Therapeutic potential of the treatment and control of severe recurrent atopic dermatitis
O. B. Tamrazova,
A. S. Stadnikova,
G. A. Novik,
A. G. Sukhotina,
A. S. Vorobeva,
G. E. Bagramova,
A. A. Bezukladnova https://doi.org/10.21518/ms2024-056
Abstract
Atopic dermatitis is a hereditary inflammatory skin disease characterized by pruritus, a long recurrent course and certain evolutionary dynamics. Atopic dermatitis of moderate and severe severity is considered a systemic disease that exacerbates the course of associated pathologies, including cardiovascular, neuropsychiatric, and malignant diseases. The current paper presents the essentials about moderate and severe severity atopic dermatitis, statistical epidemiologic and pathogenetic data is thoroughly processed, the issues of the quality of life of such patients are especially accentuated. It is known that a few years ago the therapy of moderate and severe atopic dermatitis was based on systemic corticosteroids and classical immunosuppressants, but they had limited efficacy and were not suitable for long-term treatment due to their safety profile. This article highlights the development of new effective and easy-to-use therapies for atopic dermatitis, which led to the emergence of selective Janus kinase inhibitors. The review presents the way selective inhibitors of Janus kinases works and their effect on the barrier function of the skin. The paper provides the research data on the very first drug from the group of selective inhibitors - upadacitinib, which proved its efficacy on a par with a high degree of safety. The authors presented their own clinical observation of the use of upadacitinib in adolescents with severe atopic dermatitis. The use of upadacitinib in the described clinical cases led to a decrease in the severity of subjective and objective symptoms of inflammatory skin diseases.
About the Authors
O. B. Tamrazova
Peoples’ Friendship University of Russia named after Patrice Lumumba; Bashlyaeva City Children’s Clinical
Russian Federation
Russian Federation
Olga B. Tamrazova - Dr. Sci. (Med.), Professor of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba; Head of Allergic Dermatoses Center, Bashlyaeva City Children’s Clinical Hospital.
6, Miklukho-Maklai St., Moscow, 117198; 28, Geroev Panfilovtsev St., Moscow, 125373
A. S. Stadnikova
Peoples’ Friendship University of Russia named after Patrice Lumumba; Bashlyaeva City Children’s Clinical
Russian Federation
Russian Federation
Antonina S. Stadnikova - Cand. Sci. (Med.), STD and Skin Physician, Bashlyaeva City Children’s Clinical Hospital; Teaching Assistant of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.
28, Geroev Panfilovtsev St., Moscow, 125373; 6, Miklukho-Maklai St., Moscow, 117198
G. A. Novik
St Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Gennady A. Novik - Dr. Sci. (Med.), Professor, Head of Department of Children’s Diseases named after Professor I.M. Vorontsov, St Petersburg State Pediatric Medical University.
2, Litovskaya St., St Petersburg, 194100
A. G. Sukhotina
Bashlyaeva City Children’s Clinical
Russian Federation
Russian Federation
Aleksandra G. Sukhotina - STD and Skin Physician, Bashlyaeva City Children’s Clinical Hospital.
28, Geroev Panfilovtsev St., Moscow, 125373
A. S. Vorobeva
Bashlyaeva City Children’s Clinical
Russian Federation
Russian Federation
Alexandra S. Vorobeva - Cand. Sci. (Med.), Head of Paediatrics Department, Bashlyaeva City Children’s Clinical Hospital.
28, Geroev Panfilovtsev St., Moscow, 125373
G. E. Bagramova
Peoples’ Friendship University of Russia named after Patrice Lumumba
Russian Federation
Russian Federation
Gayane E. Bagramova - Dr. Sci. (Med.), Professor of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.
6, Miklukho-Maklai St., Moscow, 117198
A. A. Bezukladnova
Peoples’ Friendship University of Russia named after Patrice Lumumba
Russian Federation
Russian Federation
Anastasia A. Bezukladnova - Clinical Resident of Department of Dermatovenerology with Cosmetology Course, Faculty of Continuing Medical Education, Institute of Medicine, Peoples’ Friendship University of Russia named after Patrice Lumumba.
