Systemic therapeutic options for severe atopic dermatitis;Welche systemischen therapieoptionen bestehen bei schweren formen der atopischen dermatitis?

JDDG - Journal of the German Society of Dermatology

Volumn 7, Issue 3, 2009, Pages 205-219

  Bußmann, Caroline ^a   Bieber, Thomas ^a   Novak, Natalija ^a  

^a UNIVERSITY OF BONN   (Germany)

Author keywords

Antibiotics; Antimycotics; Atopic dermatitis; Biologics; Immunosuppressive drugs; Immunotherapy; Systemic therapy

Indexed keywords

AZATHIOPRINE; CEPHALOSPORIN; CLINDAMYCIN; CORTICOSTEROID; CYCLOSPORIN A; DAKTACORT; EFALIZUMAB; ETANERCEPT; FLUCLOXACILLIN; IMMUNOGLOBULIN; INFLIXIMAB; ITRACONAZOLE; KETOCONAZOLE; LEFLUNOMIDE; MEPOLIZUMAB; METHOTREXATE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; OMALIZUMAB; RITUXIMAB; TACROLIMUS; TRICLOSAN;

ABDOMINAL PAIN; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ALLERGIC REACTION; ANAPHYLAXIS; ANEMIA; ASEPTIC MENINGITIS; ASPARTATE AMINOTRANSFERASE BLOOD LEVEL; ATOPIC DERMATITIS; BACKACHE; BILIRUBIN BLOOD LEVEL; BONE MARROW DEPRESSION; CANDIDA ALBICANS; CENTRAL NERVOUS SYSTEM DISEASE; CHEST TIGHTNESS; CHILL; CREATININE BLOOD LEVEL; DIABETES MELLITUS; DISEASE SEVERITY; DIZZINESS; DRUG DOSE INCREASE; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG HYPERSENSITIVITY; DRUG MECHANISM; DRUG PULSE THERAPY; DRUG SAFETY; DRUG WITHDRAWAL; DYSPNEA; EDEMA; ENDOCARDITIS; FATIGUE; FETOTOXICITY; FEVER; FLU LIKE SYNDROME; FLUSHING; GASTROINTESTINAL DISEASE; GASTROINTESTINAL SYMPTOM; GINGIVA HYPERPLASIA; GLAUCOMA; GROWTH RETARDATION; HEADACHE; HEPATITIS; HERPES RETINITIS; HERPES SIMPLEX; HIRSUTISM; HUMAN; HYPERGLYCEMIA; HYPERSENSITIVITY; HYPERTENSION; HYPOTENSION; INFECTION; INJECTION SITE REACTION; KIDNEY FAILURE; LACTATE DEHYDROGENASE BLOOD LEVEL; LEG PAIN; LEUKOPENIA; LIVER TOXICITY; LYMPHOCYTOPENIA; LYMPHOPROLIFERATIVE DISEASE; MALASSEZIA; MALASSEZIA FURFUR; MALASSEZIA SYMPODIALIS; MEGALOBLASTIC ANEMIA; METABOLIC DISORDER; MULTIPLE CYCLE TREATMENT; MUSCLE WEAKNESS; MYALGIA; MYCOSIS; NAUSEA; NAUSEA AND VOMITING; NEPHROTOXICITY; NEUROLOGIC DISEASE; NEUROTOXICITY; NEUTROPENIA; OBESITY; OFF LABEL DRUG USE; OSTEOPOROSIS; OTITIS MEDIA; PANCREATITIS; PARESTHESIA; PEPTIC ULCER; PUVA; QUALITY OF LIFE; REVIEW; SEPSIS; SIDE EFFECT; SKIN BIOPSY; SLEEP DISORDER; STAPHYLOCOCCAL BACTEREMIA; STAPHYLOCOCCUS AUREUS; STAPHYLOCOCCUS INFECTION; STOMATITIS; SYSTEMIC THERAPY; T CELL LYMPHOMA; TACHYCARDIA; TERATOGENICITY; THROMBOCYTOPENIA; THROMBOSIS; TREATMENT DURATION; TREATMENT RESPONSE; UNSPECIFIED SIDE EFFECT; UPPER RESPIRATORY TRACT INFECTION; URTICARIA; WITHDRAWAL SYNDROME; WOUND HEALING;

EID: 61449224609     PISSN: 16100379     EISSN: 16100387     Source Type: Journal    
DOI: 10.1111/j.1610-0387.2008.06834.x     Document Type: Review

