Systemic therapies can be used in the treatment of AD as monotherapy or in conjunction with other treatments, for example, in combination with topical corticosteroids. Patient education is essential to create realistic expectations as to the AD prognosis without systemic therapy and with systemic therapy. Systemic therapy is often clinically considered after treatment with topical corticosteroids has failed; therefore, clinicians should revisit the diagnosis to determine if a misdiagnosis caused the topical treatment failure before initiating systemic therapy. The risks and burdens of any course of treatment should be fully explained, along with alternatives, for a shared decision-making approach between clinician and patient.
In determining whether to initiate systemic therapy, clinicians should be guided by factors including the clinical response to topical therapy, impact on patient quality of life, and potential efficacy of systemic treatment .
Several effective systemic treatment options are currently available, including the following:
Presenter disclosure(s): The presenter has reported relationships with the following companies: AbbVie; Demira; Eli Lilly and Company; Leo Pharma Inc.; Pfizer Inc.; Pierre Fabre Dermo Cosmetique France; Regeneron.
Written by: Daniel Bennett, MPH
Reviewed by: Martina Lambertini, MD