Novel systemic drugs in treatment of atopic dermatitis: results from phase II and phase III studies published in 2017/2018

Curr Opin Allergy Clin Immunol. 2018 Oct;18(5):432-437. doi: 10.1097/ACI.0000000000000477.

Abstract

Purpose of review: The present review will give an update of recently published clinical studies on novel systemic treatment approaches in atopic dermatitis.

Recent findings: Until 2017 immunosuppressive drugs such as cyclosporine had to be used in atopic dermatitis when the disease could not sufficiently be treated with topical drugs. Several new substances specifically targeting inflammation in atopic dermatitis are currently studied. In 2017, dupilumab was approved in the United States and in Europe for first-line biologic treatment of moderate to severe atopic dermatitis in adults. The antibody blocks a subunit of the interleukin (IL)-4 and IL-13 receptor, thus inhibiting effects of two key cytokines in type 2 polarized inflammation. In addition to the studies on dupilumab recent clinical investigations on the effects on anti-IL-13 (lebrikizumab, tralokinumab), anti-IL-31 receptor (nemolizumab), anti-IL-22 (fezakinumab), and on small molecules targeting the histamine-4-receptor (ZPL389) and the Janus kinase inhibitor baricitinib have been published as full papers in the last 2 years.

Summary: A couple of promising novel therapeutical targets have recently been investigated and published in clinical trials on atopic dermatitis.

Publication types

  • Review

MeSH terms

  • Anti-Allergic Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Azetidines / therapeutic use
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Dermatitis, Atopic / drug therapy*
  • Histamine Antagonists / therapeutic use*
  • Humans
  • Interleukin-13 / antagonists & inhibitors
  • Janus Kinases / antagonists & inhibitors
  • Protein Kinase Inhibitors / therapeutic use*
  • Purines
  • Pyrazoles
  • Receptors, Histamine H4 / antagonists & inhibitors
  • Receptors, Interleukin / antagonists & inhibitors
  • Receptors, Interleukin-4 / antagonists & inhibitors
  • Sulfonamides / therapeutic use

Substances

  • Anti-Allergic Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Azetidines
  • Histamine Antagonists
  • IL31RA protein, human
  • Interleukin-13
  • Protein Kinase Inhibitors
  • Purines
  • Pyrazoles
  • Receptors, Histamine H4
  • Receptors, Interleukin
  • Receptors, Interleukin-4
  • Sulfonamides
  • fezakinumab
  • dupilumab
  • Janus Kinases
  • tralokinumab
  • nemolizumab
  • baricitinib
  • lebrikizumab