Nemolizumab for the treatment of atopic dermatitis

Atopic dermatitis (AD) is a common, heterogeneous inflammatory skin disease characterized by chronic or relapsing eczematous lesions and intense pruritus, leading to reduced quality of life and increased mental health burden. Despite recent therapeutic advances, moderate-to-severe AD remains challenging to manage, and conventional treatments often have limited long-term efficacy and safety concerns. Interleukin-31 (IL-31) is a key mediator in AD pathogenesis, driving pruritus, barrier dysfunction, type 2 inflammation, and fibrosis. Nemolizumab, a humanized monoclonal antibody targeting the IL-31 receptor α-chain (IL-31RA), has emerged as a novel therapeutic option.

This narrative review discusses current understanding of the role of IL-31 in AD pathophysiology. It also summarizes the most recent and relevant clinical trial data on the efficacy and safety of nemolizumab.

Multiple phase II and III randomized clinical trials have demonstrated nemolizumab efficacy in patients with moderate-to-severe AD, with significant and sustained reductions in pruritus and overall disease severity. Furthermore, nemolizumab has shown a favorable safety profile, with most adverse events reported as mild and non-serious.

IL-31 plays a critical role in the pathogenesis of atopic dermatitis. Findings from clinical trials support the efficacy and safety of nemolizumab in the treatment of moderate-to-severe AD.