FDA approval of dupilumab for moderate-to-severe AD shifted the paradigm from use of broad, systemic immunosuppressants to a safer, targeted treatment and led to the emergence of newer interleukin (IL)-4/IL-13 directed biologics and small molecule therapies, namely Janus kinase (JAK) inhibitors. Tralokinumab and emerging (not yet approved) lebrikizumab, which both target IL-13, are alternative biologics to dupilumab. Emerging anti-IL-31 receptor nemolizumab is likely to be used second-line to other biologics, primarily for pruritus. Three JAK inhibitors are currently in use for treating AD, two of which, abrocitinib and upadacitinib, are FDA-approved. This review provides an in-depth, practical discussion on use of these biologics and JAK inhibitors that are approved or have completed phase 3 clinical trials in pediatric patients and adults, comparing the groups of medications based on available efficacy and safety data.
【저자키워드】 Baricitinib, biologics, cytokine signaling, Janus kinase inhibitor, atopic dermatitis, eczema, Dupilumab, Interleukin-4, interleukin-13, Upadacitinib, abrocitinib, tralokinumab, lebrikizumab, nemolizumab,