Balancing Safety and Progress in Pediatric AD

In a recent interview with Dermatology Times, Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, discussed the rapidly evolving landscape of atopic dermatitis (AD) treatment and research. According to Lio, the field is moving so quickly that clinical guidelines often become outdated shortly after publication, reflecting the constant influx of new discoveries and therapies.

He emphasized the exciting advances in both the understanding of the disease’s pathogenesis and the development of new treatment options. For example, there are now 4 biologic therapies available for AD, as well as 2 oral Janus kinase (JAK) inhibitors, which have been transformative for many patients. However, he also pointed out a significant gap in available treatments for pediatric populations, particularly younger children. Of the 4 biologics, only 1 is FDA-approved for use in children under 12. The 2 oral JAK inhibitors are only approved for patients 12 and older, and there are limited topical treatments for younger children as well.

This lack of treatment options for children creates a unique set of challenges. Lio highlighted the emotional and logistical burden of pediatric eczema, noting that when a child suffers from severe AD, it impacts the entire family — including siblings and parents — and can interfere with school and social development. Additionally, doctors must be especially cautious when prescribing for children due to the potential for long-term adverse effects. This need for safety can delay the use of newer, potentially helpful therapies.

At the same time, Lio stressed that leaving pediatric atopic dermatitis untreated or under-treated also carries risks. Emerging evidence suggests that inadequate management of the condition can lead to lasting physical and psychological effects. This delicate balance between caution and proactive treatment highlights the need for continued research, especially in pediatric dermatology, to ensure that children receive both safe and effective care.

Overall, Lio's insights shed light on the progress in the treatment of atopic dermatitis, while also underscoring the critical need for more inclusive options tailored to the pediatric population.

Want to hear more pearls and expert insights on AD? Join us at the annual Revolutionizing Atopic Dermatitis Conference this June in Nashville, TN.