The last decade has seen an exceptional pace of change, particularly concerning clinical research in atopic dermatitis (AD). A review by Arkwright PD and Koplin JJ summarizes some key discoveries regarding this. 

Over the last decade, nearly 50% of all studies have evaluated the efficacy and safety of novel therapeutic agents, mainly biologics and small molecules. Clear demonstration of benefit in clinical trials with no significant safety concerns delivered strong evidence resulting in subsequent approval from the Food and Drug Administration and routine use of the anti-IL-4 receptor alpha-antagonist dupilumab in patients aged 6 months and older, the selective Janus kinase 1 (JAK1) inhibitors upadacitinib for patients 12 years and older and abrocitinib, the IL-13 antagonist tralokinumab and the JAK1/2 inhibitor baricitinib for adults 18 years and older. Several other drugs are currently under investigation.

Other areas that have drawn attention are the trials of skin moisturizers and probiotics in the prevention of AD, investigating the role of filaggrin and skin barrier function, and the role of skin and gut microbiome, with a report on Staphylococcus aureus second immunoglobulin-binding protein for uniquely triggering allergic skin responses in AD.

Researchers are now widely assessing skin microbiome, epidermal metabolites/structural components and local inflammatory biomarkers using genomic and proteomic analysis of tape strips rather than more invasive biopsy to identify factors such as C-C motif chemokine ligand-17 that correlate with disease severity and therapy response. Overall, the last decade has shown a new and exciting era regarding our understanding, diagnosis and treatment of this common allergic skin disease.

Source: Arkwright PD, Koplin JJ. Impact of a decade of research into atopic dermatitis. J Allergy Clin Immunol Pract. 2022 Sep 23:S2213-2198(22)00957-6.