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Kim HW, Lee YJ, Ha YJ, Lee EB, Lee YJ, Kang EH. Impact of socioeconomic status on biologics utilization in rheumatoid arthritis: revealing inequalities and healthcare efficiency. Korean J Intern Med 2024:kjim.2023.276. [PMID: 38419335 DOI: 10.3904/kjim.2023.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/30/2023] [Indexed: 03/02/2024] Open
Abstract
Background/Aims This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES). Methods Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis. Results Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use. Conclusions The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.
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Affiliation(s)
- Hye Won Kim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yeon Ju Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - You-Jung Ha
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Bong Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yun Jong Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Ha Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Sener S, Cam V, Ozen S, Batu ED. Biologic drugs in the treatment of juvenile dermatomyositis: a literature review. Clin Rheumatol 2024; 43:591-602. [PMID: 37582998 DOI: 10.1007/s10067-023-06740-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023]
Abstract
There is no clear consensus in the literature regarding the choice of biologic therapies and efficacy in juvenile dermatomyositis (JDM). In this review, we aimed to examine previous studies regarding biologic drug use in JDM patients. We screened MEDLINE and Scopus for articles involving JDM patients treated with biologic drugs. We identified 74 articles describing 495 JDM patients treated with biologic drugs (538 biologic treatments) during our literature search. The median (min-max) age of these patients was 9.8 (1-17) years (F/M:1.8). The most frequently used biologic drugs were rituximab (RTX, 50%) and tumor necrosis factor (TNF) inhibitors (34.8%). In a few cases, abatacept (4.3%), anti-interleukin-1 agents (0.9%), tocilizumab (0.9%), bortezomib (0.4%), ustekinumab (0.2%), eculizumab (0.2%), and golimumab (0.2%) were used. RTX was most frequently preferred in patients with severe skin involvement (46.3%). Improvement with RTX was obtained in 60.1% of RTX treatments. Infliximab was most frequently preferred in calcinosis (43.3%), while adalimumab in skin involvement (50%) and etanercept in resistant/recurrent diseases (80%). Improvement was achieved in 44.4% of anti-TNF treatments. Adverse events were observed in 46.8% (58/124) of all treatments. Our results suggest that biologic agents may be a promising alternative for the treatment of particularly resistant JDM cases. Controlled studies are required to provide higher level of evidence for the timing of biologic use in JDM treatment. Key Points • There is no consensus on the choice and efficacy of biologic therapies in JDM. • RTX and TNF inhibitors are the most commonly used biologic drugs. • Biologics were especially preferred in severe skin involvement, calcinosis, and resistant diseases.
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Affiliation(s)
- Seher Sener
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Veysel Cam
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Seza Ozen
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ezgi Deniz Batu
- Department of Pediatrics, Division of Pediatric Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Arlegui H, Mahé E, Richard MA, De Rycke Y, Viguier M, Beylot-Barry M, Dupuy A, Beneton N, Joly P, Jullien D, Bachelez H, Sbidian É, Chosidow O, Paul C, Tubach F. Impact of the first wave of the COVID-19 pandemic on the treatment of psoriasis with systemic therapies in France: Results from the PSOBIOTEQ cohort. Ann Dermatol Venereol 2023:S0151-9638(23)00009-1. [PMID: 36914553 PMCID: PMC9928748 DOI: 10.1016/j.annder.