Allergologie select, Volume 10 (2026) - 1st issue (120 - 144)

Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation
Thomas Werfel1, Annice Heratizadeh1, Matthias Augustin2, Christine Bangert3, Andrea Bauer4, Tilo Biedermann5, Richard Brans6, Nadine Domröse1, Uwe Gieler7, Oliver Gießler-Fichtner8, Eckard Hamelmann9, Selina Hampe10, Ruben Heuer11, Julia Kahle10, Maria Kinberger11, Markus Koch12, Meike Köhler13, Franz Legat14, Katja Nemat15,16, Irena Neustädter17, Eva M. J. Peters18, Susanne Radonjic-Hoesli19, Imke Reese20, Peter Schmid-Grendelmeier21, Uta-Katharina Schmidt-Göhrich22, Jochen Schmitt23, Christina Schnopp5, Thomas Schwennesen24, Dagmar Simon19, Kristina Stamos16, Christian Termeer25,26, Regina Treudler27, Ralph von Kiedrowski28, Iris Wagner24, Anja Waßmann-Otto29, Gesine Weckmann30, Ricardo Niklas Werner11, Andreas Wollenberg31,32, Margitta Worm33, Hagen Ott13,34
1 Department of Dermatology and Allergy, Hannover Medical School, Hannover, 2 Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 3 Department of Dermatology, Medical University of Vienna, Vienna, Austria, 4 Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 5 TUM University Hospital, Department of Dermatology and Allergy, Munich, 6 Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, 7 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen, 8 Gaißach Specialist Clinic of DRV Bayern Süd, Gaißach, 9 Children’s Center, Evangelical Hospital Bethel, University Hospital OWL, University of Bielefeld, Bielefeld, 1  0 German Allergy and Asthma Association (DAAB), Mönchengladbach, 1  1 Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 1  2 Alpenklinik Santa Maria, Bad Hindelang, 1  3 Section for Integrated Pediatric Dermatology (iKinD), Munich Center for Children with Medical and Developmental Complexity, LMU University Hospital, Munich, Germany, 1  4 Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria, 1  5 Practice for pediatric pneumology and allergology, Children’s Center Dresden-Friedrichstadt (Kid), 1  6 Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 1  7 Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg, 1  8 Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Gießen, Gießen, Germany, 1  9 Department of Dermatology, Inselspital Bern, Bern, Switzerland, 2  0 Private Practice for Dietary Advice and Nutrition Therapy with Special Interest in Adverse Reactions to Food, Munich, Germany, 2  1 Allergy Unit, Department of Dermatology, University Hospital Zurich and Christine Kuehne Center for Allergy Research and Education CK-CARE Davos, Switzerland, 2  2  Carus Family Practice at Dresden University Hospital, 2  3 Center for Evidence-Based Healthcare (ZEGV), University Hospital Dresden and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, 2  4 German Eczema Association (DNB), Hamburg, 2  5 Dermatology Practice at Löwenmarkt, Stuttgart-Weilimdorf, 2  6 Department of Dermatology, University-Hospital Freiburg, Freiburg, 2  7 Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 2  8 Selters Dermatology Practice, Selters, 2  9 Mensing Derma MVZ, Hamburg, 3  0 Weckmann Institute of Medical and Healthcare Education, Rostock, 3  1 Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, 3  2 Clinic and Polyclinic for Dermatology and Allergology, Ludwig Maximilian University, Munich, 3  3 Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, and 3  4 Department of Pediatric Surgery, Dr. Von Hauner Children’s Hospital, LMU University Hospital, Munich, Germany

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DOI 10.5414/ALX02638E

Abstract

This guideline is a partial update of the S3 guideline on atopic dermatitis (AWMF register no. 013-027) published in 2023. The chapters on systemic therapy with biologics and Janus kinase inhibitors as well as the chapter on pregnancy, breastfeeding and family planning in the context of systemic therapies for atopic dermatitis have been updated. This was prompted by new approvals (lebrikizumab, nemolizumab), approval extensions (abrocitinib from 12 years of age, baricitinib from 2 years of age) and new evidence on the use of biologics before and during pregnancy. In addition, a new chapter on treatment goals, treatment expectations and criteria for treatment adjustment (“treat-to-target”) in systemic therapies has been added to the guideline. This article only presents the updated and newly added chapters. The complete guideline is available on the AWMF website.

