title: Review of Systemic Treatment Options for Adult Atopic Dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease.
  
  
  OBJECTIVE
  To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy.
  
  
  METHODS
  A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search.
  
  
  RESULTS
  Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence.
  
  
  CONCLUSIONS
  Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.
authors.affiliation: 1 Queen's University, SKiN Centre for Dermatology, and Probity Medical Research, Peterborough, ON, Canada.
authors.forename: Melinda
authors.initials: M
authors.lastname: Gooderham
authors.affiliation: 2 Lynde Dermatology, Probity Medical Research, Markham Ontario, and Department of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Lynde
authors.affiliation: 3 K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada.
authors.forename: Kim
authors.initials: K
authors.lastname: Papp
authors.affiliation: 4 University of Sherbrooke, QC, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Bourcier
authors.affiliation: 5 University of Western Ontario, London ON, Canada.
authors.forename: Lyn
authors.initials: L
authors.lastname: Guenther
authors.affiliation: 6 Memorial University of Newfoundland St. John's, NL, Canada.
authors.forename: Wayne
authors.initials: W
authors.lastname: Gulliver
authors.affiliation: 7 Department of Dermatology and Skin Science, University of British Columbia, and Probity Medical Research, Surrey, BC, Canada.
authors.forename: Chih-Ho
authors.initials: CH
authors.lastname: Hong
authors.affiliation: 8 Laval University and CDQM and CRDQ, Quebec, QC, Canada.
authors.forename: Yves
authors.initials: Y
authors.lastname: Poulin
authors.affiliation: 9 Division of Clinical Immunology and Allergy, University of Toronto, Toronto, ON, Canada.
authors.forename: Gordon
authors.initials: G
authors.lastname: Sussman
authors.affiliation: 10 Dermatrials Research Inc., Hamilton, ON, Canada.
authors.forename: Ronald
authors.initials: R
authors.lastname: Vender
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001379:Azathioprine / Q000627:therapeutic use; D001688:Biological Products / Q000008:administration & dosage / Q000627:therapeutic use*; D016572:Cyclosporine / Q000627:therapeutic use; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D006801:Humans; D011788:Quality of Life
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; C582203:dupilumab; D016572:Cyclosporine; D001379:Azathioprine
keywords: IL-13; IL-4; adults; atopic dermatitis; biologics; dupilumab; systemic therapy