Are Biologics Efficacious in Atopic Dermatitis? A Systematic Review and Meta-Analysis

  title={Are Biologics Efficacious in Atopic Dermatitis? A Systematic Review and Meta-Analysis},
  author={Igor Snast and Ofer Reiter and Emmilia Hodak and Rivka Friedland and Daniel Mimouni and Yael A Leshem},
  journal={American Journal of Clinical Dermatology},
BackgroundCurrent systemic treatments for atopic dermatitis (AD) offer limited efficacy and are often restricted by safety concerns. Biologics may address the unmet need for improved AD therapeutics.ObjectiveThe aim of this study was to evaluate the efficacy and safety of biologic agents in AD.MethodsA systematic review and meta-analysis of studies evaluating AD patients treated with biologics was performed. The primary outcome was the Eczema Area and Severity Index (EASI)-75 response, while… 
Efficacy and safety of dupilumab for moderate‐to‐severe atopic dermatitis: A systematic review for the EAACI biologicals guidelines
More data on long‐term safety are needed both for children and for adults, together with more efficacy data in the paediatric population, and the incremental cost‐effectiveness ratio ranged from 28 500 £ (low certainty) to 124 541 US$ (moderate certainty).
Dupilumab: an evidence-based review of its potential in the treatment of atopic dermatitis
The evidence of clinical efficacy, safety, and patient-reported out-come (PRO) measures from Phase I–III trials of dupilumab in adult patients with moderate-to-severe AD are reviewed to determine the clinical efficacy and safety profile of its long-term use.
What’s new in atopic eczema? An analysis of systematic reviews published in 2018. Part 2: systemic therapies
This review forms part of an annual update series on atopic eczema (AE), where systematic reviews are gathered and appraised to provide a summary of key recent research findings to provide up‐to‐date evidence for clinicians on systemic therapies in AE.
Effectiveness of ustekinumab in patients with atopic dermatitis: analysis of real-world evidence
The largest cohort of AD patients treated with ustekinumab in a real-world setting is presented, demonstrating the IL-12/23 pathway is not an attractive target in AD.
Omalizumab for atopic dermatitis: evidence for and against its use.
  • J. G. Holm, S. Thomsen
  • Medicine
    Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia
  • 2019
Omalizumab is a safe and well-tolerated treatment with some clinical benefit in AD patients, however, the lack of larger RCTs and possible publication bias limit the recommendation of omalIZumab for use in clinical practice for AD.
Systemic treatments for eczema: a network meta-analysis.
A meta-analysis suggests that dupilumab ranks first for effectiveness when compared with other biological treatments, and the certainty of the body of evidence from the NMA for these primary outcomes is assessed using six domains of CiNEMA grading.
Real-World Experience and Laboratory Monitoring of Dupilumab in Patients with Moderate to Severe Atopic Dermatitis in a Tertiary Centre
Clinical response continued to improve past 16 weeks in this real-world population of patients with AD and dupilumab provides an effective and safe treatment option for patients with atopic dermatitis.
Consensus Update for Systemic Treatment of Atopic Dermatitis
An updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience is provided and it is looked forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD.
Selective IL-13 inhibitors for the treatment of atopic dermatitis
Evidence supports the hypothesis that selective antagonism of IL-13 is sufficient to control AD, providing an improvement in the patient’s quality of life, and the development of lebrikizumab and tralokinumab represents a new and exciting phase in the management of AD.


Efficacy and safety of systemic treatments for moderate-to-severe atopic dermatitis: a systematic review.
Infliximab in the treatment of moderate to severe atopic dermatitis.
Efficacy and safety of ustekinumab treatment in adults with moderate‐to‐severe atopic dermatitis
Ustekinumab had clear clinical and molecular effects, but clinical outcomes might have been obscured by a profound “placebo” effect, most likely due to background topical glucocorticosteroids and possibly insufficient dosing for AD.
Dupilumab treatment in adults with moderate-to-severe atopic dermatitis.
Patients treated with dupilumab had marked and rapid improvement in all the evaluated measures of atopic dermatitis disease activity, and side-effect profiles were not dose-limiting.
Omalizumab for atopic dermatitis: case series and a systematic review of the literature
Omalizumab appears to be a safe and well tolerated, however expensive, treatment with some clinical benefit in patients with severe recalcitrant AD and recommendation for use in clinical practice awaits evidence from larger randomized controlled trials.
Efficacy and Safety of Systemic Long-Term Treatments for Moderate-to-Severe Psoriasis: A Systematic Review and Meta-Analysis.
From the available evidence, infliximab, secuk inumab, and ustekinumab are the most efficacious long-term treatments.
Guidelines for treatment of atopic eczema (atopic dermatitis) Part II
The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted
Drug evaluation review: dupilumab in atopic dermatitis.
The robust effects of dupilumab on skin inflammation and pruritus confirm the pathogenic role of IL-4 and IL-13 signaling in adult AD, and further support the application of Th2 cytokine antagonists in the treatment of this disease.
Anti-Interleukin-31 Receptor A Antibody for Atopic Dermatitis.
The hope is that nemolizumab and related cytokine antagonists will improve the care of patients with atopic dermatitis, in a similar fashion to the careOf patients with psoriasis, for which multiple highly efficacious biologics are now available.