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/18/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND The nature of the COVID-19 pandemic led to concerns among patients and physicians about the potential impact of immunosuppressive treatments for chronic diseases such as psoriasis on the risk of severe COVID-19. OBJECTIVES To describe treatment modifications and determine the incidence of COVID-19 infection among psoriasis patients during the first wave of the pandemic, and identify the factors associated with these events. METHODS Data from PSOBIOTEQ cohort relating to the first COVID-19 wave in France (March to June, 2020), as well as a patient-centred COVID-19 questionnaire, were used to evaluate the impact of lockdown on changes (discontinuations, delays or reductions) in systemic therapies, and to determine the incidence of COVID-19 cases among these patients. Logistic regression models were used to assess associated factors. RESULTS Among the 1751 respondents (89.3%), 282 patients (16.9%) changed their systemic treatment for psoriasis, with 46.0% of these changes being initiated by the patients themselves. Patients were more likely to experience psoriasis flare-ups during the first wave if they changed their treatment during this period (58.7% vs 14.4%; P < 0.0001). Changes to systemic therapies were less frequent among patients with cardiovascular diseases (P < 0.001), and those aged ≥ 65 years (P = 0.02). Overall, 45 patients (2.9%) reported having COVID-19, and eight (17.8%) required hospitalization. Risk factors for COVID-19 infection were close contact with a positive case (P < 0.001) and living in a region with a high incidence of COVID-19 (P < 0.001). Factors associated with a lower risk of COVID-19 were avoiding seeing a physician (P = 0.002), systematically wearing a mask during outings (P = 0.011) and being a current smoker (P = 0.046). CONCLUSIONS Discontinuation of systemic psoriasis treatments during the first COVID-19 wave (16.9%) - mainly decided by patients themselves (46.0%) - was associated with a higher incidence of disease flares (58.7% vs 14.4%). This observation and factors associated with a higher risk of COVID-19 highlight the need to maintain and adapt patient-physician communication during health crises according to patient profiles, with the aim of avoiding unnecessary treatment discontinuations and ensuring that patients are informed about the risk of infection and the importance of complying with hygiene rules.
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Affiliation(s)
- H Arlegui
- AP-HP, Hôpital Pitié-Salpêtrière, Centre de Pharmaco-épidémiologie (Cephépi), INSERM, CIC-1901, Paris, France
| | - E Mahé
- Service de Dermatologie, Hôpital Victor Dupouy, Argenteuil, France
| | - M-A Richard
- Service de Dermatologie, EA 3279: CEReSS - Health Service Research and Quality of Life Centre, Timone Hospital, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Y De Rycke
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmaco-épidémiologie (Cephépi), CIC-1901, 75013 Paris, France
| | - M Viguier
- Service de Dermatologie-Vénéréologie, Hôpital Robert Debré, Université Reims Champagne Ardenne, 51100 Reims, France
| | - M Beylot-Barry
- Service de Dermatologie, CHU de Bordeaux, Translational Research on Oncodermatology and Rare skin diseases, Bordeaux Institute of Oncology, UMR 1312 INSERM, Université Bordeaux, Bordeaux, France
| | - A Dupuy
- France Univ Rennes, CHU Rennes, 35000 Rennes, France
| | - N Beneton
- REPERES Pharmaco-Epidemiology and Health Services Research, University Rennes and French School of Public Health, Rennes, France
| | - P Joly
- Service de Dermatologie, Hôpital du Mans, Le Mans, France
| | - D Jullien
- Service de Dermatologie, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon F-69003; Lyon-1 University; INSERM U1111 - CIRI, Lyon F-69007, France
| | - H Bachelez
- Service de Dermatologie, Assistance Publique- Hôpitaux de Paris, Hôpital Saint-Louis, Université Paris Cité, Paris, France; INSERM UMR1163, Institut Imagine, Paris, France
| | - É Sbidian
- Service de Dermatologie, Assistance Publique- Hôpitaux de Paris, Hôpital Saint-Louis, Université Paris Cité, Paris, France; Hôpital Henri Mondor, Clinical Investigation Centre, Université Paris-Est Créteil (UPEC), Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE) - EA 7379, Créteil, France
| | - O Chosidow
- Service de Dermatologie, Assistance Publique- Hôpitaux de Paris, Hôpital Saint-Louis, Université Paris Cité, Paris, France; Groupe de recherche Dynamyc, EA7380, Faculté de Santé de Créteil, École nationale vétérinaire d'Alfort, USC ANSES, Université Paris-Est Créteil, Créteil, France
| | - C Paul
- Service de Dermatologie, Toulouse University Hospital (CHU), Paul Sabatier University, Toulouse, France
| | - F Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmaco-épidémiologie (Cephépi), CIC-1901, 75013 Paris, France.
