Atopic dermatitis (AD), a common inflammatory dermatologic disease clinically, causes intense itch, recurrent eczematous lesions, and a chronic or relapsing disease course. It is possible to control mild-to-moderate AD by using moisturizers and topical immunomodulators such as corticosteroids and calcineurin inhibitors. In case of topical therapy failure, phototherapy and systemic immunosuppressant therapies, such as ciclosporin, methotrexate, and azathioprine, can be considered. Yet, relapse and side effects could occur.

The pathogenesis of AD includes epidermal barrier dysfunction, skin microbiome abnormalities, and cutaneous inflammation. At the same time, its development includes Inflammatory mediators, such as interleukin (IL)-4, IL-13, IL-31, IL-33, IL-17, IL-23, and thymic stromal lymphopoietin. Thus, a series of biological agents targeting these cytokines are encouraging approaches for treating AD. 

Dupilumab is the first biological agent approved for treating AD in patients aged six years and older in the United States. Tralokinumab, lebrikizumab, and nemolizumab have also shown significant efficacy against AD in phase III or IIb clinical trials. Also, fezakinumab has shown effectiveness in severe AD patients in a phase IIa trial. However, ustekinumab, tezepelumab, etokimab, secukinumab, and omalizumab couldn′t meet their primary endpoints in phase II trials. Phase II trials of GBR 830 and KHK 4083 are under investigation. Overall, further studies should explore new therapeutic targets and improve the efficacy of biological agents.

Yang N, Chen Z, Zhang X, Shi Y. Novel Targeted Biological Agents for the Treatment of Atopic Dermatitis. BioDrugs. 2021 Jul;35(4):401-415. doi: 10.1007/s40259-021-00490-x. Epub 2021 Jul 2. PMID: 34213742.