Atopic dermatitis (AD) is one of the frequented chronic inflammatory skin diseases having complex pathophysiology with a wide-spectrum of clinical phenotypes. Treating AD is challenging as there is a limited response to available therapies. But a better understanding of disease mechanisms has made the discovery of novel potential therapeutic targets and drug candidates possible. Europe has already given regulatory approval for the IL-4Ra inhibitor dupilumab, the anti-IL-13 inhibitor tralokinumab and the JAK1/2 inhibitor baricitinib, and there are about 70 new compounds in development. 

This understanding has not only elucidated the complexity and the systemic impact of this disorder but has also supported the development of a comprehensive pipeline of new compounds for disease management. Systemic therapy utilizes biologics with a slow but pathway-specific mode of action, which are now competing with small molecules like JAKi with quick but wider activity. Although biologics are more beneficial regarding long-term control and potential disease modification in AD, JAKi renders rapid relief in pruritus and inflammation, however, their benefit-risk ratio remains a substantial problem for pharmacovigilance. In initiated early in the natural course of the disorder, some of these products may even potentially act as disease modifiers.

Source: Nat Rev Drug Discov. 2022;21:21-40.