Ratchataswan Thanaporn, Banzon Tina M, Thyssen Jacob P, Weidinger Stephan, Guttman-Yassky Emma, Phipatanakul Wanda
Department of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
Department of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
J Allergy Clin Immunol Pract. 2021 Mar;9(3):1053-1065. doi: 10.1016/j.jaip.2020.11.034.
Atopic dermatitis (AD) is a common inflammatory skin disease characterized by intense pruritus and recurrent eczematous lesions that significantly impair quality of life. It is a heterogeneous disease affecting both children and adults. The treatment of moderate-to-severe forms of AD is challenging, as topical corticosteroids are often insufficient to achieve disease control or inappropriate and off-label use of immunosuppressants may have significant undesirable side effects. The development of targeted biologic therapies specifically for AD is thus highly desirable. Dupilumab is the only biologic therapy that is Food and Drug Administration approved for the treatment of moderate-to-severe AD in patients 6 years and older, with consistent long-term efficacy and safety trial data. In this article, we review the mechanisms, safety, and efficacy of dupilumab from recent clinical trials, and we review the current data, mechanism of action, clinical efficacy, and limitations of new biologics currently in phase 2 and 3 clinical trials (lebrikizumab, tralokinumab, nemolizumab, tezepelumab, and ISB 830).
特应性皮炎(AD)是一种常见的炎症性皮肤病,其特征为剧烈瘙痒和反复出现的湿疹样皮损,严重影响生活质量。它是一种异质性疾病,影响儿童和成人。中重度AD的治疗具有挑战性,因为局部使用皮质类固醇激素往往不足以控制病情,或者免疫抑制剂的不当使用及超适应症使用可能会产生显著的不良副作用。因此,非常需要开发专门针对AD的靶向生物疗法。度普利尤单抗是唯一一种获得美国食品药品监督管理局批准用于治疗6岁及以上中重度AD患者的生物疗法,并有一致的长期疗效和安全性试验数据。在本文中,我们回顾了近期临床试验中度普利尤单抗的作用机制、安全性和疗效,并回顾了目前处于2期和3期临床试验的新型生物制剂(lebrikizumab、曲洛珠单抗、奈莫利单抗、tezepelumab和ISB 830)的现有数据、作用机制、临床疗效和局限性。