A safety review of the medications used to treat atopic dermatitis

ABSTRACT

Introduction: Atopic dermatitis (AD) is a common disease in children and adults which causes severe physical discomfort and psychosocial distress. Recently novel therapies for AD have been FDA approved for use which creates the need to review the safety surrounding current FDA approved AD medications.

Areas covered: Published clinical studies involving topical and oral FDA approved medications for AD are included in this review. Authors used PubMed research database to search for clinical trials involving AD patients.

Expert opinion: AD is a common disease which currently has limited FDA approved medications. Given the chronicity of this disease, medications are needed which control disease while minimizing side effects to allow for long term use. Newer approved medications show promise but safety data is limited given their relatively new utilization for AD.

KEYWORDS:

• Atopic dermatitis
• topical corticosteroids
• dupliumab
• crisaborole
• systemic corticosteroids
• calcineurin inhibitors

Article highlights

• Topical corticosteroids have long been used for managing AD disease flares but their long-term use is limited by potential side effects such as skin atrophy and pigment alteration.

• Topical calcineurin inhibitors are newer non-steroidal medications for use in AD but vehicle and burning upon application may limit compliance.

• Topical crisaborole is the newest topical agent for AD and shows efficacy when compared to vehicle, but has not been formally evaluated compared to other standard topical agents.

• Oral corticosteroids, while approved for use in AD, are generally avoided given numerous side effects associated with longer-term use and risk of rebound disease flares upon cessation.

• Dupilumab is a novel monoclonal antibody which is the first biologic FDA approved for use in moderate to severe AD. Dupilumab shows promise in clinical studies but safety data and long-term efficacy is limited.

This box summarizes key points contained in the article.

Declaration of interest

SR Feldman has received research, speaking and or consulting support from a variety of companies including Galderma, GlaxoSmithKline, Steifel, Almirall, Leo Pharma, Baxter, Boehringer Ingleheim, Mylan, Celgene, Pfizer, Valeant, Taro, Abbvie, Cosmederm, Anacor, Astellas, Janssen, Eli Lilly, Merck, Merz, Novartis, Regeneron, Sanofi, Novan Parion, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and National Psoriasis Foundation. He also consults for others through Guidepoint Global, Gerson Lehman and other consulting organizations. He is founder and majority owner of www.DrScore.com. He is founder and part owner of Causa Research, a company dedicated to enhancing patient’s adherence to treatment. DermTreat. He has received grant support from Pfizer. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.