How is drug selection evolving in atopic dermatitis? Walter Liszewski, MD, discusses personalized therapy and long-term care.
The expanding therapeutic landscape in
Speaking with HCPLive at the
Liszewski explained that the increase in available therapies has shifted the conversation toward shared decision-making. Rather than focusing solely on efficacy, clinicians can now consider patient preferences regarding route of administration, treatment speed, potential adverse effects, and long-term disease management. He added that having multiple therapeutic options is especially valuable for patients who do not respond adequately to an initial therapy, providing clinicians with additional strategies when treatment failure occurs.
When discussing advanced systemic therapies, Liszewski noted that Janus kinase (JAK) inhibitors remain highly effective options, although current US Food and Drug Administration labeling generally reserves them for patients who have already received another systemic therapy. He suggested that as additional long-term safety data continue to emerge, dermatologist confidence in prescribing JAK inhibitors is likely to grow. Meanwhile, advanced topical therapies continue to fill an important role for patients with persistent disease who may not require biologic treatment, while also serving as adjunctive therapy to address localized areas of residual disease in patients receiving systemic agents.
Liszewski acknowledged that sequencing therapy after treatment failure remains one of the least defined areas in eczema management. Current evidence is limited, with clinicians often relying on case reports and real-world experience when considering combination therapy, phototherapy, or dose adjustments. He noted that emerging therapies with new mechanisms of action may help expand these options in the coming years.
Looking to the future, Liszewski highlighted the growing importance of patient-reported outcomes, including measures of itch and sleep, alongside objective skin clearance. He also pointed to biomarkers and accumulating real-world evidence as promising tools that could help clinicians better identify which patients are most likely to benefit from specific therapies. While an expanding evidence base may increase the complexity of treatment decisions, he emphasized that it will ultimately support more individualized, patient-centered care.
Disclosures: Liszewski did not have any relevant disclosures of note.
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