Author Details

Authors

Departments

  • 1 Department of Dermatology and Allergy, Hannover Medical School, Hannover,
  • 2 Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany,
  • 3 Department of Dermatology, Medical University of Vienna, Vienna, Austria,
  • 4 Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden,
  • 5 TUM University Hospital, Department of Dermatology and Allergy, Munich,
  • 6 Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück,
  • 7 Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen,
  • 8 Gaißach Specialist Clinic of DRV Bayern Süd, Gaißach,
  • 9 Children’s Center, Evangelical Hospital Bethel, University Hospital OWL, University of Bielefeld, Bielefeld,
  • 1 
  • 0 German Allergy and Asthma Association (DAAB), Mönchengladbach,
  • 1 
  • 1 Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin,
  • 1 
  • 2 Alpenklinik Santa Maria, Bad Hindelang,
  • 1 
  • 3 Section for Integrated Pediatric Dermatology (iKinD), Munich Center for Children with Medical and Developmental Complexity, LMU University Hospital, Munich, Germany,
  • 1 
  • 4 Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria,
  • 1 
  • 5 Practice for pediatric pneumology and allergology, Children’s Center Dresden-Friedrichstadt (Kid),
  • 1 
  • 6 Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden,
  • 1 
  • 7 Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg,
  • 1 
  • 8 Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Gießen, Gießen, Germany,
  • 1 
  • 9 Department of Dermatology, Inselspital Bern, Bern, Switzerland,
  • 2 
  • 0 Private Practice for Dietary Advice and Nutrition Therapy with Special Interest in Adverse Reactions to Food, Munich, Germany,
  • 2 
  • 1 Allergy Unit, Department of Dermatology, University Hospital Zurich and Christine Kuehne Center for Allergy Research and Education CK-CARE Davos, Switzerland,
  • 2 
  • 2  Carus Family Practice at Dresden University Hospital,
  • 2 
  • 3 Center for Evidence-Based Healthcare (ZEGV), University Hospital Dresden and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden,
  • 2 
  • 4 German Eczema Association (DNB), Hamburg,
  • 2 
  • 5 Dermatology Practice at Löwenmarkt, Stuttgart-Weilimdorf,
  • 2 
  • 6 Department of Dermatology, University-Hospital Freiburg, Freiburg,
  • 2 
  • 7 Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin,
  • 2 
  • 8 Selters Dermatology Practice, Selters,
  • 2 
  • 9 Mensing Derma MVZ, Hamburg,
  • 3 
  • 0 Weckmann Institute of Medical and Healthcare Education, Rostock,
  • 3 
  • 1 Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg,
  • 3 
  • 2 Clinic and Polyclinic for Dermatology and Allergology, Ludwig Maximilian University, Munich,
  • 3 
  • 3 Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, and
  • 3 
  • 4 Department of Pediatric Surgery, Dr. Von Hauner Children’s Hospital, LMU University Hospital, Munich, Germany

Address

PD Dr. Annice Heratizadeh, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
Email: [email protected]

Citation

Thomas Werfel, Annice Heratizadeh, Matthias Augustin, Christine Bangert, Andrea Bauer, Tilo Biedermann, Richard Brans, Nadine Domröse, Uwe Gieler, Oliver Gießler-Fichtner, Eckard Hamelmann, Selina Hampe, Ruben Heuer, Julia Kahle, Maria Kinberger, Markus Koch, Meike Köhler, Franz Legat, Katja Nemat, Irena Neustädter, Eva M. J. Peters, Susanne Radonjic-Hoesli, Imke Reese, Peter Schmid-Grendelmeier, Uta-Katharina Schmidt-Göhrich, Jochen Schmitt, Christina Schnopp, Thomas Schwennesen, Dagmar Simon, Kristina Stamos, Christian Termeer, Regina Treudler, Ralph von Kiedrowski, Iris Wagner, Anja Waßmann-Otto, Gesine Weckmann, Ricardo Niklas Werner, Andreas Wollenberg, Margitta Worm, and Hagen Ott.Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation. Allergologie select. 2026; 10: 120-144. doi: 10.5414/ALX02638E.

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