American Academy of Dermatology Issues Updated Guidelines for the Management of Atopic Dermatitis in Adults

MQ-Illustrations stock.adobe.com

The American Academy of Dermatology issued updates to the 2014 Guidelines for the Management of Atopic Dermatitis. The new guidelines were published in the Journal of the American Academy of Dermatology earlier this month.

A multidisciplinary work group developed 11 evidence-based recommendations for the management of atopic dermatitis in adults using phototherapy and systemic treatments. These include injectable biologics, oral Janus kinase (JAK) inhibitors, and older immunosuppressants, antimetabolites, and corticosteroids.

For adults with more severe atopic dermatitis or dermatitis resistant to topical treatments, the work group made strong recommendations for the use of the monoclonal antibodies Dupixent (dupilumab) and Adbry (tralokinumab). Strong recommendations were also made for the JAK inhibitors Rinvoq (upadacitinib), Cibinqo (abrocitinib), and (Olumiant) baricitinib.

All but Olumiant are FDA-approved to treat moderate to severe atopic dermatitis. Olumiant is approved for this use in Europe and is approved for rheumatoid arthritis in the United States. The drug is currently under FDA regulatory review for the potential treatment of atopic dermatitis.

Phototherapy and the antimetabolite methotrexate were conditionally recommended with proper monitoring. The immunosuppressants mycophenolate, azathioprine, and cyclosporine were also conditionally recommended with appropriate monitoring.

Lastly, the work group conditionally recommended against the use of systemic corticosteroids, adding that their use should be limited to acute, severe exacerbations. These drugs should only be used as a short-term bridge therapy to other corticosteroid-sparing treatments.

A future publication will cover guidelines for the management of pediatric atopic dermatitis the authors wrote.