Nuevos inmunomoduladores para la dermatitis atópicaterapia a la carta

Resumo

Narrative review of the evidence of clinical efficacy and safety of new immunomodulatory agents for the treatment of severe atopic dermatitis. Proposal for selecting therapies according to criteria of efficacy, safety, tolerance and cost. Material and methods: Search in the web clinicaltrials.com for phase III randomized controlled trials of dupilumab, tralokinumab, baricitinb, upadacitinb, and abrocitinib for the treatment of moderate-severe atopic Results: In the pivotal studies, the new immunomodulatory agents were more effective than placebo in the treatment of moderate and severe atopic dermatitis. In head-to-head comparisons, abrodicitinb and upadacitinib, in higher dose regimens, were superior to dupilumab in some categories of disease severity scales, but with a more unfavorable adverse effect profile. Several meta-analyses have suggested some differences in efficacy, although their results should be interpreted with caution due to the heterogeneity of the studies. The availability of several alternatives allows adjusting the optimal treatment for each patient. Conclusions: The new immunomodulatory agents for the treatment of atopic dermatitis constitute a notable contribution, covering a therapeutic gap and allowing therapeutic individualization.