A wide range of different therapeutic regimens are used for
atopic dermatitis. Although many treatment modalities are well established worldwide among clinicians, only the minority of these
therapy recommendations are based on results of randomised controlled trials (RCTs). To close the gap between such 'generally' recommended
therapies and
therapies that are based on data from controlled trials, this review focuses not only on the pharmacological and clinical aspects of the currently proven agents, but also on the advantages and disadvantages of
therapies that have not yet been completely tested.A review of the available literature concerning the pharmacological profile and also the level of evidence of therapeutic efficacy of all currently known topical and systemic agents for the treatment of
atopic dermatitis reveals a large gap between the knowledge concerning the pharmacological action in vitro and the evidence of clinical efficacy in many cases. We agree with the conclusion of previous reviews that numerous
therapies for
atopic dermatitis urgently require more independent RCTs and especially comparative trials (e.g.
corticosteroids vs
calcineurin inhibitors). These are required in order to facilitate the choice of therapeutic strategy for the individual treatment of
atopic dermatitis, with its broad spectrum of clinical manifestations and potential complications in adult patients and, particularly, in children.Finally, we also review preclinical trials with several new drugs.
Immunomodulators appear to promise a new dimension for the future of
therapy for
atopic dermatitis, especially for severe and otherwise refractory forms or as alternatives to
corticosteroids, that is, to treat facial
atopic eczema without the risk of adverse effects.