title: An update on current pharmacotherapy options in atopic dermatitis.
abstract: BACKGROUND
  New knowledge on the pathogenesis of atopic dermatitis (AD) gives us new treatment options. This review emphasizes long-term treatment results.
  
  
  METHODS
  This study includes basic pathogenic factors in AD and presents present and future treatment options. Topical corticosteroids treat the inflammation effectively short term. Topical calcineurin inhibitors (TCIs) show better benefit/risk ratio in long-term treatment. For topical treatment, an effective maintenance treatment results in optimal control of the AD. Of systemic immunosuppressive treatments, efficacy has been shown with azathioprine, ciclosporin, methotrexate and mycophenolate-free sodium. With these compounds, the treatment outcome was ~ 50% improvement in clinical signs compared with baseline. New treatments under study include systemic compounds, which suppress the T helper type 2 cells. The importance of adherence to treatment is often overlooked, although it has a major impact on treatment outcome. For the present review, PubMed was used as a primary source.
  
  
  CONCLUSIONS
  Combination of future T(H)2-specific systemic treatment with optimal topical treatment with TCI, especially tacrolimus ointment, could help to completely control the skin inflammation in AD. The ultimate goal is to control AD completely, which should help to control the atopic airway disease as well.
authors.affiliation: University of Helsinki, Skin and Allergy Hospital , Meilahdentie 2, 00250 Helsinki , Finland +358 9 471 86482 ; +358 9 471 86561 ; sakari.reitamo@hus.fi.
authors.forename: Sakari
authors.initials: S
authors.lastname: Reitamo
authors.forename: Anita
authors.initials: A
authors.lastname: Remitz
mesh_terms: D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008134:Long-Term Care; D060046:Maintenance Chemotherapy; D055118:Medication Adherence; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D016559:Tacrolimus
keywords: T-cell subsets; adherence; atopic dermatitis; corticosteroids; long-term treatment; maintenance treatment; pimecrolimus; tacrolimus