Dr Amy Paller Discusses Using Systemic Therapies to Treat Children With AD

Amy S. Paller, MD, chair of the department of dermatology at Northwestern University's Feinberg School of Medicine, discussed using systemic therapies to treat children with atopic dermatitis (AD).

More specifically, she listed the main factors considered when deciding whether to treat children with AD using systemic therapies. Paller also discussed implementing lifestyle changes and additional treatments to complement systemic therapies for better results in children with AD.

Transcript

What are some of the main factors you consider when it comes to treating children with AD using systemic therapies?

With respect to systemic therapies for atopic dermatitis, it's really very individualized. Of course, for each patient, we have to optimize topical therapies first, and we have new topical therapies that are coming out; that will be exciting to add to our armamentarium.

When we advanced to systemic therapies, it really very much is dependent on the needs of the child, the decision-making input from the family, and, very importantly, access. Because, in the United States, we are limited in what we can give a child based on insurance and what they have used previously.

Of course, when we're dealing with children, we also have another factor to think about, and that's that we have to give injections now to use some of the systemic therapies that are available to pediatric patients for atopic dermatitis. Even though these are incredibly safe, and we're very comfortable with using them, we do have to inflict some pain through that injection. For some children, for some families, that's just fine, and it may be the treatment of choice. For others, we have to think about the fact that it can be a real struggle, and we may not be able to get past that struggle for the child and have to think about other ways to treat with oral medication.

Are there any lifestyle changes or additional treatments that can complement systemic therapies for better results?

We don't give anyone systemic therapies only. We, of course, complement them with topical therapies to try to get that child 100% clear. We also do other things, like continue the use of emollients; they're critically important to reduce dryness and improve the barrier function of the skin.

We encourage people to have a healthy lifestyle in all ways, and that means keeping a neat house and trying to reduce dust and clutter in homes that can increase the risk for many of these children who also have a tendency towards allergic disorders.

We also, in general, just consider a healthy lifestyle for the entire family to be important because good diet and exercise are important for good health for everyone.