Not enough is still being said about AD treatment

What is atopic dermatitis (AD)?

It is a disease in which genetic factors lead to immunological abnormalities that translate into the phenotype, or clinical picture. However, AD is a condition that is also modified by environmental factors that affect its course and can lead to exacerbations. The lesions we can observe in patients vary in severity. In their characteristic image, they are located in the elbow and knee flexures, sometimes affecting the face or other areas. They are usually accompanied by severe pruritus, which significantly impairs patients' quality of life, causing insomnia, among other things.

How can patients with AD be helped?

Treatment depends on several factors. These include the course of the disease, that is, the severity of the lesions, both at the time of control and during life. There are patients whose lesions occur episodically, and there are those who are severely ill for life. Inclusion of treatment also takes into account comorbidities. I will remind at this point that a significant proportion of people with AD also have other diseases, such as atopic asthma, allergic rhinitis or allergic conjunctivitis. Genetically determined permeability of the skin to various external substances stimulates the formation of immunological disorders.

In the classical approach, therapy uses various types of preparations to support treatment. The basis for this is care with emollients. If this is sufficient, various topical therapies are used, such as topical inflammatory drugs: glucocorticosteroids or calcineurin inhibitors. Other drugs are also available worldwide, including phosphodiesterase inhibitors. It's also worth remembering that for patients suffering from severe forms that require general treatment, we have different types of drugs. These are classic, disease-modifying drugs, as well as many innovative drugs. In Poland, we have a program for the treatment of patients with AD with severe forms, with two biologic drugs and three small molecules that block janus kinases. The choice of therapy depends on several factors, including clinical characteristics.

And what is the awareness about atopic dermatitis, both the disease itself and treatment options?

Patient education is the gold standard when it comes to raising awareness about the disease itself, as well as its treatment. Although we talk about the disease very often, we still have to work hard on this awareness. Lack of knowledge about the need for treatment, proper management, as well as the therapies and topical treatment options available in the drug program evidently translates into a reduced supply of the correct drugs. It is worth remembering that this is a chronic disease that requires ongoing treatment. Patients, after many years of treatment, are sometimes frustrated with their current form of therapy and, even if they have the option to join an innovative treatment, are not willing to trust it. Education should therefore be key.

And do we have equal access to treatment in Poland?

There is certainly a problem of accessibility to innovative therapies. The disparity between different parts of Poland is apparent in this case. We are trying to level out these disparities. Contrary to appearances, the number of centers that have contracted innovative treatment is not at all as small as it might seem. Increasing it is not necessarily a recipe for solving this problem. I think that what is needed here more are systemic solutions, and above all - spreading knowledge about the disease and its treatment options.