Abordaje terapéutico de la Dermatitis Atópica (DA) en pediatría
DOI:
https://doi.org/10.36314/cunori.v7i1.219Keywords:
dermatitis atópica, abordaje terapéutico, pediatría, dupilumabAbstract
PROBLEM: atopic dermatitis (AD) is the most common pediatric dermatologic condition. Considered a chronic inflammatory disease, characterized by intense pruritus, its treatment requires the use of active therapy to control outbreaks and prophylactic therapy to maintain the integrity of the skin barrier. OBJECTIVE: describe the therapeutic approach to atopic dermatitis in pediatrics and the use of dupilumab in the management of moderate to severe AD. METHOD: bibliographies from the last 5 years are reviewed, mainly from UpToDate, PubMed and Elsevier. RESULTS: AD normally affects 10-30% of the pediatric population, with onset within the first 6 months of life, it’s a complex disorder that can seriously affect a child's life quality, unless it’s treaten in an optimal and timely manner. CONCLUSION: the therapeutic options for mild AD are emollients and low-potency topical corticosteroids (TCS) such as 2.5% hydrocortisone. On the face or folds, topical tacrolimus or pimecrolimus can be used. In moderate to severe AD use medium to high potency TCS such as betamethasone 0.05%, phototherapy and systemic drugs such as cyclosporine or methotrexate, however, in these patients you can use dupilumab, a recombinant IgG4 monoclonal scaffold approved by the Food and Drug Association (FDA) for it’s use in children with age over six months old who do not respond to conventional therapies.
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Cather, J., Young, M., DiRuggiero, D. C., Tofte, S., Williams, L. y Gonzalez, T. (2022). A review of phase 3 trials of dupilumab for the treatment of atopic dermatitis in adults, adolescents, and children aged 6 and up. Dermatology and Therapy, 12, 2013-2038. https://doi.org/10.1007/s13555-022-00778-y DOI: https://doi.org/10.1007/s13555-022-00778-y
Chaoimh, C. N., Lad, D., Nico, C., Puppels, G. J., Wong, X. F. C. C., Common, J. E., Murray, D. M., Irvine, A. D., & Hourihane, J. O. (2022). Early initiation of short‐term emollient use for the prevention of atopic dermatitis in high risk infants – the STOP- AD randomised controlled trial. Allergy, 2022, 1.11. https://doi.org/10.1111/all.15491 DOI: https://doi.org/10.1111/all.15491
Eichenfield, L. F., Ahluwalia, J., Waldman, A., Borok, J., Udkoff, J. y Boguniewicz, M. (2017). Current guidelines for the evaluation and management of atopic dermatitis: a comparison of the joint task force practice parameter and american academy of dermatology guidelines. Journal of Allergy and Clinical Immunology, 139, 49-57. https://doi.org/10.1016/j.jaci.2017.01.009 DOI: https://doi.org/10.1016/j.jaci.2017.01.009
Ferreira, S. y Torres, T. (2018). Dupilumab for the Treatment of atopic dermatitis. Actas Dermo-Sifiliograficas, 109, 230-240. https://doi.org/10.1016/j.ad.2017.10.012 DOI: https://doi.org/10.1016/j.adengl.2018.02.019
Grupo de Coordinación de Posicionamiento Terapéutico. (2019). Informe de Posicionamiento Terapéutico de dupilumab (Dupixent ®) en dermatitis atópica. Ministerio de Sanidad, Consumo y Bienestar Social/Agencia Española de Medicamentos y Productos Sanitarios. https://www.aemps.gob.es/medicamentosUsoHumano/informesPublicos/docs/IPT-dupilumab-Dupixent-dermatitis-atopica.pdf
Howe, W. (18 de octubre de 2022). Treatment of atopic dermatitis (eczema). UpToDate. https://www.uptodate.com/contents/treatment-of-atopic-dermatitis-eczema
Lansang, P., Lam, J. M., Marcoux, D., Prajapati, V. H., Spring, S. y Lara-Corrales, I. (2019). Approach to the assessment and management of pediatric patients with atopic dermatitis: a consensus document. section iii: treatment options for pediatric atopic dermatitis. Journal of Cutaneous Medicine and Surgery, 23, 19S-31S. https://doi.org/10.1177/1203475419882647 DOI: https://doi.org/10.1177/1203475419882647
Napolitano, M., Fabbrocini, G., Neri, I., Stingeni, L., Boccaletti, V., Piccolo, V., Amoruso, G. F., Malara, G., De Pasquale, R., Di Brizzi, E. V., Diluvio, L., Bianchi, L., Chiricozzi, A., Di Guida, A., Del Duca, E., Moschese, V., Di Lernia, V., Dragoni, F., Gruber, M., … y Patruno, C. (2022). Dupilumab treatment in children aged 6–11 years with atopic dermatitis: a multicenter, real-life study. Pediatric Drugs, 24, 671-678.https://doi.org/10.1007/s40272-022-00531-0 DOI: https://doi.org/10.1007/s40272-022-00531-0
O’Connor, C., Livingstone, V., Hourihane, J. O. B., Irvine, A. D., Boylan, G. y Murray, D. (2022). Parental atopy and risk of atopic dermatitis in the first two years of life in the BASELINE birth cohort study. Pediatric Dermatology, 39, 896-902. https://doi.org/10.1111/pde.15090 DOI: https://doi.org/10.1111/pde.15090
Porumb-Andrese, E., Florida Costea, C., Cucu, A., Rusu-Zota, G., Braisteanu, D. E., Porumb, V., Scutariu, M. M., Dorobanțu, A. M., y Ursu, R. G. (2022). Skin dialogues in atopic dermatitis. Diagnostics, 12, 1889. https://doi.org/10.3390/diagnostics12081889 DOI: https://doi.org/10.3390/diagnostics12081889
Regeneron. (07 de Junio de 2022). FDA approves dupixent® (dupilumab) as first biologic medicine for children aged 6 months to 5 years with moderate-to-severe atopic dermatitis. https://investor.regeneron.com/news-releases/news-release-details/fda-approves-dupixentr-dupilumab-first-biologic-medicine-0/
Ricardo Alonso, O. E., Rodríguez Sánchez, M. B., Hernández Fernández, M. y Alonso González, M. (2019). Aspectos de interés sobre dermatitis atópica, su diagnóstico y tratamiento. Revista Médica Electrónica, 41(2), 496-507. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1684-18242019000200496&lng=es&tlng=es
Rivas-Calderón, M., Orozco-Covarrrubias, L., y Sáez-de-Ocariz, M. (2020). Atención y tratamiento integral de la dermatitis atópica. Acta Pediátrica de México, 42(6), 286-292. https://ojs.actapediatrica.org.mx/index.php/APM/article/view/2130/1227 DOI: https://doi.org/10.18233/APM41No6pp286-2922130
Torres, T., Osório Ferreira, E., Gonçalo, M., Mendes-Bastos, P., Selores, M. y Filipe, P. (2019). Update on atopic dermatitis. Acta Médica Portuguesa, 32(9), 606-613. https://doi.org/10.20344/amp.11963 DOI: https://doi.org/10.20344/amp.11963
Votto, M., Delle Cave, F., de Filippo, M., Marseglia, A., Marseglia, G. L., Brazzelli, V., & Licari, A. (2022). Rapid response to dupilumab treatment in children with moderate-to-severe atopic dermatitis: a case series. Pediatric Allergy and Immunology, 33, 31-33. https://doi.org/10.1111/pai.13623 DOI: https://doi.org/10.1111/pai.13623
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