Unmet Needs in Modern Atopic Dermatitis Management

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Despite significant advances in atopic dermatitis treatment options, including biologics and JAK inhibitors, substantial unmet clinical needs remain for patients with moderate to severe disease. Lawrence Eichenfield, MD, highlights that many patients still experience partial responses rather than achieving minimal rash, minimal itch, and minimal sleep disturbance––key indicators of optimal disease control. The challenge extends beyond medication availability to include patient awareness of therapeutic options and understanding how early intervention might prevent comorbidity development.

Raj Chovatiya, MD, PhD, MSCI, emphasizes the critical need for highly durable, stable therapeutic responses in atopic dermatitis management. Given the naturally unpredictable, waxing-and-waning nature of the disease, challenges exist with current medications in providing consistent long-term control without secondary loss of effectiveness. The discussion reveals a fundamental treatment dilemma: whether to focus on raising the response floor to help more patients achieve clinical improvement or raising the ceiling to achieve deeper, more comprehensive responses in existing responders.

The heterogeneous nature of atopic dermatitis significantly complicates treatment selection and outcomes across different patient populations. This variability manifests in clinical dimensions including signs, symptoms, comorbidities, and quality-of-life impacts, making one-size-fits-all approaches challenging. The experts identify clinical response heterogeneity and the need for broader, more selective therapies that can address T-cell mediated immunity dysregulation as key areas requiring innovative therapeutic approaches beyond current targeted treatments.