What is Atopic Dermatitis?
Atopic dermatitis is the most common type of eczema. More than 18 million American adults have atopic dermatitis. "Dermatitis" refers to a condition of the skin and "atopic" relates to diseases caused by allergic reactions.
During a flare, Atopic Dermatitis becomes a red, itchy rash which often appears on the cheeks, arms and legs. Many different physical and internal factors can trigger an eczema flare-up. The resulting inflammation causes increased blood flow and the urge to itch.
Eczema flares are part of the agonizing itch-scratch cycle. It’s hard to fight the physical and psychological components that drive the itch-scratch cycle. Scratching feels good at the time but can lead to more inflammation and even skin infections.
How is Atopic Dermatitis treated?
There’s no known cure for AD. Finding the right treatment is important to help reduce itching and discomfort. Calming the skin reduces stress and helps prevent excessive scratching that leads to skin infections.
Treatment options vary from over-the-counter skin care, prescription medication, and lifestyle changes. The best preventive measure is to moisturize the skin. This improves the function of the skin barrier. Healthier skin will become inflamed less often and provide a better barrier against allergens and irritants.
New Medications for Atopic Dermatitis
Dupilumab (Dupixent) was approved by the U.S. Food and Drug Administration (FDA) in March 2018. It is the first biologic agent approved to treat moderate to severe Atopic Dermatitis. Dupilumab is also in development for treating moderate to severe asthma. In two studies published in the New England Journal of Medicine, dupilumab improved the symptoms of AD compared with placebo. This included itchy skin (pruritus), anxiety and depression, and quality of life.
A recent phase II clinical trial evaluated an oral drug called baricitinib. In the trial, about 61 percent of patients with moderate to severe Atopic Dermatitis receiving baricitinib achieved a 50 percent or more reduction in the Eczema Area and Severity Index (EASI-50). This was compared to 37 percent of patients who received a placebo. Baricitinib is already approved by the FDA for rheumatoid arthritis.
Another study looked at a new treatment called nemolizumab in 216 adults with moderate-to-severe atopic dermatitis. All monthly doses of nemolizumab significantly improved pruritus in these patients during the course of the study.
In a 2015 study, 69 adults with Atopic Dermatitis were tested with a topical formulation of a drug called tofacitinib citrate. This drug is most often given orally to treat rheumatoid arthritis. It’s also used for psoriatic arthritis and ulcerative colitis. Tofacitinib citrate was shown to also have efficacy in people with Atopic Dermatitis. This was a very small study and more testing is needed. But the use of an RA medication in Atopic Dermatitis patients highlights some similarities. It suggests that Atopic Dermatitis functions more like an autoimmune disease than a surface-level skin disorder. More research to better understand these similarities should pave the way for new treatments.
Clinical trials are a great option for people looking to try a new treatment. If you’re interested in participating in clinical trial for AD, the National Eczema Association (NEA) posts a current list on their website. By participating in clinical trials, you can help shape the future of AD treatment options.
The Future of Atopic Dermatitis
It’s a promising time for AD research. There’s a public demand for more information, and researchers have taken an active interest in providing solutions. Based on current research and clinical studies, the outlook for AD patients is promising.
There are new medications and treatments on the horizon. Researchers are starting to treat AD like an autoimmune disease, which has opened a new realm of possibilities.
The statements provided above, along with additional information, can be found on a variety of Atopic Dermatitis informational websites, including: