the systemic treatment of AD in these specific patient populations. To provide practical guidance on the choice of systemic therapy for atopic dermatitis in these six topics of clinical interest, 25 expert consensus statements and a summary of the supporting data are presented herein.
Keyphrases
- atopic dermatitis
- case report
- systematic review
- chronic obstructive pulmonary disease
- big data
- clinical practice
- squamous cell carcinoma
- herpes simplex virus
- early onset
- papillary thyroid
- pregnant women
- preterm birth
- lung function
- high intensity
- tyrosine kinase
- hepatitis c virus
- preterm infants
- middle aged
- lymph node metastasis
- community dwelling
- pregnancy outcomes
- human immunodeficiency virus
- artificial intelligence
- antiretroviral therapy