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Sustained efficacy of dupilumab in pediatric patients with moderate-to-severe atopic dermatitis over 1 year.

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Current and Emerging Biologics for Atopic Dermatitis.

Michael Nevid1, Mark Boguniewicz2

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|October 10, 2024
PubMed
Summary

Atopic dermatitis (AD) is a chronic skin condition involving immune dysregulation and skin barrier issues. Systemic therapies targeting immune pathways are being developed, with several monoclonal antibodies in late-stage trials.

Keywords:
Atopic dermatitisBiologicsDupilumabEczemaLebrikizumabMonoclonal antibodyNemolizumabTralokinumab

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Atopic dermatitis (AD) is a prevalent, chronic, pruritic inflammatory skin disease with global health implications.
  • Its complex pathophysiology involves skin barrier defects, immune system dysregulation, and microbial imbalances.
  • Circulating immune markers support the use of systemic therapies for AD management.

Purpose of the Study:

  • To review the current understanding of atopic dermatitis pathophysiology.
  • To highlight the role of immune dysregulation and potential systemic therapeutic targets.
  • To discuss the development status of novel biologic therapies for AD.

Main Methods:

  • Literature review of atopic dermatitis (AD) pathophysiology.
  • Analysis of immune and inflammatory markers in AD.
  • Overview of current and developing biologic treatments for AD.

Main Results:

  • Type 2 immune polarization is a key feature of AD, with other pathways like Th22 and Th17/IL-23 also implicated.
  • These pathways suggest additional therapeutic targets for specific patient subsets.
  • Several monoclonal antibodies, including dupilumab and tralokinumab, are approved, with others like lebrikizumab and nemolizumab in advanced development.

Conclusions:

  • Atopic dermatitis (AD) pathogenesis is multifactorial, involving skin barrier, immune, and microbial components.
  • Systemic therapies targeting specific immune pathways represent a promising approach for moderate-to-severe AD.
  • The pipeline of biologic agents for AD offers new hope for effective treatment.