Análise para o tratamento da Dermatite Atópica: uma abordagem sobre a eficácia e segurança de novas terapias

Authors

  • Lavínia Kobayashi Grigoletto Unicesumar
  • Gabriel Ourique Balbé Unicesumar
  • Emilene Dias Fiuza Ferreira Unicesumar
  • Letícia de Souza Pilan UNICESUMAR
  • Rômulo Lourenço Séleri UNICESUMAR

DOI:

https://doi.org/10.36557/2674-8169.2026v8n3p1817-1847

Keywords:

Dermatitis, Monoclonal Antibodies, Imunosupressive agents, Methods

Abstract

Atopic dermatitis (AD), also known as atopic eczema, is a chronic inflammatory disease that commonly begins in childhood and can significantly affect the quality of life of affected patients. In recent years, treatment has advanced through the development of new therapies aimed at controlling inflammation and improving clinical symptoms. After analysis, this review gathered 64 articles published between 2019 and 2025 from major databases such as Scielo, Google Scholar, and PubMed, aiming to compare the main medications currently in use, including biologics, JAK inhibitors, and off-label methotrexate. The studies involved patients with moderate to severe AD, across different age groups, from children to the elderly. As results, Dupilumab remains the first-line option due to its safety, efficacy, and well-known side effect profile from its time on the market. Meanwhile, JAK inhibitors such as Abrocitinib and Upadacitinib have gained attention for their faster onset of action and significant short-term results. Tralokinumab, which targets IL-13, may be a promising alternative in the coming years, although current evidence is still in early stages. Thus, while scientific advancements have expanded the range of treatment options, the ideal therapy should be individualized, taking into account efficacy, safety, cost, and patient profile. Long-term studies are still needed to confirm the durability of outcomes and the real-life impact of these emerging therapies on patients with this condition.

Downloads

Download data is not yet available.

References

AGUIAR, Mariana herculano. Relatório apresentado para a obtenção do grau de Mestre em Ciências Farmacêuticas. Hospital privado de gaia, Porto, ano 2022, v. 1, n. 1, p. 1 -61, 14 out. 2022.

AOKI, V. et al. Consensus on the therapeutic management of atopic dermatitis. Brazilian Society of Dermatology, [S. l.], ano 2019, n. 1, p. 1 - 9, 13 jan. 2019. DOI: http://dx.doi.org/10.1590/abd1806-4841.2019940210.

BAWANY, F. et al. Sleep Disturbances and Atopic Dermatitis: Relationships, Methods for Assessment, and Therapies. The journal of allergy and clinical immunology. In practice, v. 9, n. 4, p. 1488–1500, 1 abr. 2021.

BIEBER, T. et al. Abrocitinib versus Placebo or Dupilumab for Atopic Dermatitis. The New England Journal of Medicine, v. 384, n. 12, p. 1101–1112, 25 mar. 2021.

BLAUVELT, A. et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis. JAMA Dermatology, v. 157, n. 9, p. 1047, 1 set. 2021.

BURMESTER, G. R. et al. Safety profile of upadacitinib over 15 000 patient-years across rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and atopic dermatitis. RMD Open, v. 9, n. 1, p. e002735, fev. 2023.

CARON, A. G. M. et al. The wide variety of methotrexate dosing regimens for the treatment of atopic dermatitis: a systematic review. Journal of Dermatological Treatment, v. 35, n. 1, 20 dez. 2023.

CHOVATIYA, R.; PALLER, A. S. JAK inhibitors in the treatment of atopic dermatitis. Journal of Allergy and Clinical Immunology, v. 148, n. 4, p. 927–940, out. 2021.

CHU, A. W. L. et al. Systemic treatments for atopic dermatitis (eczema): systematic review and network meta-analysis of randomized trials. The Journal of Allergy and Clinical Immunology, v. 152, n. 6, 5 set. 2023.

DAVARI, D. R. et al. Current Perspectives on the Systemic Management of Atopic Dermatitis. Journal of Asthma and Allergy, v. Volume 14, p. 595–607, jun. 2021.

DELEURAN, M. et al. Dupilumab Provides Significant Clinical Benefit in a Phase 3 Trial in Adolescents with Uncontrolled Atopic Dermatitis Irrespective of Prior Systemic Immunosuppressant Use. Acta dermato-venereologica, v. 101, n. 7, p. adv00504, Autumn 2021.

FANG, Z. et al. Gut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A Review. Frontiers in Immunology, v. 12, 14 jul. 2021.

FAYE, O. et al. Validation of the Patient‐Oriented SCOR ing for Atopic Dermatitis tool for black skin. Journal of the European Academy of Dermatology and Venereology, v. 34, n. 4, p. 795–799, abr. 2020.

GHANNOUM, M. et al. Extracorporeal Treatment for Methotrexate Poisoning. Clinical Journal of the American Society of Nephrology, p. CJN.08030621, 2 mar. 2022.

GILBERTO et al. Dupilumab in pediatric atopic dermatitis: real-world evidence from two national centers. Portuguese Journal of Dermatology and Venereology, v. 82, n. 2, 12 mar. 2024.

GRAJALES, D. B. et al. Unveiling abrocitinib: A thorough examination of the 2022 USFDA-approved treatment for atopic dermatitis (AD). Medicine in Drug Discovery, v. 20, p. 100161, 1 dez. 2023.

GRISTAN, Y. D.; PATEL, P.; MOOSAVI, L. Folinic Acid. StatPearls, 2024.

HANIFIN, J. M. et al. The Eczema Area and Severity Index—A Practical Guide. Dermatitis, v. 33, n. 3, p. 187–192, maio 2022.

KHADKA, V. D. et al. The Skin Microbiome of Patients With Atopic Dermatitis Normalizes Gradually During Treatment. Frontiers in Cellular and Infection Microbiology, v. 11, n. 11, 24 set. 2021.

LEE, Y.-J. et al. Interactions between Malassezia and New Therapeutic Agents in Atopic Dermatitis Affecting Skin Barrier and Inflammation in Recombinant Human Epidermis Model. International journal of molecular sciences, v. 24, n. 7, p. 6171–6171, 24 mar. 2023.

MAKOWSKA, K. et al. Immunopathogenesis of Atopic Dermatitis: Focus on Interleukins as Disease Drivers and Therapeutic Targets for Novel Treatments. International Journal of Molecular Sciences, v. 24, n. 1, p. 781, 2 jan. 2023.

MEDINA-RODRIGUEZ, E. M.; BEUREL, E. Blood brain barrier and inflammation in depression. Neurobiology of Disease, v. 175, p. 105926, 1 dez. 2022.

MORENO, A.; RENERT-YUVAL, Y.; GUTTMAN-YASSKY, E. Shedding light on key pharmacological knowledge and strategies for pediatric atopic dermatitis. Expert Review of Clinical Pharmacology, v. 16, n. 2, p. 119–131, 27 jan. 2023.

MUZZOLON, M. et al. DERMATITE ATÓPICA E TRANSTORNOS MENTAIS: ASSOCIAÇÃO EM RELAÇÃO À GRAVIDADE DA DOENÇA. Revista Brasileira de Neurologia e Psiquiatria, v. 25, n. 1, 24 set. 2021.

NASCIMENTO, G. et al. Inhibidores de JAK en pacientes con dermatitis atópica: revisión sistemática sobre el uso de Abrocitinib. Revista Cubana de Reumatología, v. 25, n. 2, p. -, 2023.

ONG, Peck. Atopic dermatitis: Is innate or adaptive immunity in control? A clinical perspective. Frontiers immunology, [S. l.], ano 2022, v. 13, p. 1 - 9, 26 jul. 2022. DOI https://doi.org/10.3389/fimmu.2022.943640.

PALLER, A. S. et al. Efficacy and Safety of Dupilumab Treatment with Concomitant Topical Corticosteroids in Children Aged 6 Months to 5 Years with Severe Atopic Dermatitis. Advances in Therapy, v. 41, n. 3, p. 1046–1061, 9 jan. 2024.

PALLER, A. S. et al. Efficacy and Safety of Upadacitinib Treatment in Adolescents With Moderate-to-Severe Atopic Dermatitis: Analysis of the Measure Up 1, Measure Up 2, and AD Up Randomized Clinical Trials. JAMA Dermatology, v. 159, n. 5, p. 526–535, 1 maio 2023.

PEREYRA-RODRIGUEZ, J.-J. et al. Short-Term Effectiveness and Safety of Biologics and Small Molecule Drugs for Moderate to Severe Atopic Dermatitis: A Systematic Review and Network Meta-Analysis. Life, v. 11, n. 9, p. 927, 6 set. 2021.

PESSOA E COSTA, T. et al. Dupilumab Treatment in Atopic Dermatitis: Real-World Evidence from a Portuguese Tertiary Center. Journal of the Portuguese Society of Dermatology and Venereology, v. 79, n. 2, p. 113–116, 25 jun. 2021.

PETER et al. Efficacy and safety of switching from dupilumab to upadacitinib versus continuous upadacitinib in moderate-to-severe atopic dermatitis: Results from an open-label extension of the phase 3, randomized, controlled trial (Heads Up). Journal of The American Academy of Dermatology, v. 89, n. 3, p. 478–485, 1 set. 2023.

PRADO, E. et al. Dermatite atópica grave: guia prático de tratamento da Associação Brasileira de Alergia e Imunologia e Sociedade Brasileira de Pediatria. Arquivos de Asmas Alergia e Imunologia, v. 6, n. 4, 2022.

RATCHATASWAN, T. et al. Biologics for treatment of atopic dermatitis: current status and future prospect. Journal of Allergy and Clinical Immunology: In Practice, v. 9, n. 3, p. 1053-1065, mar. 2021. DOI: https://doi.org/10.1016/j.jaip.2020.11.034

SAMORANO, L. P. et al. Methotrexate for refractory adult atopic dermatitis leads to alterations in cutaneous IL-31 and IL-31RA expression. Anais Brasileiros de Dermatologia, v. 99, n. 1, p. 72–79, 18 set. 2023.

SANDHU, J. K. et al. Association Between Atopic Dermatitis and Suicidality. JAMA Dermatology, v. 155, n. 2, p. 178, 1 fev. 2019.

SCHONMANN, Y. et al. Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort Study. The Journal of Allergy and Clinical Immunology. in Practice, v. 8, n. 1, p. 248-257.e16, 1 jan. 2020.

SEDEH, F. B. et al. Comparative Efficacy and Safety of Monoclonal Antibodies and Janus Kinase Inhibitors in Moderate-to-severe Atopic Dermatitis: A Systematic Review and Meta-analysis. Acta Dermato-Venereologica, v. 102, p. adv00764, 24 ago. 2022.

SHI, V. Y. et al. Phase 3 efficacy and safety of abrocitinib in adults with moderate-to-severe atopic dermatitis after switching from dupilumab (JADE EXTEND). Journal of the American Academy of Dermatology, v. 87, n. 2, p. 351–358, ago. 2022.

SIEGFRIED, E. C. et al. Effect of Dupilumab on Laboratory Parameters in Adolescents with Atopic Dermatitis: Results from a Randomized, Placebo-Controlled, Phase 3 Clinical Trial. American Journal of Clinical Dermatology, v. 22, n. 2, p. 243–255, mar. 2021.

SILVERBERG, J. I. et al. Comparative efficacy and safety of systemic therapies used in moderate‐to‐severe atopic dermatitis: a systematic literature review and network meta‐analysis. Journal of the European Academy of Dermatology and Venereology, v. 35, n. 9, p. 1797–1810, 12 jun. 2021.

SILVERBERG, J. I. et al. Upadacitinib plus topical corticosteroids in atopic dermatitis: Week 52 AD Up study results. v. 149, n. 3, p. 977-987.e14, 14 ago. 2021.

SIMPSON, E. L. et al. Efficacy and safety of abrocitinib in adults and adolescents with moderate-to-severe atopic dermatitis (JADE MONO-1): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. The Lancet, v. 396, n. 10246, p. 255–266, jul. 2020.

SIMPSON, E. L. et al. Efficacy and Safety of Abrocitinib in Patients with Severe and/or Difficult-to-Treat Atopic Dermatitis: A Post Hoc Analysis of the Randomized Phase 3 JADE COMPARE Trial. American Journal of Clinical Dermatology, v. 24, n. 4, p. 609–621, 22 maio 2023.

SIMPSON, E. L. et al. Safety of tralokinumab in adult patients with moderate‐to‐severe atopic dermatitis: pooled analysis of five randomized, double‐blind, placebo‐controlled phase II and phase III trials*. British Journal of Dermatology, v. 187, n. 6, p. 888–899, 26 out. 2022.

SROKA-TOMASZEWSKA, J.; TRZECIAK, M. Molecular Mechanisms of Atopic Dermatitis Pathogenesis. International Journal of Molecular Sciences, v. 22, n. 8, 16 abr. 2021.

TAVARES, F. et al. O impacto da Dermatite Atópica na saúde mental da população pediátrica: Uma revisão integrativa. Research Society and Development, v. 13, n. 7, p. e9613746379-e9613746379, 19 jul. 2024.

TORRES, T. et al. Update on Atopic Dermatitis. Acta Médica Portuguesa, v. 32, n. 9, p. 606, 2 set. 2019.

VERBERNE, E. A. et al. “Fetal methotrexate syndrome: A systematic review of case reports.” Reproductive toxicology (Elmsford, N.Y.) vol. 87 (2019): 125-139. doi:10.1016/j.reprotox.2019.05.066

WOLLENBERG, A. et al. Tralokinumab for moderate‐to‐severe atopic dermatitis: results from two 52‐week, randomized, double‐blind, multicentre, placebo‐controlled phase III trials (ECZTRA 1 and ECZTRA 2)*. British Journal of Dermatology, v. 184, n. 3, p. 437–449, 30 dez. 2020.

YIM, H. J.; JEAN, T.; ONG, P. Y. Comparison of Old and New Systemic Treatments for Moderate to Severe Atopic Dermatitis. Current allergy and asthma reports, 18 abr. 2024.

Published

2026-03-30

How to Cite

Grigoletto, L. K., Balbé, G. O., Ferreira, E. D. F., Pilan, L. de S., & Séleri, R. L. (2026). Análise para o tratamento da Dermatite Atópica: uma abordagem sobre a eficácia e segurança de novas terapias. Brazilian Journal of Implantology and Health Sciences, 8(3), 1817–1847. https://doi.org/10.36557/2674-8169.2026v8n3p1817-1847