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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.
Summary
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.
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.
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