Dupilumab in the treatment of moderate-to-severe atopic dermatitis

Expert Rev Clin Immunol. 2017 Apr;13(4):301-310. doi: 10.1080/1744666X.2017.1292134. Epub 2017 Feb 15.

Abstract

Atopic dermatitis is a common inflammatory skin disease with an increasing prevalence. Treatment of patients suffering from mild or moderate disease includes the use of emollients and topical glucocorticoids or topical calcineurin inhibitors. Patients with chronic and severe atopic dermatitis where topical therapy is usually insufficient require the use of systemic immunosuppressive drugs, which is often limited due to toxicity and severe adverse effects. Areas covered: This review summarizes the literature on the mechanism of action, clinical efficacy and safety of dupilumab, a monoclonal antibody that targets the α-subunit of the interleukin-4 receptor (IL-4Rα) leading to the inhibition of both the IL-4 and IL-13 pathways. A literature search was performed on Pubmed and ClinicalTrials.gov using key words 'dupilumab', 'REGN668', 'IL-4'/'IL-13' and 'atopic dermatitis'. Expert commentary: Dupilumab offers an innovative therapeutic approach for moderate-to-severe atopic dermatitis. It is not approved for clinical use in any country yet; however, due to its excellent clinical efficacy and a favorable safety profile, dupilumab may revolutionize the treatment of moderate-to-severe atopic dermatitis in the next upcoming years.

Keywords: Atopic dermatitis; IL-13; IL-4; REGN668; atopic eczema; biologics; dupilumab.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Biological Therapy
  • Dermatitis, Atopic / drug therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Interleukin-13 / antagonists & inhibitors*
  • Interleukin-4 / antagonists & inhibitors*
  • Receptors, Interleukin-4 / immunology
  • Signal Transduction / drug effects

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Immunosuppressive Agents
  • Interleukin-13
  • Receptors, Interleukin-4
  • Interleukin-4
  • dupilumab