Biologicals in Atopic Dermatitis

Atopic dermatitis (AD) is a debilitating condition, and its management in both children and adults can be challenging for clinicians and patients alike. The current treatment options approved by the Food and Drug Administration (FDA) have variable efficacies, and long-term adverse effects, which further complicate the plan of management. There has been considerable progress towards the use of targeted medicines like biologicals and small molecular agents for atopic dermatitis. Various molecules targeting the TH2 pathway, JAK/STAT pathway, cAMP, IL-22, Il-12/IL-23 and IgE, have been developed, and are being studied extensively in both adults and pediatric patients of atopic dermatitis. Currently, only Dupilumab is approved by the FDA for the treatment of moderate to severe refractory atopic dermatitis. The other biological agents are currently in phase 2 or phase 3 trials. There is a paucity of multicentric, large-scale studies on the above drugs, along with a lack of comparative studies with the existing modalities of treatment. Therefore, more studies with a larger sample size and longer follow up periods are needed to determine their efficacy and long-term safety profiles. Overall, these agents are likely to be a part of the therapeutic armamentarium for atopic dermatitis in the near future.