Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review

<b>Background/Objectives/Methods</b>: Atopic dermatitis (AD) impacts various aspects of patients’ lives including personal life, psychological aspects/disturbances (e.g., depression, anxiety, or even suicidal thoughts), school, and work-related activities, including career advancement. T...

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Main Authors: Liborija Lugović-Mihić, Ema Barac, Renata Tomašević, Ena Parać, Lucija Zanze, Ana Ljevar, Lorena Dolački, Maja Štrajtenberger
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/17/11/1455
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author Liborija Lugović-Mihić
Ema Barac
Renata Tomašević
Ena Parać
Lucija Zanze
Ana Ljevar
Lorena Dolački
Maja Štrajtenberger
author_facet Liborija Lugović-Mihić
Ema Barac
Renata Tomašević
Ena Parać
Lucija Zanze
Ana Ljevar
Lorena Dolački
Maja Štrajtenberger
author_sort Liborija Lugović-Mihić
collection DOAJ
description <b>Background/Objectives/Methods</b>: Atopic dermatitis (AD) impacts various aspects of patients’ lives including personal life, psychological aspects/disturbances (e.g., depression, anxiety, or even suicidal thoughts), school, and work-related activities, including career advancement. The aim of this narrative review is to present the latest information available on how to best approach AD patient management, as well as decisions regarding standard/advanced systemic therapy, by gathering evidence from the relevant medical literature (PubMed and other prominent medical databases). <b>Results</b>: Thus, AD patient management and decisions regarding advanced/systemic therapy are complex, requiring the consideration of multiple disease-related factors: age; disease severity; patient medical history and comorbidities; previous topical therapy use and any adverse reactions; treatment efficacy concerns; patient preferences, expectations and fears; pregnancy planning; ability and willingness to adhere to the treatment regimen; impact on related risks; and any associated psychological or psychiatric issues. Current guidelines and systematic reviews support the safety and efficacy of systemic therapy including conventional drugs (cyclosporine, methotrexate, and azathioprine), biologics (dupilumab and tralokinumab), and JAK inhibitors (baricitinib, upadacitinib, and abrocitinib) recommended for treating moderate and severe AD. Recently, additional biologics have been evaluated in clinical trials, including lebrikizumab, nemolizumab, eblasakimab, and OX40/OX40L, among others. <b>Conclusions</b>: The most recently suggested approach to treating AD patients suggests focusing on therapy that targets and achieves minimal disease activity (MDA), where therapy decisions are informed by both the patient and the clinician. Available data also indicate the importance of a personalized, stepwise, and multidisciplinary approach. This type of approach promotes patient compliance, satisfaction with therapy, and increased engagement, which all lead to better patient outcomes.
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spelling doaj-art-9d3c62181fc644598dabe0a60e6371682025-08-20T01:53:57ZengMDPI AGPharmaceuticals1424-82472024-10-011711145510.3390/ph17111455Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A ReviewLiborija Lugović-Mihić0Ema Barac1Renata Tomašević2Ena Parać3Lucija Zanze4Ana Ljevar5Lorena Dolački6Maja Štrajtenberger7Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, CroatiaDepartment of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, CroatiaDepartment of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, CroatiaDivision of Pulmonology, Immunology, Allergology, and Rheumatology, Department of Paediatrics, University Children’s Hospital, 10000 Zagreb, CroatiaFamily Physician Office, 10000 Zagreb, CroatiaFamily Physician Office, 10000 Zagreb, CroatiaDepartment of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, CroatiaSchool of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia<b>Background/Objectives/Methods</b>: Atopic dermatitis (AD) impacts various aspects of patients’ lives including personal life, psychological aspects/disturbances (e.g., depression, anxiety, or even suicidal thoughts), school, and work-related activities, including career advancement. The aim of this narrative review is to present the latest information available on how to best approach AD patient management, as well as decisions regarding standard/advanced systemic therapy, by gathering evidence from the relevant medical literature (PubMed and other prominent medical databases). <b>Results</b>: Thus, AD patient management and decisions regarding advanced/systemic therapy are complex, requiring the consideration of multiple disease-related factors: age; disease severity; patient medical history and comorbidities; previous topical therapy use and any adverse reactions; treatment efficacy concerns; patient preferences, expectations and fears; pregnancy planning; ability and willingness to adhere to the treatment regimen; impact on related risks; and any associated psychological or psychiatric issues. Current guidelines and systematic reviews support the safety and efficacy of systemic therapy including conventional drugs (cyclosporine, methotrexate, and azathioprine), biologics (dupilumab and tralokinumab), and JAK inhibitors (baricitinib, upadacitinib, and abrocitinib) recommended for treating moderate and severe AD. Recently, additional biologics have been evaluated in clinical trials, including lebrikizumab, nemolizumab, eblasakimab, and OX40/OX40L, among others. <b>Conclusions</b>: The most recently suggested approach to treating AD patients suggests focusing on therapy that targets and achieves minimal disease activity (MDA), where therapy decisions are informed by both the patient and the clinician. Available data also indicate the importance of a personalized, stepwise, and multidisciplinary approach. This type of approach promotes patient compliance, satisfaction with therapy, and increased engagement, which all lead to better patient outcomes.https://www.mdpi.com/1424-8247/17/11/1455atopic dermatitistreatmentquality of lifedisease burdentherapyeconomic costs
spellingShingle Liborija Lugović-Mihić
Ema Barac
Renata Tomašević
Ena Parać
Lucija Zanze
Ana Ljevar
Lorena Dolački
Maja Štrajtenberger
Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
Pharmaceuticals
atopic dermatitis
treatment
quality of life
disease burden
therapy
economic costs
title Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
title_full Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
title_fullStr Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
title_full_unstemmed Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
title_short Atopic Dermatitis-Related Problems in Daily Life, Goals of Therapy and Deciding Factors for Systemic Therapy: A Review
title_sort atopic dermatitis related problems in daily life goals of therapy and deciding factors for systemic therapy a review
topic atopic dermatitis
treatment
quality of life
disease burden
therapy
economic costs
url https://www.mdpi.com/1424-8247/17/11/1455
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