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Akaba T, Kondo M, Kobayashi F, Honda N, Muramatsu S, Yagi O, Takeyama K, Seo Y, Nonaka M, Tagaya E. Characteristics of patients with severe asthma who experienced treatment failure with omalizumab. Pulm Pharmacol Ther 2021; 68:102032. [PMID: 33862220 DOI: 10.1016/j.pupt.2021.102032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Omalizumab, an anti-IgE antibody, has been widely used in many countries, including Japan. However, some patients do not respond to omalizumab, and the cause of treatment failure has not been fully elucidated. OBJECTIVE This study aimed to evaluate the characteristics of adult asthma patients who failed to achieve disease control with omalizumab in a real-world setting. METHODS We retrospectively reviewed the medical records of patients in Tokyo Women's Medical University Hospital between March 2009 and May 2016. The patient characteristics and factors for treatment failure with omalizumab were evaluated, as were treatment alternatives after discontinuation of omalizumab. RESULTS In total, 59 patients were included in this study. The omalizumab-ineffective group had a significantly higher number of patients with eosinophilic sinusitis (P = 0.001) and eosinophilic otitis media (P = 0.023) than the omalizumab-effective group. A multivariate analysis revealed that both eosinophilic chronic rhinosinusitis (odds ratio: 23.4; P = 0.011) and eosinophilic otitis media (odds ratio: 6.71; P = 0.039) were associated with treatment failure with omalizumab. Most patients with eosinophilic comorbidities of the ear, nose, and throat (ENT) in the omalizumab-ineffective group received mepolizumab or benralizumab as alternative therapy, following which disease control was achieved. CONCLUSION Eosinophilic comorbidities of the ENT may affect treatment failure with omalizumab in patients with severe asthma. Anti-interleukin-5 antibody or anti-interleukin-5Rα antibody rather than anti-IgE antibody should be considered as an additional therapy for patients with severe asthma who have eosinophilic comorbidities of the ENT.
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Affiliation(s)
- Tomohiro Akaba
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Mitsuko Kondo
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Fumi Kobayashi
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Nahoko Honda
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Soshi Muramatsu
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Osamitsu Yagi
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Kiyoshi Takeyama
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yukako Seo
- Department of Otolaryngology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Manabu Nonaka
- Department of Otolaryngology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Etsuko Tagaya
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan; Allergy Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan.
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Haslak F, Yildiz M, Adrovic A, Sahin S, Koker O, Aliyeva A, Barut K, Kasapcopur O. Management of childhood-onset autoinflammatory diseases during the COVID-19 pandemic. Rheumatol Int 2020; 40:1423-1431. [PMID: 32661928 PMCID: PMC7355083 DOI: 10.1007/s00296-020-04645-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022]
Abstract
Concerns regarding the comorbidity as a significant risk factor for Coronavirus Disease-2019 (COVID-19), gave rise to an urgent need for studies evaluating patients with chronic conditions such as autoinflammatory diseases (AIDs). We prepared a web-based survey investigating the clinical findings and contact histories among pediatric patients with AIDs. Confirmed COVID-19 cases, patients with contact history and those with symptoms which were highly suggestive of COVID-19 were called via phone or recruited to a video or face to face appointment. Data of AIDs were obtained from their medical records, retrospectively. Laboratory and screening findings were confirmed by our national health registry website. There were 404 patients (217 female) eligible for the enrollment. During pandemic, 375 (93%) were on colchicine treatment and 48 (11.8%) were receiving biologic treatment. Twenty-four out of 404 patients were admitted to hospital due to COVID-19 suspicion. Severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) was identified through rhinopharyngeal swabs in seven patients, six of whom were only on colchicine treatment. Only one patient with no finding of any severe respiratory complications was hospitalized. All of seven patients recovered completely. Among patients on biologic drugs, neither a symptom nor a positive polymerase chain reaction test for COVID 19 was detected. In conclusion, pediatric patients with AIDs, those receiving biologic treatment and/or colchicine, may not be at increased risk for neither being infected nor the severe disease course.
