Navigating the atopic dermatitis toolbox: Challenging scenarios and shared decision-making.

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Atopic dermatitis (AD) is a chronic inflammatory skin condition with varied clinical presentations.
• Recent approvals of advanced therapies, including biologics and oral Janus kinase (JAK) inhibitors, offer new treatment options for moderate-severe AD.
• The diverse efficacy, safety, and monitoring needs of these new treatments present a challenge in selecting the most suitable therapy.

Purpose of the Study:

• To guide healthcare providers and patients in shared decision-making for advanced systemic therapies in atopic dermatitis.
• To highlight key clinical considerations for selecting between biologic agents and oral Janus kinase inhibitors.
• To incorporate patient perspectives into the treatment selection process for moderate-to-severe AD.

Main Methods:

• Review of clinical considerations for advanced therapies in atopic dermatitis.
• Analysis of efficacy, safety, and tolerability profiles of biologic and Janus kinase inhibitor treatments.
• Integration of patient perspectives and risk predispositions into treatment selection.

Main Results:

• New biologic therapies (dupilumab, tralokinumab, lebrikizumab) and oral Janus kinase inhibitors (abrocitinib, upadacitinib, baricitinib) have distinct profiles.
• Treatment selection necessitates evaluating patient-specific factors such as medical history, symptom severity, and safety concerns.
• Shared decision-making is crucial for optimizing outcomes in moderate-to-severe atopic dermatitis.

Conclusions:

• Selecting the optimal advanced therapy for atopic dermatitis requires a personalized approach.
• Balancing treatment efficacy with safety, tolerability, and patient-specific risks is essential.
• Shared decision-making, informed by clinical data and patient values, improves the management of moderate-to-severe AD.