Executive summary: Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies

Dawn M R Davis; Aaron M Drucker; Ali Alikhan; Lionel Bercovitch; David E Cohen; Jennifer M Darr; Lawrence F Eichenfield; Lindsy Frazer-Green; Amy S Paller; Kathryn Schwarzenberger; Jonathan I Silverberg; Anne Marie Singh; Peggy A Wu; Robert Sidbury

doi:10.1016/j.jaad.2023.08.103

Executive summary: Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies

J Am Acad Dermatol. 2024 Feb;90(2):342-345. doi: 10.1016/j.jaad.2023.08.103. Epub 2023 Nov 7.

Authors

Affiliations

¹ Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota.
² Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
³ Department of Dermatology, Sutter Medical Foundation, Sacramento, California.
⁴ Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
⁵ The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
⁶ Department of Pediatrics, Pediatric Behavioral Health, National Jewish Health, Denver, Colorado.
⁷ Departments of Dermatology and Pediatrics, University of California San Diego and Rady Children's Hospital San Diego, San Diego, California.
⁸ American Academy of Dermatology, Rosemont, Illinois. Electronic address: lfrazer-green@aad.org.
⁹ Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
¹⁰ Department of Dermatology, Oregon Health and Science University, Portland, Oregon.
¹¹ Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
¹² Departments of Pediatrics, Dermatology and Medical Microbiology/Immunology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
¹³ Department of Dermatology, University of California, Davis, Sacramento, California.
¹⁴ Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington.

PMID: 37943241
DOI: 10.1016/j.jaad.2023.08.103

Abstract

Background: The summarized guidelines update the 2014 recommendations for the management of AD with phototherapy and systemic therapies.

Methods: A multidisciplinary workgroup conducted a systematic review and applied the GRADE approach for assessing the certainty of the evidence and formulating and grading recommendations.

Results: The workgroup developed 11 recommendations on the management of AD in adults with phototherapy and systemic therapies, including biologics, oral Janus Kinase inhibitors, and other immunomodulatory medications.

Conclusions: The evidence supported strong recommendations for the use of dupilumab, tralokinumab, abrocitinib, baricitinib, and upadacitinib and conditional recommendations in favor of using phototherapy, azathioprine, cyclosporine, methotrexate, and mycophenolate, and against the use of systemic corticosteroids.

Keywords: JAK inhibitor; atopic dermatitis; azathioprine; biologic; cyclosporine; dupilumab; eczema; methotrexate; phototherapy.

Publication types

Practice Guideline

MeSH terms

Adult
Cyclosporine / therapeutic use
Dermatitis, Atopic* / drug therapy
Humans
Immunosuppressive Agents / therapeutic use
Methotrexate / therapeutic use
Phototherapy

Substances

Cyclosporine
Immunosuppressive Agents
Methotrexate