Emerging Treatment Options in Atopic Dermatitis: Topical Therapies

Abstract

Atopic dermatitis is a chronic inflammatory skin disorder affecting children and adults, with the majority presenting mild to moderate disease severity. The use of topical corticosteroids (TCSs) in combination with emollients has been the mainstay for treating mild to moderate atopic dermatitis since the 1950s, and as a supplement to systemic treatment in severe disease. However, while very effective, TCSs are often accompanied by poor adherence due to corticophobia (fear of using corticosteroids in patients or doctors), unwanted side effects, and in some cases insufficient clinical response. Topical calcineurin inhibitors (TCIs) are able to inhibit the activation of T-lymphocytes and thereby diminish inflammation. In some patients the use of TCIs has been limited due to a localized burning sensation on the first days of treatment, and also due to fear of other adverse effects. Consequently, there has been a need for the development of new topical products for atopic dermatitis. Novel topical therapies are in the pipeline and comprise both new doses and formulations of well-known pharmaceutical molecules and novel approaches targeting unique inflammatory pathways and mechanisms of disease, with a promise of higher efficacy and less harmful side effects. We review topical drugs in the pipeline for atopic dermatitis, and focus on those available in the clinicaltrials.gov database with a first received date from January 1, 2014 to May 31, 2017.

Keywords: Atopic dermatitis; Calcineurin inhibitors; Corticosteroids; Eczema; JAK inhibitors; Phosphodiesterase-4 inhibitors; Pruritus; Topical treatment.