References (71)

1. Akdis CA, Akdis M, Bieber T, Bind-slev-Jensen C, Boguniewicz M, Eigen-mann P, Hamid Q, Kapp A, Leung DY, Lipozencic J, Luger TA, Muraro A, Novak N, Platts-Mills TA, Rosenwasser L, Scheynius A, Simons FE, Spergel J, Turjanmaa K, Wahn U, Weidinger S, Werfel T, Zuberbier T. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Im-munol 2006 118 : 152 69.
2. Nomura I, Tanaka K, Tomita H, Kat-sunuma T, Ohya Y, Ikeda N, Takeda T, Saito H, Akasawa A. Evaluation of the staphylococcal exotoxins and their specific IgE in childhood atopic dermatitis. J Allergy Clin Immunol 1999 104 : 441 6.
3. Abeck D, Mempel M. Staphylococcus aureus colonization in atopic dermatitis and its therapeutic implications. Br J Dermatol 1998 139 Suppl 53 : 13 6.
4. Ewing CI, Ashcroft C, Gibbs AC, Jones GA, Connor PJ, David TJ. Flu-cloxacillin in the treatment of atopic dermatitis. Br J Dermatol 1998 June 138 (6 1022 9.
5. Schmid-Grendelmeier P, Scheynius A, Crameri R. The role of sensitization to Malassezia sympodialis in atopic eczema. Chem Immunol Allergy 2006 91 : 98 109.
6. Kim TY, Jang IG, Park YM, Kim HO, Kim CW. Head and neck dermatitis: the role of Malassezia furfur, topical steroid use and environmental factors in its causation. Clin Exp Dermatol 1999 24 : 226 31.
7. Svejgaard E, Larsen PO, Deleuran M, Ternowitz T, Roed-Petersen J, Nilsson J. Treatment of head and neck dermatitis comparing itraconazole 200 mg and 400 mg daily for 1 week with placebo. J Eur Acad Dermatol Venereol 2004 18 : 445 9.
8. Lintu P, Savolainen J, Kortekangas-Savolainen O, Kalimo K. Systemic ke-toconazole is an effective treatment of atopic dermatitis with IgE-mediated hypersensitivity to yeasts. Allergy 2001 56 : 512 7.
9. Back O, Scheynius A, Johansson SG. Ketoconazole in atopic dermatitis: therapeutic response is correlated with decrease in serum IgE. Arch Dermatol Res 1995 287 : 448 51.
10. Broberg A, Faergemann J. Topical an-timycotic treatment of atopic dermatitis in the head/neck area. A double-blind randomised study. Acta Derm Venereol 1995 75 : 46 9.
11. Caproni M, Salvatore E, Cardinali C, Brazzini B, Fabbri P. Soluble CD30 and cyclosporine in severe atopic dermatitis. Int Arch Allergy Immunol 2000 121 : 324 8.
12. Bottari V, Frezzolini A, Ruffelli M, Puddu P, Fontana L, De PO. Cy-closporin A (CyA) reduces sCD30 serum levels in atopic dermatitis: a possible new immune intervention. Allergy 1999 54 : 507 10.
13. van Joost T, Kozel MM, Tank B, Troost R, Prens EP. Cyclosporine in atopic dermatitis. Modulation in the expression of immunologic markers in le-sional skin. J Am Acad Dermatol 1992 December 27 (6 Pt 1 922 8.
14. Kinaciyan T, Natter S, Kraft D, Stingl G, Valenta R. IgE autoantibodies monitored in a patient with atopic dermatitis under cyclosporin A treatment reflect tissue damage. J Allergy Clin Immunol 2002 109 : 717 9.
15. Berth-Jones J, Finlay AY, Zaki I, Tan B, Goodyear H, Lewis-Jones S, Cork MJ, Bleehen SS, Salek MS, Allen BR, Smith S, Graham-Brown RA. Cyclosporine in severe childhood atopic dermatitis: a multicenter study. J Am Acad Dermatol 1996 34 : 1016 21.
16. Berth-Jones J, Graham-Brown RA, Marks R, Camp RD, English JS, Freeman K, Holden CA, Rogers SC, Oliwiecki S, Friedmann PS, Lewis-Jones MS, Archer CB, Adriaans B, Douglas WS, Allen BR. Long-term efficacy and safety of cyclosporin in severe adult atopic dermatitis. Br J Dermatol 1997 136 : 76 81.
