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The Mechanisms of Action of AD Treatments


Raj Chovatiya, MD, PhD, and Adelaide A. Hebert, MD, FAAD, comment on the newer treatments in AD, highlighting the positive impact these agents have had in managing the disease.

This is a video synopsis/summary of a panel discussion involving Raj Chovatiya, MD, PhD, and Adelaide A. Hebert, MD, FAAD.

In the discussion on treatments for moderate to severe atopic dermatitis, the emphasis is on optimizing therapeutic benefits while minimizing adverse effects, both for the dermatologist and the patient. The speaker explores various mechanisms and medications employed in this context.

Topical corticosteroids are mentioned as a nonspecific approach, along with nonsteroidal options such as tacrolimus and pimecrolimus, which are calcineurin inhibitors. However, their use is limited due to cutaneous adverse events, including stinging and burning sensations. Topical Janus kinase (JAK) inhibitors are introduced as a more selective option, focusing on specific immune system elements.

In the systemic approach, the discussion revolves around targeting type 2 inflammation, a key area in atopic dermatitis. Biologic agents like dupilumab (a blocker of IL-4 and IL-13) and tralokinumab (a selective IL-13 blocker) are highlighted. Oral JAK inhibitors, including upadacitinib and abrocitinib, are noted for their efficacy, but their usage comes with box warnings related to various adverse events.

Traditional medications like methotrexate, cyclosporin, and azathioprine are acknowledged for their efficacy, but concerns about broad-acting effects and the reluctance to keep patients on them indefinitely are raised.

The conversation touches on the ideal goal of finding a cure for atopic dermatitis, acknowledging the current limitations in preventing the disease state from recurring. The importance of focusing on research to develop future curative solutions is stressed.

Despite the challenges, the speaker expresses gratitude for the abundance of new medicines and therapeutic options available. Personal anecdotes about a patient's life improvement demonstrate the positive impact of these treatments. The discussion concludes with a reminder of the significant progress made in atopic dermatitis care, highlighting the need to appreciate and not take for granted the access to these transformative drugs.

Video synopsis is AI-generated and reviewed by Dermatology Times editorial staff.

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