Departments of Dermatology and Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Md.
J Allergy Clin Immunol Pract. 2023 May;11(5):1361-1373. doi: 10.1016/j.jaip.2023.03.011. Epub 2023 Mar 21.
The U.S. Food and Drug Administration approval of dupilumab for moderate-to-severe atopic dermatitis 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 (JAKi). Tralokinumab and emerging (not yet approved) lebrikizumab, which both target IL-13, are alternative biologics to dupilumab. The emerging anti-IL-31 receptor nemolizumab is likely to be used second-line to other biologics, primarily for pruritus. Three JAKi are currently in use for treating atopic dermatitis, 2 of which, abrocitinib and upadacitinib, are U.S. Food and Drug Administration-approved. This review provides an in-depth, practical discussion on use of these biologics and JAKi 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.
美国食品和药物管理局批准度普利尤单抗用于中重度特应性皮炎，这一转变将治疗模式从广泛的全身性免疫抑制剂转变为更安全的靶向治疗，并推动了新型白细胞介素 (IL)-4/IL-13 靶向生物制剂和小分子疗法的出现，即 Janus 激酶 (JAK) 抑制剂 (JAKi)。特利鲁单抗和新兴（尚未批准）的 lebrikizumab，均靶向 IL-13，是度普利尤单抗的替代生物制剂。新兴的抗 IL-31 受体 nemolizumab 可能作为二线药物用于其他生物制剂，主要用于瘙痒。目前有 3 种 JAKi 用于治疗特应性皮炎，其中 2 种，即阿布昔替尼和乌帕替尼，已获得美国食品和药物管理局批准。这篇综述深入探讨了这些已批准或已完成 3 期临床试验的生物制剂和 JAKi 在儿科和成人患者中的应用，根据现有疗效和安全性数据比较了这些药物组。
