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An overview of drug discovery efforts for eczema: why is this itch so difficult to scratch?

Abstract
Introduction: Atopic dermatitis (AD) is a type of allergic/inflammatory dermatitis characterized by itch and an impairment in quality of life.Areas covered: Herein, the authors review drug discovery efforts for AD, highlighting the clinical efficacy of novel drugs, with a particular focus on the relief of pruritus. Topical agents include emollients, topical antihistamines, corticosteroids, calcineurin inhibitors and herbs. Recently, topical phosphodiesterase E4 (PDE4) inhibitors like crisaborole have become available and are efficacious for mild to moderate AD with few side effects. For more severe AD, monoclonal antibodies like dupilumab are considered as efficacious subcutaneous treatment options. In severe and recalcitrant AD, systemic treatment can ameliorate AD symptoms.Expert opinion: Many topical and systemic medications have demonstrated therapeutic benefits for AD. Indeed, randomized trials have shown that topical PDE4 inhibitors and subcutaneous dupilumab are safe and efficacious. Objective tools to evaluate itch and gauge treatment efficacy is important, but current methodology relies primarily on clinical scores. AD is a systemic atopic disease with a lot of complicated psychosocial issues. Suboptimal efficacy is often due to poor compliance and unrealistic expectation of curative treatment, rendering treatment difficult despite the existence of effective medications.
AuthorsKam Lun Hon, Steven Loo, Alexander K C Leung, Joyce T S Li, Vivian W Y Lee
JournalExpert opinion on drug discovery (Expert Opin Drug Discov) Vol. 15 Issue 4 Pg. 487-498 (Apr 2020) ISSN: 1746-045X [Electronic] England
PMID32050818 (Publication Type: Journal Article, Review)
Chemical References
  • Antipruritics
  • Dermatologic Agents
Topics
  • Administration, Cutaneous
  • Animals
  • Antipruritics (administration & dosage, pharmacology)
  • Dermatitis, Atopic (drug therapy, pathology)
  • Dermatologic Agents (administration & dosage, pharmacology)
  • Drug Discovery
  • Eczema (drug therapy, pathology)
  • Humans
  • Pruritus (drug therapy, etiology)
  • Quality of Life
  • Randomized Controlled Trials as Topic

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