Biologics for Atopic Dermatitis

Reviewed by: HU Medical Review Board | Last reviewed: January 2022 | Last updated: February 2022

There are many different medicines available to treat atopic dermatitis. It can be helpful to understand what makes them different and how they work to control symptoms.

Biologics are one class of drugs used to treat atopic dermatitis. Biologics are drugs made from living cells. These cells can come from parts of the blood, proteins, viruses, or tissue. The process of making biologics turns these cells into drugs that can prevent, treat, and cure disease.

Biologics work to block cellular pathways in your immune system that can lead to disease flares. When used for atopic dermatitis, these drugs target cells that cause inflammatory reactions by blocking certain proteins called cytokines.1

How do biologics treat atopic dermatitis?

The immune system makes chemical messengers called interleukins (ILs). Interleukins help fight off germs like viruses and bacteria. In atopic dermatitis, the immune system overreacts and releases certain ILs that lead to inflammation. Biologics that treat atopic dermatitis turn down or stop these specific ILs, which reduces symptoms of atopic dermatitis.2

How do biologics differ from other drugs?

Biologics are different from ordinary drugs. Since these drugs are made from living cells, each individual molecule of a biological agent is very large and complex.

The process used to make these agents is very strictly controlled. Biologics must be made in a consistent way because even small changes in the manufacturing process can have a big impact on how it will work in someone's system.3

In contrast, traditional drugs are created by adding multiple chemicals together in a specific order. The molecules that regular drugs are made of are much less complex and much easier to make. While making traditional drugs is also strictly controlled, it is easier to change the ingredients without changing how effective the medicine will be.3

Examples of biologics for atopic dermatitis

As of 2022, there are 2 biologics approved by the U.S. Food and Drug Administration (FDA) to treat atopic dermatitis:1,2,4

Other biologics are being researched, including IL-17 and IL-22 blocking agents.2 There is also currently active research about the safety of biologics in children.1,2

Because atopic dermatitis is a chronic (long-term) disease, people will have to remain on Dupixent or Adbry indefinitely to continue getting benefits from the drugs.1,4

What are the possible side effects of biologics?

Biologics target specific cells and how those cells work, so they tend to have fewer side effects than traditional drugs. Many traditional drugs can change the chemistry of multiple body systems, which can cause many of the side effects. Common side effects of biologics for atopic dermatitis include:1,4

  • Conjunctivitis (more commonly known as pink eye)
  • Eye and eyelid redness, swelling, and itching
  • Injection site reactions
  • Cold sores on the mouth or lips
  • Upper respiratory tract infections

These are not all the possible side effects of these drugs. Talk to your doctor about what to expect before you start these treatments. Talk to your doctor if you have any health changes while using these drugs.

Things to know about biologics

These drugs may be used in combination with topical (skin) steroid creams to provide extra symptom control.1,4

Both Dupixent and Adbry are injectable drugs that come in a pre-filled syringe. After being trained by their doctor or nurse, the drugs can be injected at home.1,4

Increased risks

As with all therapeutic proteins, there is a risk for an immune response to biologics, which lowers effectiveness over time. This is known as immunogenicity.5

Who can and can not use the drugs?

Doctors do not yet know if it is safe to take these drugs while pregnant or breastfeeding. If you are pregnant or breastfeeding, talk to your doctor before treatment with biologics.1

Other treatments

Before beginning any treatment for atopic dermatitis, tell your doctor about all of your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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