Atopic dermatitis (AD) is a widely acquired, relapsing inflammatory skin disease. Many biological therapeutic methods are currently used in AD treatment.

In a review, Zhou et al revealed that the biological therapies with the most robust evidence of efficacy and long-term safety for AD treatment include dupilumab, barcitinib, abrocitinib and delgocitinib. The classifications of biologics include interleukin (IL)-4/IL-13 inhibitors, Janus kinase (JAK) inhibitors, anti-IL-13 antibodies, anti-IL-22 antibodies, anti-IL-33 antibodies, thymic stromal lymphopoietin inhibitor (TSLP), OX40 antibodies and H4R-antagonists.

Besides dupilumab, four other IL-4/IL-13 inhibitors recruited were clinical trials at the phase 2-3 stage. Among others, tralokinumab has proved to be an acceptable and efficient therapeutic method for AD patients. Six different kinds of JAK inhibitors (i.e., tofacitinib, abrocitinib, baricitinib, upadacitinib, delgocitinib and ruxolitinib) were summarized with strong evidence revealing their significant therapeutic effects on AD. There were three trials for nemolizumab, an anti-IL-13 antibody, all of which were in phase 2 clinical trial stage. Results showed that nemolizumab could be another alternative therapy for moderate to severe AD with long-term efficiency and safety. The biological therapies with the most robust evidence of efficacy and long-term safety for AD treatment include dupilumab, barcitinib, abrocitinib and delgocitinib. Most of the biologics mentioned in this review were still at the exploratory stage. This review will help practitioners advise patients seeking suitable biological therapies and offer experimental study directions for treatment.

Source: Zhou S, Qi F, Gong Y, et al. Biological therapies for atopic dermatitis: a systematic review. Dermatology. 2021;237(4):542-52.