17. Bunikowski R, Staab D, Kussebi F, Brautigam M, Weidinger G, Renz H, Wahn U. Low-dose cyclosporin A microemulsion in children with severe atopic dermatitis: clinical and immunological effects. Pediatr Allergy Im-munol 2001 12 : 216 23.
18. Sowden JM, Berth-Jones J, Ross JS, Motley RJ, Marks R, Finlay AY, Salek MS, Graham-Brown RA, Allen BR, Camp RD. Double-blind, controlled, crossover study of cyclosporin in adults with severe refractory atopic dermatitis. Lancet 1991, 20 338 : 137 40.
19. van Joost T, Stolz E, Heule F. Efficacy of low-dose cyclosporine in severe atopic skin disease. Arch Dermatol 1987 123 : 166 7.
20. Schmitt J, Schmitt N, Meurer M. Cyclosporin in the treatment of patients with atopic eczema - a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2007 21 : 606 19.
21. Zonneveld IM, De Rie MA, Beljaards RC, Van Der Rhee HJ, Wuite J, Zeege-laar J, Bos JD. The long-term safety and efficacy of cyclosporin in severe refractory atopic dermatitis: a comparison of two dosage regimens. Br J Dermatol 1996 135 Suppl 48 : 15 20.
22. Schroer B, Lockey R. Oral tacrolimus for severe recalcitrant atopic eczema. J Allergy Clin Immunol 2003 111 : 1409 10.
23. Grundmann-Kollmann M, Podda M, Ochsendorf F, Boehncke WH, Kaufmann R, Zollner TM. Mycophenolate mofetil is effective in the treatment of atopic dermatitis. Arch Dermatol 2001 137 : 870 3.
24. Kitchin JE, Pomeranz MK, Pak G, Washenik K, Shupack JL. Rediscovering mycophenolic acid: a review of its mechanism, side effects, and potential uses. J Am Acad Dermatol 1997 37 : 445 9.
25. Benez A, Fierlbeck G. Successful long-term treatment of severe atopic dermatitis with mycophenolate mofetil. Br J Dermatol 2001 144 : 638 9.
26. Grundmann-Kollmann M, Korting HC, Behrens S, Leiter U, Krahn G, Kaufmann R, Peter RU, Kerscher M. Successful treatment of severe refractory atopic dermatitis with mycophenolate mofetil. Br J Dermatol 1999 141 : 175 6.
27. Hansen ER, Buus S, Deleuran M, Andersen KE. Treatment of atopic dermatitis with mycophenolate mofetil. Br J Dermatol 2000 143 : 1324 6.
28. Neuber K, Schwartz I, Itschert G, Dieck AT. Treatment of atopic eczema with oral mycophenolate mofetil. Br J Dermatol 2000 143 : 385 91.
29. Satchell AC, Barnetson RS. Staphylococcal septicaemia complicating treatment of atopic dermatitis with mycophenolate. Br J Dermatol 2000 143 : 202 3.
30. Bangert CA, Costner MI. Methotrexate in dermatology. Dermatol Ther 2007 20 : 216 28.
31. Egan CA, Rallis TM, Meadows KP, Krueger GG. Low-dose oral methotrexate treatment for recalcitrant palmo-plantar pompholyx. J Am Acad Derma-tol 1999 40 : 612 4.
32. Shaffrali FC, Colver GB, Messenger AG, Gawkrodger DJ. Experience with low-dose methotrexate for the treatment of eczema in the elderly. J Am Acad Dermatol 2003 48 : 417 9.
33. Weatherhead SC, Wahie S, Reynolds NJ, Meggitt SJ. An open-label, dose-ranging study of methotrexate for moderate-to-severe adult atopic eczema. Br J Dermatol 2007 156 : 346 51.
34. Goujon C, Berard F, Dahel K, Guillot I, Hennino A, Nosbaum A, Saad N, Nicolas JF. Methotrexate for the treatment of adult atopic dermatitis. Eur J Dermatol 2006 16 : 155 8.
35. Murphy LA, Atherton D. A retrospective evaluation of azathioprine in severe childhood atopic eczema, using thiop-urine methyltransferase levels to exclude patients at high risk of myelosuppression. Br J Dermatol 2002 147 : 308 15.
36. Meggitt SJ, Gray JC, Reynolds NJ. Azathioprine dosed by thiopurine methyltransferase activity for moderate-to-severe atopic eczema: a double-blind, randomised controlled trial. Lancet 2006 March 11 367 : 839 46.
