Department of Dermatology, Centro Hospitalar Universitário de Sto António, Porto, Portugal.
Department of Dermatology and Allergy, University Hospital, Bonn Germany and Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
Am J Clin Dermatol. 2023 Sep;24(5):753-764. doi: 10.1007/s40257-023-00793-5. Epub 2023 Jun 2.
Atopic dermatitis (AD) is a common, heterogeneous, inflammatory skin disorder characterized by chronic or relapsing eczematous lesions with intense pruritus and discomfort. Affected patients often experience significant impairment in their quality of life, and the treatment of moderate-to-severe AD forms remains challenging. In the past few decades, increasing knowledge on the AD pathogenesis has driven the development of novel targeted therapies. Interleukin (IL)-13 plays a central and pleiotropic role in AD pathogenesis, contributing directly or indirectly to epidermal barrier disfunction, type-2 inflammation, dysbiosis, fibrosis, and itch response. For this reason, agents selectively targeting IL-13, such as lebrikizumab, emerged as a potential therapy for AD. This article reviews the current evidence about lebrikizumab in the management of AD. The phase II and phase III trials seem to corroborate efficacy of lebrikizumab in the treatment of moderate-to-severe AD, as shown by significant improvement of Eczema Area and Severity Index, body surface area, and pruritus scores. Also, lebrikizumab demonstrated favorable safety and tolerability profiles, with the majority of patients experiencing no significant adverse events. Lebrikizumab seems to be a promising emerging targeted biological agent for patients with moderate-to-severe AD. More data on the long-term efficacy and safety, head-to-head comparisons with other agents, and real-world evidence will help to clarify its place in therapy in AD.
特应性皮炎(AD)是一种常见的、异质性的炎症性皮肤疾病,其特征为慢性或复发性湿疹样病变,伴有剧烈瘙痒和不适。受影响的患者常经历显著的生活质量受损,中重度 AD 的治疗仍然具有挑战性。在过去的几十年中,对 AD 发病机制的深入了解推动了新型靶向治疗的发展。白细胞介素(IL)-13 在 AD 发病机制中发挥核心和多效性作用,直接或间接导致表皮屏障功能障碍、2 型炎症、微生态失调、纤维化和瘙痒反应。因此,选择性靶向 IL-13 的药物,如 lebrikizumab,成为 AD 的潜在治疗方法。本文综述了 lebrikizumab 在 AD 管理中的现有证据。II 期和 III 期试验似乎证实了 lebrikizumab 在治疗中重度 AD 中的疗效,表现为 Eczema Area and Severity Index、体表面积和瘙痒评分的显著改善。此外,lebrikizumab 表现出良好的安全性和耐受性,大多数患者无明显不良反应。Lebrikizumab 似乎是一种有前途的新兴靶向生物药物,适用于中重度 AD 患者。更多关于长期疗效和安全性的数据、与其他药物的头对头比较以及真实世界的证据将有助于明确其在 AD 治疗中的地位。