Emerging Biologics in the Management of Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, relapsing and remitting inflammatory skin disease marked by intense pruritus that significantly impacts the daily activities and quality of life of those affected. Topical therapies such as topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI) have been the mainstay of treatment and may offer symptomatic relief. However, their efficacy is often suboptimal, they carry the potential for adverse effects, application adherence can be challenging, and they are not suitable for more widespread disease. Conventional systemic agents such as methotrexate and cyclosporine are used off-label for AD. However, these medications are associated with off-target toxicities and are generally unsuitable for long-term use due to safety concerns. Advances in understanding the immunopathogenesis of AD (Figure 1) have led to the development of multiple new therapies. These include biological agents that target these pathways by neutralizing specific cytokines or their receptors. This paper will review the therapies that have been recently approved or are currently in various stages of development.