NOVEL THERAPIES FOR ATOPIC DERMATITIS

This chapter provides a comprehensive overview of emerging and novel therapeutic modalities for atopic dermatitis (AD), a chronic inflammatory skin disease characterized by intense pruritus and ec-zematous lesions that significantly impairs patients’ quality of life (QoL). AD affects approximately 20% of children and up to 10% of adults globally, with its pathogenesis involving complex interactions between skin barrier dysfunction, immune dysregulation, and environmental factors. The traditional treatment paradigm, which historically relied on emollients, topical corticosteroids, and calcineurin inhibitors, has evolved significantly with the advent of targeted biologics and small-molecule inhib-itors that precisely address the multifaceted immunopathogenesis of AD. This chapter systematical-ly summarizes the mechanisms of action, clinical efficacy, safety profiles, and practical applications of several therapeutic classes that have transformed AD management. Additionally, focus is placed on Janus kinase inhibitors (JAKi), including both oral formulations (upadacitinib, abrocitinib, and baricitinib) and topical preparations (ruxolitinib, delgocitinib), which function by blocking multiple cytokine signaling pathways simultaneously. On the other hand, the chapter examines monoclonal antibodies targeting key inflammatory pathways, specifically dupilumab, tralokinumab, lebrikizumab, and nemolizumab, which selectively modulate Type 2 inflammation through interleukine (IL)-4, IL-13, and IL-31 inhibition. Emerging novel agents targeting alternative pathways, including thymic stromal lymphopoietin (TSLP), the OX40/OX40L axis, and transient receptor potential vanilloid 1 (TRPv1), are also discussed as promising future therapeutic options.