Chronic inflammatory skin disease: New therapy for severe neurodermatitis
The quality of life is significantly reduced in people with severe neurodermatitis. Because the chronic inflammatory skin disease is accompanied by acute flare-ups, which lead to extremely dry, itchy, reddened and inflamed skin. A newly developed antibody, which is injected into the abdomen or thigh by patients, now gives hope for improvement.
Many children and adolescents affected
Neurodermatitis (atopic dermatitis, atopic eczema) is a chronic inflammatory skin disease and, according to the Robert Koch Institute (RKI), "one of the most common diseases in childhood and adolescence". The disease is usually accompanied by severe itching, dry, scaly and reddened skin. "Due to the itching and the visible rashes, neurodermatitis can severely affect the psyche and quality of life of those affected," write the experts. The cause of the disease cannot be cured, but a new therapy can stop the flare-ups.
Illness often causes a high level of suffering
In Germany, about 3.5 to 5 million people suffer from neurodermatitis, the Freiburg University Hospital reports.
"In adults, the course is often particularly difficult and causes a high level of suffering," explains Dr. Sabine Müller.
The senior physician at the Department of Dermatology and Venerology at the University Medical Center Freiburg is the head of the area for clinical allergy as well as the office hours for urticaria and neurodermatitis for adults.
Natural help for neurodermatitis
In some cases, natural remedies can help with eczema. Radon heat therapy also relieves the symptoms in many patients.
Since certain foods can exacerbate the effects of the skin disease, the menu should be individually tailored.
Many people with atopic dermatitis experience relief from their symptoms by avoiding alcohol and white sugar. The consumption of dairy products should also be restricted.
Strong side effects
In addition, with mild to moderate symptoms, individually tailored skin care as well as anti-itch and anti-inflammatory ointments help, writes the Freiburg University Clinic.
In adults with severe neurodermatitis, cortisone or drugs that suppress the immune system almost completely, so-called immunosuppressive drugs, have been used.
However, due to the often strong side effects, these two therapies are not suitable for long-term therapy and do not work for about every fifth patient.
Good effectiveness, few side effects
"After many years of waiting, we have recently been able to offer these particularly severely affected patients a so-called antibody therapy that specifically intervenes in the inflammatory cascade of neurodermatitis," said Dr. Müller.
Not only does the severity of eczema and its expansion decrease, the active ingredient also relieves the excruciating itching. "About every third patient is symptom-free or almost symptom-free after three months," summarizes the senior physician.
Dupilumab antibody is injected regularly into the thigh or abdomen at two-week intervals, comparable to the injection of insulin.
"After a briefing, our patients can do this independently at home," explains Dr. Müller.
Quality of life improves greatly
“Another positive aspect is that if the symptoms improve, existing fears or depression also decrease. This also increases the quality of life for our patients, ”the dermatologist describes her observations.
In a neurodermatitis episode, the body releases the inflammatory substance interleukin-4. The newly developed monoclonal antibody dupilumab intercepts and neutralizes the inflammatory substance.
In this way, it mitigates the excessive inflammatory reactions in a targeted manner or even prevents them altogether. "The effect of the drug is very good, with minor side effects at the same time," explains Dr. Müller.
Admission for children is expected
“We hope that antibody therapy will also be approved for children in a few years. Because twice as many children suffer from severe eczema as adults, ”adds Professor Dr. Christoph Schempp.
The doctor heads the pediatric dermatology clinic at the Department of Dermatology and Venerology at the University Medical Center Freiburg, where children with neurodermatitis receive medical care.
"Luckily for many, the disease disappears again until puberty," says the dermatologist.
Professor Schempp and Dr. Müller the profile group "Inflammatory Skin Diseases" at the Clinic for Dermatology and Venereology.
The two doctors are convinced that new and very effective drugs for neurodermatitis will follow in the next few years. (ad)