这篇全面的综述详细介绍了意大利的特应性皮炎(AD)治疗,主要集中在生物制品和小分子的使用。为了提高对AD的病因和治疗方法的认识,全球需要更新指南,为医生提供更全面的临床观点,促进个性化治疗策略。Dupilumab,一种开创性的生物制剂,获得批准是一个重要的里程碑。临床试验证明其能够显着降低AD严重程度评分,令人印象深刻的37%的患者在短短16周的治疗内达到清晰或接近清晰的皮肤。现实世界的研究进一步支持其在不同年龄段的功效,包括老年人,具有类似于年轻人的安全性。曲洛金单抗,最近的批准,在临床试验中显示出希望,特别是在年轻人群中。然而,它的实际应用,尤其是老年人,缺乏全面的数据。Janus激酶抑制剂如Upadacitinib,Baricitinib,和阿布西替尼具有治疗AD的巨大潜力。然而,75岁以上患者的数据仍然有限,老年人被认为具有较高的风险.综合安全性分析显示,60岁及以上的个体经历重大不良心血管事件和恶性肿瘤,强调需要谨慎考虑。虽然这些疗法提供了希望,尤其是在年轻患者中,进一步的研究对于确定它们在不同人群中的安全性和有效性至关重要,包括儿科,老年病学,和那些有合并症的人。生物制剂和小分子正在改善AD治疗,如这篇评论所示。
This comprehensive review offers a detailed look at atopic dermatitis (AD) treatment in Italy, focusing primarily on the use of biologics and small molecules. In response to advancing knowledge of AD\'s causes and treatments, there\'s a global need for updated guidelines to provide physicians with a more comprehensive clinical perspective, facilitating personalized treatment strategies. Dupilumab, a groundbreaking biologic, gained approval as a significant milestone. Clinical trials demonstrated its ability to significantly reduce AD severity scores, with an impressive 37% of patients achieving clear or nearly clear skin within just 16 weeks of treatment. Real-world studies further support its efficacy across various age groups, including the elderly, with a safety profile akin to that of younger adults. Tralokinumab, a more recent approval, shows promise in clinical trials, particularly among younger populations. However, its real-world application, especially in older individuals, lacks comprehensive data. Janus Kinases inhibitors like Upadacitinib, Baricitinib, and Abrocitinib hold substantial potential for AD treatment. Nevertheless, data remains limited for patients over 75, with older adults perceived to carry a higher risk profile. Integrated safety analyses revealed individuals aged 60 and above experiencing major adverse cardiovascular events and malignancies, underscoring the need for cautious consideration. While these therapies offer promise, especially among younger patients, further research is essential to determine their safety and efficacy in various populations, including pediatric, geriatric, and those with comorbidities. Biologics and small molecules are improving AD treatment, as shown in this review.