6, Miklukho-Maklai St., Moscow, 117198
References
1. Frazier W, Bhardwaj N. Atopic Dermatitis: Diagnosis and Treatment. Am Fam Physician. 2020;101(10):590–598. Available at: https://pubmed.ncbi.nlm.nih.gov/32412211.
2. Silverwood RJ, Forbes HJ, Abuabara K, Ascott A, Schmidt M, Schmidt SAJ et al. Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study. BMJ. 2018.23(361):1786. https://doi.org/10.1136/bmj.k1786.
3. Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Investig Dermatol. 2017;137(1):26–30. https://doi.org/10.1016/j.jid.2016.07.012.
4. Xu X, van Galen LS, Koh MJ, Bajpai R, Thng S, Yew YW et al. Factors influencing quality of life in children with atopic dermatitis and their caregivers: A crosssectional study. Sci Rep. 2019;9(1):15990. https://doi.org/10.1038/s41598-019-51129-5.
5. Ali F, Vyas J, Finlay AY. Counting the Burden: Atopic Dermatitis and Health-related Quality of Life. J Acta Dermato-Venereologica. 2020;100(12):331–332. https://doi.org/10.2340/00015555-3511.
6. Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic child-hood diseases. Br J Dermatol. 2006;155(1):145–151. https://doi.org/10.1111/j.1365-2133.2006.07185.x.
7. Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657–682. https://doi.org/10.1111/jdv.14891
8. Bylund S, Kobyletzki LB, Svalstedt M, Svensson Å. Prevalence and Incidence of Atopic Dermatitis: A Systematic Review. Acta Derm Venereol. 2020;100(12):adv00160. https://doi.org/10.2340/00015555-3510.
9. Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–351. https://doi.org/10.1016/j.jaad.2013.10.010.
10. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112(6):118–127. https://doi.org/10.1016/j.jaci.2003.09.033.
11. Tran MM, Lefebvre DL, Dharma C, Dai D, Lou WYW, Subbarao P et al. Predicting the atopic march: Results from the Canadian Healthy Infant Longitudinal Development Study. J Allergy Clin Immunol. 2018;141(2):601–607.e8. https://doi.org/10.1016/j.jaci.2017.08.024.
12. Yang L, Fu J, Zhou Y. Research Progress in Atopic March. Front Immunol. 2020;11:1907. https://doi.org/10.3389/fimmu.2020.01907.
13. Schoos AM, Chawes BL, Bønnelykke K, Stokholm J, Rasmussen MA, Bisgaard H. Increasing severity of early-onset atopic dermatitis, but not late-onset, associates with development of aeroallergen sensitization and allergic rhinitis in childhood. Allergy. 2022;77(4):1254–1262. https://doi.org/10.1111/all.15108.
14. Keet C, Pistiner M, Plesa M, Szelag D, Shreffler W, Wood R et al. Age and eczema severity, but not family history, are major risk factors for peanut allergy in infancy. J Allergy Clin Immunol. 2021;147(3):984–991.e5. https://doi.org/10.1016/j.jaci.2020.11.033.
15. Roh YS, Huang AH, Sutaria N, Choi U, Wongvibulsin S, Choi J et al. Real-world comorbidities of atopic dermatitis in the US adult ambulatory population. J Am Acad Dermatol. 2022;86(4):835–845. https://doi.org/10.1016/j.jaad.2021.11.014.
16. Villani AP, Pavel AB, Wu J, Fernandes M, Maari C, Saint-Cyr Proulx E et al. Vascular inflammation in moderate-to-severe atopic dermatitis is associated with enhanced Th2 response. Allergy. 2021;76(10):3107–3121. https://doi.org/10.1111/all.14859.
17. Budu-Aggrey A, Watkins SH, Brumpton B, Løset M, Tyrrell J, Modalsli EH et al. Assessment of a causal relationship between body mass index and atopic dermatitis. J Allergy Clin Immunol. 2021;147(1):400–403. https://doi.org/10.1016/j.jaci.2020.04.050.