37. Liu HN, Wong CK. In vitro immunosuppressive effects of methotrexate and azathioprine on Langerhans cells. Arch Dermatol Res 1997 January 289 : 94 7.
38. Scerri L. Azathioprine in dermatologi-cal practice. An overview with special emphasis on its use in non-bullous inflammatory dermatoses. Adv Exp Med Biol 1999 455 : 343 8.
39. Berth-Jones J, Takwale A, Tan E, Barclay G, Agarwal S, Ahmed I, Hotchkiss K, Graham-Brown RA. Azathioprine in severe adult atopic dermatitis: a double-blind, placebo-controlled, crossover trial. Br J Dermatol 2002 147 : 324 30.
40. Kuanprasert N, Herbert O, Barnetson RS. Clinical improvement and significant reduction of total serum IgE in patients suffering from severe atopic dermatitis treated with oral azathioprine. Australas J Dermatol 2002 43 : 125 7.
41. Wozel G, Vitez L, Pfeiffer C. Severe atopic dermatitis and leflunomide: first clinical experience and highlights of pertinent experimental data. Dermatol Online J 2006 12 : 6.
42. Schmitt J, Wozel G, Pfeiffer C. Leflunomide as a novel treatment option in severe atopic dermatitis. Br J Dermatol 2004 150 : 1182 5.
43. Weinberg JM, Siegfried EC. Successful treatment of severe atopic dermatitis in a child and an adult with the T-cell modulator efalizumab. Arch Dermatol 2006 142 : 555 8.
44. Farshidi A, Sadeghi P. Successful treatment of severe refractory atopic dermatitis with efalizumab. J Drugs Der-matol 2006 5 : 994 8.
45. Hassan AS, Kaelin U, Braathen LR, Yawalkar N. Clinical and immunopathologic findings during treatment of recalcitrant atopic eczema with efalizumab. J Am Acad Dermatol 2007 56 : 217 21.
46. Takiguchi R, Tofte S, Simpson B, Harper E, Blauvelt A, Hanifin J, Simpson E. Efalizumab for severe atopic dermatitis: a pilot study in adults. J Am Acad Dermatol 2007 56 : 222 7.
47. Harper EG, Simpson EL, Takiguchi RH, Boyd MD, Kurtz SE, Bakke AC, Blauvelt A. Efalizumab therapy for atopic dermatitis causes marked increases in circulating effector memory CD4+ T-cells that express cutaneous lymphocyte antigen. J Invest Dermatol 2008 128 : 1173 81.
48. Yawalkar N, Schmid S, Braathen LR, Pichler WJ. Perforin and granzyme B may contribute to skin inflammation in atopic dermatitis and psoriasis. Br J Dermatol 2001 144 : 1133 9.
49. Jacobi A, Antoni C, Manger B, Schuler G, Hertl M. Infliximab in the treatment of moderate to severe atopic dermatitis. J Am Acad Dermatol 2005 52 : 522 6.
50. Buka RL, Resh B, Roberts B, Cunningham BB, Friedlander S. Etanercept is minimally effective in 2 children with atopic dermatitis. J Am Acad Dermatol 2005 53 : 358 9.
51. Oldhoff JM, Darsow U, Werfel T, Katzer K, Wulf A, Laifaoui J, Hijnen DJ, Plotz S, Knol EF, Kapp A, Bruijnzeel-Koomen CA, Ring J, de Bruin-Weller MS. Anti-IL-5 recombinant humanized monoclonal antibody [mepolizumab) for the treatment of atopic dermatitis. Allergy 2005 60 : 693 6.
52. Prussin C, Griffith DT, Boesel KM, Lin H, Foster B, Casale TB. Omalizumab treatment downregulates dendritic cell FcepsilonRI expression. J Allergy Clin Immunol 2003 December 112 : 1147 54.
53. Lim A, Luderschmidt S, Weidinger A, Schnopp C, Ring J, Hein R, Ollert M, Mempel M. The IgE repertoire in PBMCs of atopic patients is characterized by individual rearrangements without variable region of the heavy immunoglobulin chain bias. J Allergy Clin Immunol 2007 120 : 696 706.
