Abstract

Atopic dermatitis (AD) is a chronic, inflammatory skin disease with an eczematous rash and itching. Due to undesired adverse effects of traditional systemic treatment, there is still an unmet need for safe and effective long-term therapy for refractory AD. As our understanding of the pathogenesis underlying AD grows, novel treatments targeting specific molecules have been developed. Here, we discuss the efficacy and safety profiles of these drugs in recent clinical trials. Among their adverse effects, of particular note is AD acceleration. Although there is still debate about whether certain adverse reactions can be said to be paradoxical adverse events (PAEs), a wide range of PAEs have been reported during biological treatment for chronic immune-mediated diseases. Close surveillance of novel biologics is crucial to detect new undescribed paradoxical reactions and to shed light on the convoluted pathogenesis of AD.

Highlights

  • Atopic dermatitis (AD) is one of the most common chronic, inflammatory, relapsing skin diseases [1]

  • There is still a debate about whether certain adverse reactions can be said to be paradoxical adverse events (PAEs), a wide range of PAEs have been reported during biological treatment for chronic immunemediated diseases [12]

  • Significant reductions in Th1 (IFN-γ/CXCL10), Th2 (IL31/CCL11/CCL17), and Th17/Th22 (IL-23p19/IL-8/S100As) mRNA expression in lesional skin were induced by GBR 830, but the key cytokines Th2 (IL-4 and IL-13) and Th17/Th22 (IL-17A and IL-22) were not significantly reduced with GBR 830 compared with placebo

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Summary

Introduction

Atopic dermatitis (AD) is one of the most common chronic, inflammatory, relapsing skin diseases [1]. An IL-4 and IL-13 inhibitor, was the first biological drug approved by the FDA for the treatment of AD in adults [8]. It is noteworthy for its acceptable low side effect profile (lower rate of conjunctivitis, injection-site reactions, and infections) and high efficacy (36%-44% of patients achieve clear or almost clear skin) [9,10,11]. This review discusses the efficacy, safety, and possible PAEs of novel biological therapies currently in phase II and phase III clinical trials for moderate-to-severe AD

Pathogenesis
Targeted to IL-13
Findings
Discussion
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