18. Manjunath J, Silverberg JI. Association of obesity in early childhood with atopic dermatitis in late childhood and adolescence. J Am Acad Dermatol. 2022;87(2):426–427. https://doi.org/10.1016/j.jaad.2021.08.048.
19. Patrick MT, Zhang H, Wasikowski R, Prens EP, Weidinger S, Gudjonsson JE et al. Associations between COVID-19 and skin conditions identified through epidemiology and genomic studies. J Allergy Clin Immunol. 2021;147(3):857–869.e7. https://doi.org/10.1016/j.jaci.2021.01.006.
20. Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017;23(8): 115–123. Available at: https://pubmed.ncbi.nlm.nih.gov/28978208.
21. Kader HA, Azeem M, Jwayed SA, Al-Shehhi A, Tabassum A, Ayoub MA et al. Current Insights into Immunology and Novel Therapeutics of Atopic Dermatitis. Cells. 2021;10(6):1392. https://doi.org/10.3390/cells10061392.
22. Gorodnichev PV. The role of the aromatic hydrocarbon receptor in the pathogenesis of atopic dermatitis. Vestnik Dermatologii i Venerologii. 2023;99(3):11–22. (In Russ.) https://doi.org/10.25208/vdv4775.
23. Ferreira S, Guttman-Yassky E, Torres T. Selective JAK1 Inhibitors for the Treatment of Atopic Dermatitis: Focus on Upadacitinib and Abrocitinib. Am J Clin Dermatol. 2020;21(6):783–798. https://doi.org/10.1007/s40257-020-00548-6.
24. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345–360. https://doi.org/10.1016/S0140-6736(20)31286-1.
25. Rodrigues MA, Torres T. JAK/STAT inhibitors for the treatment of atopic dermatitis. J Dermatolog Treat. 2019:1–8. https://doi.org/10.1080/09546634.2019.1577549.
26. Lytvyn Y, Mufti A, Abduelmula A, Sachdeva M, Maliyar K, Georgakopoulos JR, Yeung J. Efficacy and Safety of Upadacitinib for Management of Moderate-to-Severe Atopic Dermatitis: An Evidence-Based Review. Pharmaceutics. 2022;14(11):2452. https://doi.org/10.3390/pharmaceutics14112452.
27. Lytvyn Y, Mufti A, Abduelmula A, Sachdeva M, Maliyar K, Georgakopoulos JR, Yeung J. Efficacy and Safety of Upadacitinib for Management of Moderate-to-Severe Atopic Dermatitis: An Evidence-Based Review. Pharmaceutics. 2022;14(11):2452. https://doi.org/10.3390/pharmaceutics14112452.
28. Guttman-Yassky E, Teixeira HD, Simpson EL, Papp KA, Pangan AL, Blauvelt A et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet. 2021;397(10290):2151–2168. https://doi.org/10.1016/S0140-6736(21)00588-2.
29. Silverberg J, Yassky E, Simpson E, Papp K, Blauvelt A, Chu C et al. Efficacy and Safety of Upadacitinib Through 140 Weeks in Adolescents and Adults with Moderate-to-Severe Atopic Dermatitis: Phase 3 Randomized Clinical Trial Results. In: Presented at European Association of Dermatology and Venereology Congress 2023; October 11–14, 2023; Berlin, Germany. Available at: https://s3.eu-central-1.amazonaws.com/m-anage.com.storage.eadv/abstracts_congress2023/37119.pdf.
30. Simpson EL, Costanzo A, Prajapati VH, Calimlim BM, Chu AD, Wu T, Eyerich K. 528 – Rapid skin clearance and itch improvement with upadacitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: results from a phase 3b head-to-head clinical trial (Heads Up). Br J Derm. 2024;190(Suppl_2):ii30–ii31. https://doi.org/10.1093/bjd/ljad498.033
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For citations:
Tamrazova OB, Stadnikova AS, Novik GA, Sukhotina AG, Vorobeva AS, Bagramova GE, Bezukladnova AA. Therapeutic potential of the treatment and control of severe recurrent atopic dermatitis. Meditsinskiy sovet = Medical Council. 2024;(2):8-16. (In Russ.) https://doi.org/10.21518/ms2024-056
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