Biologics to Treat Atopic Dermatitis: Effectiveness, Safety, and Future Directions

TY - JOUR

T1 - Biologics to Treat Atopic Dermatitis

T2 - Effectiveness, Safety, and Future Directions

AU - de Bruin-Weller, Marjolein S

AU - Boesjes, Celeste M

AU - Achten, Roselie A

AU - Beck, Lisa A

AU - Irvine, Alan D

AU - Vestergaard, Christian

AU - de Graaf, Marlies

AU - van Wijk, Femke

AU - Bakker, Daphne S

AU - Weidinger, Stephan

N1 - Publisher Copyright: © 2025 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

PY - 2026/2

Y1 - 2026/2

N2 - Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases worldwide. The clinical presentation of AD is heterogeneous and is characterized by a relapsing and remitting course. Most patients suffer from mild AD while approximately 5% to 20% experience severe disease activity, which often requires systemic treatment. Before 2017, systemic treatment options were limited to broad immunosuppressants, which often had significant toxicity and limited effectiveness. Advances in understanding AD pathophysiology have led to the development of targeted biologic therapies, including dupilumab, tralokinumab, lebrikizumab, and nemolizumab. These monoclonal antibodies specifically block key pro-inflammatory cytokines involved in AD, improving disease control and symptom relief. Dupilumab, the first approved biologic, inhibits IL-4 and IL-13 signaling, while tralokinumab and lebrikizumab selectively block IL-13. Nemolizumab targets IL-31, which plays a crucial role in pruritus. This review summarizes primarily real-world data on the effectiveness and safety of these biologics, providing clinical guidance for their use and management of side effects. It also briefly discusses promising therapeutic targets currently in phase 3 trials.

AB - Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases worldwide. The clinical presentation of AD is heterogeneous and is characterized by a relapsing and remitting course. Most patients suffer from mild AD while approximately 5% to 20% experience severe disease activity, which often requires systemic treatment. Before 2017, systemic treatment options were limited to broad immunosuppressants, which often had significant toxicity and limited effectiveness. Advances in understanding AD pathophysiology have led to the development of targeted biologic therapies, including dupilumab, tralokinumab, lebrikizumab, and nemolizumab. These monoclonal antibodies specifically block key pro-inflammatory cytokines involved in AD, improving disease control and symptom relief. Dupilumab, the first approved biologic, inhibits IL-4 and IL-13 signaling, while tralokinumab and lebrikizumab selectively block IL-13. Nemolizumab targets IL-31, which plays a crucial role in pruritus. This review summarizes primarily real-world data on the effectiveness and safety of these biologics, providing clinical guidance for their use and management of side effects. It also briefly discusses promising therapeutic targets currently in phase 3 trials.

KW - atopic dermatitis

KW - biologics

KW - dermatology

UR - https://www.scopus.com/pages/publications/105016801488

U2 - 10.1111/all.70061

DO - 10.1111/all.70061

M3 - Review article

C2 - 40990093

SN - 0105-4538

VL - 81

SP - 326

EP - 344

JO - Allergy

JF - Allergy

IS - 2

ER -