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Systemic Treatments of Atopic Dermatitis

Systemic treatments of atopic dermatitis were critically evaluated in a presentation at the European Academy of Dermatology and Venerology Congress recently.

Professor Julien Seneschal spoke reviewed the evidence for treatment of atopic dermatitis with systemic therapies, highlighting three important studies:

  • Methotrexate vs azathioprine (2012): similar efficacy and good safety profile
  • Methotrexate vs cyclosporine (2017 in press): at 8 weeks cyclosporine was better but at 24 weeks there were small differences
  • Mycophenolate vs cyclosporine (2017): both effective

A retrospective study comparing methotrexate, azathioprine, cyclosporine and the combination of methotrexate and azathioprine found that cyclosporine is effective even at low in two weeks, and that systemic steroids are rapidly effective but have an unfavourable safety profile in long-term treatment.

In Professor Seneschal’s opinion, the treatment plan should be: cyclosporine (RCT, higher evidence) then methotrexate, followed by azathioprine (due to long-term side effects) and lastly mycophenolate (due to lack of enough studies).

Read more recent research in atopic dermatitis.


Seneschal, J. (13-17 September, 2017.) Systemic treatments of atopic dermatitis: A critical evaluation. 26th EADV Congress 2017 Conference Review: Research Review.

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