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S3 guideline Atopic dermatitis: Part 2 - Systemic treatment.

Thomas Werfel1, Annice Heratizadeh1, Werner Aberer2

  • 1Department of Dermatology, Allergology and Venereology, Hannover Medical School, Hannover, Germany.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|December 31, 2023
PubMed
Summary
This summary is machine-generated.

This guideline details systemic therapies for atopic dermatitis (AD), covering approved biologics, JAK inhibitors, and conventional immunosuppressants for all age groups. It also discusses off-label treatments for managing moderate-to-severe AD.

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Area of Science:

  • Dermatology
  • Clinical Guidelines
  • Pharmacology

Background:

  • Atopic dermatitis (AD) is a chronic inflammatory skin disease.
  • Systemic therapy is indicated for moderate-to-severe AD cases unresponsive to topical treatments.
  • German-speaking region-specific considerations are integrated into this guideline.

Purpose of the Study:

  • To provide evidence-based recommendations for systemic therapy in atopic dermatitis.
  • To outline indications for systemic treatment in pediatric, adolescent, and adult AD patients.
  • To review approved and off-label systemic medications for AD management.

Main Methods:

  • Adaptation of the European S3 guideline for the German-speaking region.
  • Inclusion of additions from the previous German-language version.
  • Adherence to AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften) criteria.

Main Results:

  • Comprehensive review of systemic therapies for atopic dermatitis.
  • Detailed information on biologics (dupilumab, tralokinumab) and JAK inhibitors (abrocitinib, baricitinib, upadacitinib).
  • Discussion of systemic glucocorticosteroids, ciclosporin, and off-label treatment options.

Conclusions:

  • Systemic therapy is a crucial component in managing moderate-to-severe atopic dermatitis.
  • The guideline provides a framework for selecting appropriate systemic treatments based on approved indications and patient profiles.
  • This guideline complements the first part, which covers AD definition, diagnosis, topical, and non-drug therapies.