Objective

To discuss the efficacy and safety of novel and emerging topical and systemic therapeutic agents for atopic dermatitis (AD).

Data Sources

The review of the published literature was performed using the PubMed database, published abstracts and virtual presentations from scientific meetings, posted results on ClinicalTrials.gov, and data from industry press releases.

Study Selections

Primary manuscripts with trial results, case reports, case series, clinical trial data from ClinicalTrials.gov, and articles highlighting expert perspectives on management of AD were selected.

Results

Emerging topical and systemic therapies primarily target the type 2 immune pathway. Moreover, 2 newer targeted medications are now approved by the Food and Drug Administration for both children and adults, crisaborole 2% ointment and dupilumab, with several others in the therapeutic pipeline. New directions in developing topical medications include Janus kinase inhibitors, tapinarof (an aryl hydrocarbon receptor agonist), and agents to correct microbial dysbiosis. In addition to the subcutaneously injected monoclonal antibody targeting the interleukin (IL) 4 receptor (dupilumab), other biologics targeting IL-13, IL-31, IL-33, OX40, and thymic stromal lymphopoietin are currently being tested. Oral Janus kinase inhibitors are showing outstanding efficacy and no serious safety signs, but safety concerns remain.

Conclusion

Given the tremendous burden of AD on physical, mental, and social health, the need is high to develop new, targeted therapies. Advances in our understanding of AD pathogenesis have paved the way toward the development of new therapies that promise to revolutionize our management of AD. Future research will focus on long-term efficacy and safety and creating predictive models for choosing best management options on a personalized basis.

中文翻译：

---

特应性皮炎的新疗法。

目的

讨论新型和新兴的局部和全身治疗剂用于特应性皮炎的疗效和安全性。

数据源

使用PubMed，科学会议的已发表摘要和虚拟演示文稿，clinicaltrials.gov上发布的结果以及行业新闻稿中的数据对公开文献进行了回顾。

研究选择

选择具有试验结果，病例报告，病例系列，来自ClinicalTrials.gov的临床试验数据以及强调专家对AD管理观点的文章的主要手稿。

结果

新兴的局部和全身疗法主要针对2型免疫途径。现在，FDA批准了针对儿童和成人的两种新的靶向药物，2％的克瑞沙伯乐（cisaborole）软膏和dupilumab，以及其他几种正在治疗中的药物。开发局部用药的新方向包括Janus激酶（JAK）抑制剂，tapinarof（一种芳基烃受体激动剂）和纠正微生物营养不良的药物。除了针对白介素（IL）4受体（dupilumab）的皮下注射单克隆抗体外，目前还针对靶向IL-13，IL-31，IL-33，OX40和胸腺基质淋巴细胞生成素（TSLP）的其他生物制剂进行测试。口服JAK抑制剂显示出出色的功效，没有严重的安全征兆，但仍存在安全隐患。

结论

鉴于AD对身体，心理和社会健康的巨大负担，因此迫切需要开发新的针对性疗法。我们对AD发病机制的了解的进步为开发有望彻底改变AD管理的新疗法铺平了道路。未来的研究将集中于长期疗效和安全性，以及创建预测模型以在个性化基础上选择最佳管理方案。