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Adam DN, Gooderham MJ, Beecker JR, Hong CH, Jack CS, Jain V, Lansang P, Lynde CW, Papp KA, Prajapati VH, Turchin I, Yeung J. Expert consensus on the systemic treatment of atopic dermatitis in special populations. J Eur Acad Dermatol Venereol 2023; 37:1135-1148. [PMID: 36695072 DOI: 10.1111/jdv.18922] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
With the increasing number of options for the treatment of moderate-to-severe atopic dermatitis, clinicians need guidance on a practical approach to selecting a systemic agent for specific patient populations. We convened an expert panel consisting of 12 members to conduct a literature review and summarize relevant data related to six scenarios of clinical interest: comorbid asthma, ocular surface disease, history of cancer, past and ongoing infections of interest (including herpes simplex virus, herpes zoster, hepatitis B, and tuberculosis), pregnancy and lactation, and the elderly. We performed a literature search and examined each clinical scenario with respect to three major categories of available systemic agents: traditional systemics (azathioprine, cyclosporine A, methotrexate, and mycophenolate mofetil), Janus kinase inhibitors (abrocitinib, baricitinib, and upadacitinib), and biologics (dupilumab, lebrikizumab, and tralokinumab). The expert panel and steering committee met virtually to review the data and discuss the drafted consensus statements. A modified Delphi process was used to arrive at a set of final consensus statements related to the systemic treatment of AD in these specific patient populations. To provide practical guidance on the choice of systemic therapy for atopic dermatitis in these six topics of clinical interest, 25 expert consensus statements and a summary of the supporting data are presented herein.
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Affiliation(s)
- D N Adam
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,CCA Medical Research, Ajax, Ontario, Canada.,Probity Medical Research Inc., Waterloo, Ontario, Canada
| | - M J Gooderham
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,SKiN Centre for Dermatology, Peterborough, Ontario, Canada
| | - J R Beecker
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada.,Division of Dermatology, The Ottawa Hospital, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - C H Hong
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.,Dr. Chih-ho Hong Medical Inc., Surrey, British Columbia, Canada
| | - C S Jack
- Division of Dermatology, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - V Jain
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | - P Lansang
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - C W Lynde
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Probity Medical Research Inc., Waterloo, Ontario, Canada.,Lynde Institute for Dermatology, Markham, Ontario, Canada
| | - K A Papp
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,K Papp Clinical Research, Waterloo, Ontario, Canada
| | - V H Prajapati
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Section of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Section of Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Dermatology Research Institute, Calgary, Alberta, Canada.,Skin Health & Wellness Centre, Calgary, Alberta, Canada
| | - I Turchin
- Probity Medical Research Inc., Waterloo, Ontario, Canada.,Brunswick Dermatology Centre, Fredericton, New Brunswick, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - J Yeung
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Probity Medical Research Inc., Waterloo, Ontario, Canada.,Division of Dermatology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
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Lytvyn Y, Georgakopoulos JR, Mufti A, Devani AR, Gooderham MJ, Jain V, Lansang P, Vender R, Prajapati VH, Yeung J. Incidence and prognosis of COVID-19 in patients with psoriasis on apremilast: a multicentre retrospective cohort study. J Eur Acad Dermatol Venereol 2021; 36:e94-e95. [PMID: 34657332 PMCID: PMC8656447 DOI: 10.1111/jdv.17749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/14/2021] [Indexed: 01/02/2023]
Affiliation(s)
- Y Lytvyn
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - J R Georgakopoulos
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - A Mufti
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada
| | - A R Devani
- Dermatology Research Institute, Calgary, AB, Canada.,Skin Health & Wellness Centre, Calgary, AB, Canada.,Probity Medical Research, Calgary, AB, Canada
| | - M J Gooderham
- Queen's University, Kingston, ON, Canada.,SKiN Centre for Dermatology, Peterborough, ON, Canada.,Probity Medical Research, Peterborough, ON, Canada
| | - V Jain
- Clinal Immunology and Allergy, McMaster University, Hamilton, ON, Canada.,Probity Medical Research, Hamilton, ON, Canada
| | - P Lansang
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada.,Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Section␣of Paediatric Dermatology, Department of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - R Vender
- Department of Dermatology, McMaster University, Hamilton, ON, Canada.,Dermatrials Research Inc. & Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | - V H Prajapati
- Skin Health & Wellness Centre, Calgary, AB, Canada.,Probity Medical Research, Calgary, AB, Canada.,Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.,Section␣of Community Pediatrics, Department of Pediatrics, University of Calgary, Calgary, AB, Canada.,Section␣of Pediatric Rheumatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada
| | - J Yeung
- Division of Dermatology, Department of Medicine, University of Toronto, ON, Canada.,Department of Dermatology, McMaster University, Hamilton, ON, Canada.,Department of Dermatology, Women's College Hospital, Toronto, ON, Canada.,Probity Medical Research Inc, Waterloo, ON, Canada
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