Biologics in the Management of Childhood Atopic Dermatitis
TLDR Biologics, especially Dupilumab, are effective and safe for treating severe childhood eczema.
The document discusses the use of biologics in managing childhood atopic dermatitis (AD). Dupilumab, an FDA-approved treatment for children with moderate-to-severe AD as young as 6 months, inhibits IL-4 and IL-13 cytokines and has a superior safety profile compared to immunosuppressants. However, it can cause ocular surface disease and occasionally, new or worsening alopecia areata. Other biologics include tralokinumab and lebrikizumab, which inhibit IL-13 cytokine directly. Tralokinumab is FDA-approved for use in adults and patients aged 12 years or older in Europe, while lebrikizumab has completed adolescent and adult trials and will be submitted for FDA approval in 2023. Other biologics like nemolizumab and omalizumab had limited success, while Janus kinase (JAK) inhibitors provide an oral alternative for those who fail to respond to dupilumab, but their safety is a concern.