54. Belloni B, Ziai M, Lim A, Lemercier B, Sbornik M, Weidinger S, Andres C, Schnopp C, Ring J, Hein R, Ollert M, Mempel M. Low-dose anti-IgE therapy in patients with atopic eczema with high serum IgE levels. J Allergy Clin Immunol 2007 120 : 1223 5.
55. Ong YE, Menzies-Gow A, Barkans J, Benyahia F, Ou TT, Ying S, Kay AB. Anti-IgE [omalizumab) inhibits late-phase reactions and inflammatory cells after repeat skin allergen challenge. J Allergy Clin Immunol 2005 116 : 558 64.
56. Lane JE, Cheyney JM, Lane TN, Kent DE, Cohen DJ. Treatment of recalcitrant atopic dermatitis with omalizumab. J Am Acad Dermatol 2006 54 : 68 72.
57. Krathen RA, Hsu S. Failure of omal-izumab for treatment of severe adult atopic dermatitis. J Am Acad Dermatol 2005 53 : 338 40.
58. Vigo PG, Girgis KR, Pfuetze BL, Critchlow ME, Fisher J, Hussain I. Efficacy of anti-IgE therapy in patients with atopic dermatitis. J Am Acad Der-matol 2006 55 : 168 70.
59. Forman SB, Garrett AB. Success of omalizumab as monotherapy in adult atopic dermatitis: case report and discussion of the high-affinity immunoglobulin E receptor, FcepsilonRI. Cutis 2007 80 : 38 40.
60. Simon D, Hosli S, Kostylina G, Yawalkar N, Simon HU. Anti-CD20 (rituximab) treatment improves atopic eczema. J Allergy Clin Immunol 2008 12 : 122 8.
61. Bussmann C, Bockenhoff A, Henke H, Werfel T, Novak N. Does allergen-specific immunotherapy represent a therapeutic option for patients with atopic dermatitis? J Allergy Clin Immunol 2006 December 118 : 1292 8.
62. Werfel T, Breuer K, Rueff F, Przybilla B, Worm M, Grewe M, Ruzicka T, Brehler R, Wolf H, Schnitker J, Kapp A. Usefulness of specific immunotherapy in patients with atopic dermatitis and allergic sensitization to house dust mites: a multi-centre, randomized, dose-response study. Allergy 2006 61 : 202 5.
63. Jolles S, Hughes J, Rustin M. The treatment of atopic dermatitis with adjunctive high-dose intravenous immunoglobulin: a report of three patients and review of the literature. Br J Dermatol 2000 142 : 551 4.
64. Gelfand EW, Landwehr LP, Esterl B, Mazer B. Intravenous immune globulin: an alternative therapy in steroid-dependent allergic diseases. Clin Exp Immunol 1996 104 Suppl 1 : 61 6.
65. Jolles S, Sewell C, Webster D, Ryan A, Heelan B, Waite A, Rustin M. Adjunc-tive high-dose intravenous immunoglobulin treatment for resistant atopic dermatitis: efficacy and effects on intracellular cytokine levels and CD4 counts. Acta Derm Venereol 2003 83 : 433 7.
66. Paul C, Lahfa M, Bachelez H, Chevret S, Dubertret L. A randomized controlled evaluator-blinded trial of intravenous immunoglobulin in adults with severe atopic dermatitis. Br J Dermatol 2002 147 : 518 22.
67. Noh G, Lee KY. Intravenous immune globulin [i.v.IG) therapy in steroid-resistant atopic dermatitis. J Korean Med Sci 1999 14 : 63 8.
68. Sand M, Bechara FG, Sand D, Raden-hausen M, Tomi NS, Altmeyer P, Hoff-mann K. Extracorporeal photopheresis as a treatment for patients with severe, refractory atopic dermatitis. Dermatology 2007 215 : 134 8.
69. Prinz B, Nachbar F, Plewig G. Treatment of severe atopic dermatitis with extracorporeal photopheresis. Arch Dermatol Res 1994 287 : 48 52.
70. Prinz B, Michelsen S, Pfeiffer C, Plewig G. Long-term application of extracor-poreal photochemotherapy in severe atopic dermatitis. J Am Acad Dermatol 1999 40 : 577 82.
71. Richter HI, Billmann-Eberwein C, Grewe M, Stege H, Berneburg M, Ruzicka T, Krutmann J. Successful monotherapy of severe and intractable atopic dermatitis by photo-pheresis. J Am Acad Dermatol 1998 38 : 585 8.