Systemic Therapy of Atopic Dermatitis: When, How, for How Long?

Purpose of Review: The increasingly recognized nature of atopic dermatitis/AD as a cytokine-driven, systemic disease has led to rapid development of target-specific therapies. We review advances in systemic treatments for AD, including indications for use, as well as available data on safety and efficacy. Recent Findings: Of the traditional therapies for recalcitrant AD, cyclosporine has been considered the short-term treatment of choice. Novel biologic and small molecule therapies are rapidly emerging, with dupilumab/anti IL-4R, being the first biologic therapy approved for AD that shows clinical and molecular efficacy. Summary: Severe AD is emerging as a systemic disease and mandates better and safer systemic treatments. Targeted treatments against Th2 and other cytokine pathways with novel agents are rapidly changing the therapeutic arena for AD with testing and/or development of many agents for AD patients, for more efficacious long-term disease control.