New therapies for atopic dermatitis: Additional treatment classes - 21/02/18

Doi : 10.1016/j.jaad.2017.12.024

Paras P. Vakharia, PharmD ^a, Jonathan I. Silverberg, MD, PhD, MPH ^a,^b,^c,^d,^⁎
^a Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^b Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^c Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^d Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois

^∗Reprint requests: Jonathan I. Silverberg, MD, PhD, MPH, 676 N St. Clair St, Suite 1600, Chicago, IL 60611.676 N St. Clair StSuite 1600ChicagoIL60611

Abstract

Background

A wide array of miscellaneous agents is being studied for the treatment of atopic dermatitis (AD), including targeted topical, oral systemic, and biologic agents.

Objective

To review the known efficacy and safety to date for such agents being studied for the treatment of AD.

Methods

A nonsystematic review of the literature was performed. PubMed and ClinicalTrials.gov were searched for studies assessing agents not described previously for the treatment of AD. Randomized controlled trials were primarily sought, but other study types were also included if they contained pertinent data. Agents are presented by mechanism of action, with analysis of mechanism of action and data regarding efficacy and safety in patients with AD.

Results

Data regarding the following agents are presented: omiganan (an antimicrobial peptide), tapinarof (a nonsteroidal anti-inflammatory agent), PR022 (hypochlorous acid), asimadoline (a κ-opioid agonist), DS107 (dihomo-γ-linolenic acid), ZPL-389 (a histamine H4 receptor antagonist), secukinumab (an interleukin 17A inhibitor), and fezakinumab (interleukin 22 inhibitor).

Limitations

Limited clinical data exist for many of the described agents.

Conclusions

As recent research has improved our understanding of AD pathogenesis, various agents with unique mechanisms of action have been studied for the treatment of AD. Many of these hold great therapeutic promise for AD, and continued research and development is warranted.

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Key words : asimadoline, atopic dermatitis, emerging agents, fezakinumab, hypocholrous acid, omiganan, secukinumab, tapinarof

Abbreviations used : AD, AE, AhR, AMP, EFA, HOCl, IGA, IL, NaOCl, RCT, SCORAD

Plan

Topical agents

AMP: omiganan

Nonsteroidal anti-inflammatory agent: tapinarof

Hypochlorous acid: PR022

Oral systemic agents

κ-Opioid agonists: asimadoline

DGLA: DS107

Histamine H4 receptor antagonist: ZPL-389

Biologic agents

IL 17A inhibitor: secukinumab

IL-22 inhibitor: fezakinumab

Conclusion

	Publication of this article was supported by Leo Pharma, Bayer, and Sanofi/Regeneron.
	Funding sources: Supported by Bayer, LEO Pharma, and Sanofi.
	Disclosure: Dr Silverberg has received honoraria for participation in advisory boards and/or consulting for Abbvie, Eli Lilly, Galderma, GlaxoSmithKline, Kiniksa, Leo, Menlo, Pfizer, Realm-1, Regeneron-Sanofi, and Roivant; performed contracted research from GlaxoSmithKline; and participated in a speaker's bureau for Regeneron-Sanofi. Dr Vakharia disclosed no conflicts of interest.