Biological therapies for atopic dermatitis: An update�(Review)

Abstract

Severe atopic dermatitis, which affects both adults and children, is a debilitating disorder with a significant decline of patients' quality of life. Although aetiopathogenic factors are currently a topic of study and interpretation, the main features of atopic eczema are skin barrier disturbance and immune dysregulation. Severe refractory disease that fails to improve with conventional therapy may benefit from biologic therapy. Progress in understanding immunopathology of atopic dermatitis have allowed identification of therapeutic molecular targets in the field of biological therapy. We reviewed the different biological treatments with a focus on novel targeted agents:

Managing atopic dermatitis with systemic therapies in adults and adolescents: An Australian/New Zealand narrative

“…Omalizumab is a monoclonal antibody that blocks IgE function, indicated for the treatment of chronic urticaria. To date, studies in atopic dermatitis are disappointing with an open‐label study in 21 patients, four case series totalling 64 patients and two small randomised controlled trials in a total of 28 patients not providing convincing evidence of efficacy …”

“…To date, studies in atopic dermatitis are disappointing with an open-label study in 21 patients, four case series totalling 64 patients and two small randomised controlled trials in a total of 28 patients not providing convincing evidence of efficacy. 78,79 Mepolizumab, a monoclonal antibody to IL-5 that reduces peripheral blood eosinophils, failed to show a significant clinical benefit in a randomised controlled trial of 40 patients with atopic dermatitis. 80 Although treatment led to a reduction in peripheral blood eosinophils, a subsequent analysis showed there was no effect on numbers of tissue eosinophils in skin biopsies.…”

Atopic Dermatitis: From Physiopathology to the Clinics

“…Crisaborole is a topical phosphodiesterase 4 (PDE4) blocker approved in the US for the treatment of mild-to-moderate AD in patients 2 years old and older, which has shown to be more effective than the vehicle alone. There are no comparative studies with topical corticosteroids or calcineurin inhibitors [67,68,70].…”

Dupilumab for the treatment of adolescents with atopic dermatitis

“…Tralokinumab, lebrikizumab, nemolizumab, a number of JAK inhibitors, and at least one histamine 4 receptor antagonist will probably have obtained approval for AD in the next few years. As the drug target of lebrikizumab and tralokinumab, IL-13, is quite similar to the one of dupilumab, is it possible that the prescribing dermatologists will group all three drugs in the same entity of Th2 blockers [67].…”