Skill Checkup: A 32-Year-Old Man With a History of Atopic Dermatitis Presents With Worsening Itch

Diamant Thaçi, MD, PhD; Alan Irvine, MD, DSc


July 13, 2023

Dupilumab, an injectable IL-4Rα inhibitor, is approved as systemic therapy in patients ≥ 6 years of age with moderate to severe AD in whom topical prescription therapies are not sufficient or appropriate. In 2023, the European Medicines Agency extended the approval of dupilumab to include patients aged 6 months to 5 years with severe AD.

Kappa-opioid receptor agonists show promise in the treatment of pruritus from a variety of causes, including AD. However, they are not yet approved for this indication.

The JAK inhibitors baricitinib, upadacitinib and abrocitinib have been approved in Europe for first-line treatment of AD, but not in combination with an IL-4Rα inhibitor.

Antihistamines are widely used for the treatment of AD; however, according to consensus-based European guidelines for the treatment of AD, there is not enough evidence to support the general use of either first- or second-generation antihistamines for the treatment of pruritus in patients with AD.


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