Expert consensus on the systemic treatment of atopic dermatitis in special populations

Author:

Adam D. N.123,Gooderham M. J.34,Beecker J. R.3567,Hong C. H.389,Jack C. S.1011,Jain V.312,Lansang P.11314,Lynde C. W.1315,Papp K. A.316ORCID,Prajapati V. H.317181920,Turchin I.32122,Yeung J.131314

Affiliation:

1. Division of Dermatology, Temerty Faculty of Medicine University of Toronto Toronto Ontario Canada

2. CCA Medical Research Ajax Ontario Canada

3. Probity Medical Research Inc. Waterloo Ontario Canada

4. SKiN Centre for Dermatology Peterborough Ontario Canada

5. Division of Dermatology University of Ottawa Ottawa Ontario Canada

6. Division of Dermatology The Ottawa Hospital Ottawa Ontario Canada

7. Ottawa Hospital Research Institute Ottawa Ontario Canada

8. Department of Dermatology and Skin Science University of British Columbia Vancouver British Columbia Canada

9. Dr. Chih‐ho Hong Medical Inc. Surrey British Columbia Canada

10. Division of Dermatology McGill University Montreal Quebec Canada

11. Research Institute of the McGill University Health Centre Montreal Quebec Canada

12. Division of Clinical Immunology and Allergy McMaster University Hamilton Ontario Canada

13. Division of Dermatology Sunnybrook Health Sciences Centre Toronto Ontario Canada

14. Division of Dermatology Women's College Hospital Toronto Ontario Canada

15. Lynde Institute for Dermatology Markham Ontario Canada

16. K Papp Clinical Research Waterloo Ontario Canada

17. Division of Dermatology, Department of Medicine University of Calgary Calgary Alberta Canada

18. Section of Community Pediatrics, Department of Pediatrics University of Calgary Calgary Alberta Canada

19. Section of Pediatric Rheumatology, Department of Pediatrics University of Calgary Calgary Alberta Canada

20. Dermatology Research Institute Calgary Alberta Canada

21. Brunswick Dermatology Centre Fredericton New Brunswick Canada

22. Department of Medicine Dalhousie University Halifax Nova Scotia Canada

Abstract

AbstractWith the increasing number of options for the treatment of moderate‐to‐severe atopic dermatitis, clinicians need guidance on a practical approach to selecting a systemic agent for specific patient populations. We convened an expert panel consisting of 12 members to conduct a literature review and summarize relevant data related to six scenarios of clinical interest: comorbid asthma, ocular surface disease, history of cancer, past and ongoing infections of interest (including herpes simplex virus, herpes zoster, hepatitis B, and tuberculosis), pregnancy and lactation, and the elderly. We performed a literature search and examined each clinical scenario with respect to three major categories of available systemic agents: traditional systemics (azathioprine, cyclosporine A, methotrexate, and mycophenolate mofetil), Janus kinase inhibitors (abrocitinib, baricitinib, and upadacitinib), and biologics (dupilumab, lebrikizumab, and tralokinumab). The expert panel and steering committee met virtually to review the data and discuss the drafted consensus statements. A modified Delphi process was used to arrive at a set of final consensus statements related to the systemic treatment of AD in these specific patient populations. To provide practical guidance on the choice of systemic therapy for atopic dermatitis in these six topics of clinical interest, 25 expert consensus statements and a summary of the supporting data are presented herein.

Funder

AbbVie

Publisher

Wiley

Subject

Infectious Diseases,Dermatology

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