Investigational drugs for atopic dermatitis.

Expert Opin Investig Drugs. 2018 Jul 30:1-11. doi: 10.1080/13543784.2018.1494723. [Epub ahead of print] Ellis Hon KL1, Leung AKC2, Leung TNH3, Lee VWY4. Author information 1 a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong. 2 b Department of Pediatrics, The University of Calgary , Alberta Children's Hospital , Calgary , Canada. 3 c Department of Paediatrics and Adolescent Medicine , The University of Hong Kong , Hong Kong. 4 d School of Pharmacy , The Chinese University of Hong Kong , Hong Kong. Abstract Many novel medications and herbal medicines have claimed efficacy on atopic dermatitis (AD). Areas covered: This review covers evidence on efficacy of topical and oral forms of novel and investigational drugs. Topical agents include emollients, phosphodiesterase E4 (PDE4) inhibitors, and topical herbs. There is little evidence that ceramides or natural moisturizing factors provide relief in AD. PDE4 inhibitors have shown promise as an effective topical treatment for mild-to-moderate AD with minimal adverse events, and dupilumab as an effective subcutaneous agent for the treatment of moderate-to-severe AD in adult patients with little adverse effects. However, only preliminary data are available for dupilumab in children with AD. The long-term effects of dupilumab are also not known. Potential new systemic treatments include a number of herbal concoctions. Expert opinion: Randomized, double-blind placebo-controlled trials (RCTs) have demonstrated topical PDE4 inhibitors are effective and safe in the treatment of both children and adults with AD but further evaluations are needed. RCTs have also shown that subcutaneous dupilumab is an effective and safe agent for the treatment of AD in adults. Long-term effects of these topical and systemic investigational drugs are currently unavailable. Regarding herbal medications, scientific methods are often flawed and objective evidence is lacking. KEYWORDS: Atopic dermatitis; Chinese medicine; PDE4; crisaborole; dupilumab; eczema; herbs; investigational drugs