Topical agents for the treatment of atopic dermatitis

Expert Rev Clin Immunol. 2019 Apr;15(4):369-382. doi: 10.1080/1744666X.2019.1564038. Epub 2019 Jan 8.

Abstract

Atopic dermatitis (AD) is perhaps the most common inflammatory skin disorder worldwide, with an increasing incidence in developed countries. The mainstay treatment for patients with AD is topical therapies, which are used not only by the mild patients but also by the moderate-to-severe patients, in conjunction with systemic treatment. While topical steroids and calcineurin antagonists are widely used, these are associated with long-term cutaneous adverse effects (AEs) or a black box warning, preventing their chronic use. Areas covered: The aim of this review is to provide a comprehensive overview of new and upcoming topical therapies currently in development and undergoing clinical trials, as well as their safety and efficacy profiles, and discuss current topicals used in the management of AD. Expert opinion: AD is a heterogeneous disease with complex pathophysiology. Treatments available to date for AD provide disease control; however, patients struggle to find an optimized therapeutic regimen they may use long term and without severe effects. Novel therapies are currently under investigation, with the hope of shifting the paradigm of AD management from symptom control to disease eradication.

Keywords: Atopic dermatitis; crisaborole; tapinarof; topical calcineurin inhibitors; topical corticosteroids; topical janus kinase inhibitors; topical phosphodiaesterase-4 inhibitors.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Animals
  • Calcineurin Inhibitors / therapeutic use*
  • Clinical Trials as Topic
  • Dermatitis, Atopic / drug therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Skin / drug effects
  • Skin / pathology*
  • Tacrolimus / therapeutic use*

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Tacrolimus