It’s an exciting time for atopic dermatitis patients as many new treatment options are on the market and in the pipeline. But treatment doesn’t yet offer a cure and many patients continue to suffer with symptoms, including itch, psychosocial and quality-of-life issues, according to a paper published February 2020 in Expert Opinion on Drug Discovery.
“[Atopic dermatitis] is a systemic atopic disease with a lot of complicated psychosocial issues. Suboptimal efficacy is often due to poor compliance and unrealistic expectation of curative treatment, rendering treatment difficult despite the existence of effective medications,” write the review’s Chinese and Canadian authors.
In their review of atopic dermatitis drug discovery efforts, the authors study treatment options from topical corticosteroids to dupilumab. They also address treatment hurdles.
Topical corticosteroids and calcineurin inhibitors remain treatment mainstays, along with moisturizers. Corticosteroids, which mediate anti-inflammatory effects in affected cells in atopic dermatitis, can lead to side effects, especially in pediatric patients. The perception of risk is another problem. Unfortunately, patient hesitation and steroid phobias leave many using corticosteroids sub-optimally. Topical calcineurin inhibitor use has been limited by high treatment costs and black box warning controversies, they write.
The challenge with commercial moisturizers is there aren’t many research trials to prove their clinical efficacy. The research that does exist suggests moisturizers can have a beneficial effect on atopic dermatitis but no one product seems to stand out from the others, according to the review.
Hon KL, Loo S, Leung AKC, Li JTS, Lee VWY. An overview of drug discovery efforts for eczema: why is this itch so difficult to scratch?. Expert Opin Drug Discov. 2020;:1-12.