The evidence- and consensus-based living guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. The original EuroGuiDerm Guideline on atopic eczema was published in June 2022. Since then, the part of the guideline dealing with systemic therapy has been updated twice. This paper summarizes the results of the second update. Twenty-eight experts (including clinicians and patient representatives) from 12 European countries participated. The updated guideline provides guidance on which patients should be treated with systemic therapies, as well as recommendations and detailed information on each systemic drug. The systemic treatment options discussed in the guideline comprise conventional immunosuppressive drugs (azathioprine, ciclosporin, glucocorticosteroids, methotrexate and mycophenolate mofetil), biologics (dupilumab, lebrikizumab, nemolizumab and tralokinumab) and Janus kinase (JAK) inhibitors (abrocitinib, baricitinib and upadacitinib). Additionally, the updated guidelines address considerations for paediatric, adolescent, pregnant and breastfeeding patients. For all other aspects, please refer to the 2022 version.

特应性湿疹循证和共识生活指南是根据《EuroGuiDerm指南和共识声明制定手册》制定的。最初的EuroGuiDerm特应性湿疹指南于2022年6月发布。此后，指南中有关系统治疗的部分已更新了两次。本文总结了第二次更新的结果。来自12个欧洲国家的28位专家（包括临床医生和患者代表）参加了此次会议。更新后的指南为哪些患者应接受系统疗法提供了指导，并就每种系统药物提出了建议和详细信息。指南中讨论的全身治疗方案包括常规免疫抑制剂（硫唑嘌呤、环孢素、糖皮质激素、甲氨蝶呤和霉酚酸酯）、生物制剂（dupilumab、lebrikizumab、nemolizumab和tralokinumab）和Janus激酶（JAK）抑制剂（阿昔替尼、巴利替尼和乌达替尼）。此外，更新版指南还涉及儿科、青少年、孕妇和哺乳期患者的注意事项。所有其他方面请参考2022年版本。