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Affiliation(s)
- Fatih Haslak
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Mehmet Yildiz
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Amra Adrovic
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Sezgin Sahin
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Oya Koker
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Ayten Aliyeva
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Kenan Barut
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
| | - Ozgur Kasapcopur
- Department of Pediatric Rheumatology, Istanbul University-Cerrahpasa Cerrahpasa Medical School, Istanbul, Turkey
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Plaza V, Blanco M, Delgado J, Martínez I, Zubeldía JM, Molina J. Survey of Opinion of Spanish Physicians on the Role of Eosinophils in Asthma and Other Diseases. J Investig Allergol Clin Immunol 2019; 29:456-458. [PMID: 31172950 DOI: 10.18176/jiaci.0423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V Plaza
- Director del Comité Ejecutivo de la Guía Española para el Manejo del Asma (GEMA), Servei de Pneumologia i Allèrgia, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelo
| | - M Blanco
- Servicio de Neumología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - J Delgado
- Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - I Martínez
- Hospital Universitario Son Espases, Palma, Spain
| | - J M Zubeldía
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - J Molina
- Centro de Salud Francia, Fuenlabrada, Spain
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Quartuccio L, Zabotti A, Del Zotto S, Zanier L, De Vita S, Valent F. Risk of serious infection among patients receiving biologics for chronic inflammatory diseases: Usefulness of administrative data. J Adv Res 2019; 15:87-93. [PMID: 30581616 DOI: 10.1016/j.jare.2018.09.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/21/2022] Open
Abstract
In this cohort, adalimumab and etanercept are the most commonly prescribed biologics. Risk of hospitalized infections increases under biologic agents. Risk is much higher in the elderly and in the presence of comorbidities. Upper and lower respiratory tract infections are the most common infections. Administrative data are useful for confirming the observation of clinical trials.
Risk of hospitalized infections under biologics among patients suffering from chronic inflammatory autoimmune diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PSA), or psoriasis was investigated using administrative data. The hospital discharge records database, the medical prescription database, and the database of exemptions from medical charges were linked at the individual patient level. A cohort of patients diagnosed with RA, SA, PSA, and severe psoriasis from 2006 to 2017 was identified and followed-up to either the end of 2017 or hospitalization with the main discharge diagnosis of infection, death, or they moved out of the region. Multiple Cox regression was used to estimate the hazard ratio (HR) of hospitalization associated with bDMARDs and adjusting for age, sex, Charlson’s Comorbidity Index, calendar year, prescription of steroids, and use of csDMARDs. Use of bDMARDs was treated as a time-dependent variable. A total of 5596 patients diagnosed with RA, AS, or PSA/severe psoriasis were included in the cohort. Overall, 289 (4.2%) were hospitalized due to infection. Time to first use of biological drugs was significantly associated with a 55% increased risk of hospitalization for infections. Thus, large cohorts from administrative databases are useful to support observations from registries and clinical trials. Patients with chronic autoimmune inflammatory diseases are at risk of serious infections when starting biologics. This risk is higher in the elderly or those with comorbidities. Upper and lower respiratory tract infections are the most common infections. Our findings support prevention policies such as vaccination.
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Abstract
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease which predominately affects children and usually clears up during infancy or childhood. However, AD may persist with a chronic relapsing course until adulthood or develop at a later age. AD treatment can often be complicated. Treating moderate-to-severe AD can be challenging: only a few therapeutic options are available, with cyclosporine being the only approved and labeled systemic drug. In the last few years, advances in the knowledge of AD pathogenesis have been made that can provide the basis for developing new topical and systemic drugs. Among them, biologic drugs targeting specific cytokines involved in the development of the disease will probably revolutionize AD therapy. Currently, dupilumab, a monoclonal antibody that binds to the shared alpha chain subunit of the receptors for IL-4 and IL-13, is the only biologic drug licensed for the treatment of AD in adults. However, other biologic drugs that selectively target some key cytokines in AD pathogenesis (IL-13, IL-31, and IL-22) are also being studied. In this review, we discuss all of the biologic drugs that have been studied for AD treatment.
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Affiliation(s)
| | - Maddalena Napolitano
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Matteo Megna
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - Nicola Balato
- Department of Dermatology, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Dermatology, University of Naples Federico II, Naples, Italy.
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