Atopic dermatitis is characterized by agonizing itching, reddening of the skin with swelling, blistering, scaling and weeping of various areas of the skin, which can be affected to varying degrees. The disease usually begins between the 3rd and 6th month of life, but it is also possible to develop it as an adult. Atopic dermatitis is usually a multifactorial disease, so genetic predisposition, disorders of the skin barrier and the immune system can also be responsible, as well as provoking factors due to environmental influences. Each individual aspect can cause atopic dermatitis, but it is usually a combination of these factors. Atopic patients very often also suffer from allergic asthma and food allergies, as well as hay fever.

Therapy options for treating neurodermatitis

Treatment of atopic dermatitis is currently not directed against the cause, but is primarily intended to alleviate the symptoms and prevent new flare-ups. A step-by-step therapy plan is used here in order to be able to respond to different phases and individual disease progressions. The main pillar of the step-by-step plan is basic therapy, in which the barrier disorder of the skin is favorably influenced by the regular use of care products and dryness and itching are to be reduced. In this stage, possible trigger factors should also be identified and eliminated. For mild to moderate eczema, antiseptic and antipruritic products and phototherapy are also used. Anti-inflammatory creams or ointments should also be prescribed. After controlling the eczema with the anti-inflammatory substances, maintenance therapy is carried out for a further 3 months in order to prevent a rapid recurrence of the disease. However, if the eczema is very severe and does not respond adequately to local therapy, systemic immunosuppressants are required. Unfortunately, these drugs sometimes have severe side effects and can only be used for a limited period of time.

Allergen-specific immunotherapy

However, there are new therapeutic approaches for treating neurodermatitis. Small clinical studies have shown that immunotherapy, e.g., against house dust mites or birch pollen, can achieve a significant improvement in skin symptoms, especially at higher doses. It remains to be clarified whether mild or severe eczema patients can benefit from such immunotherapy and what dosage is most appropriate.

Targeted immunomodulation through biologics

Furthermore, there are increasing reports on the use of biologics in the treatment of atopic dermatitis, which block a messenger substance relevant to the development of the disease. These drugs have previously been used in the treatment of psoriasis. However, such drugs are also being developed for the treatment of atopic dermatitis and are currently being tested in studies.

Products to combat itching

One strategy to alleviate itching in atopic dermatitis is to block interleukin-31. The tolerability of the antibody against interleukin-31 is currently being tested in a phase 1 trial in patients suffering from atopic dermatitis. Other products to combat itching are also currently being tested, such as neurokinin-1 receptor antagonists, which are already in a phase 2 trial. Dupilumab (anti-IL4R), which blocks a messenger substance that is important for the development of the disease, is already in the third study phase. This drug has shown very good results in previous studies and is currently the most promising form of therapy for severe atopic dermatitis.

The complete article "New active ingredients in the pipeline for the treatment of atopic dermatitis" from springermedizin.de can be read here:

pdficon_largeNew active ingredients for the treatment of atopic dermatitis by Dr. Bangert from JUVENIS

 

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