Treating moderate-to-severe AD can be challenging: only a few therapeutic options are available, with cyclosporine being the only approved and labeled systemic drug. However, other biologic drugs that selectively target some key cytokines in AD pathogenesis (IL-13, IL-31, and IL-22) are also being studied. In this review, we discuss all of the biologic drugs that have been studied for AD treatment. is a fully human monoclonal antibody that binds to the shared alpha chain subunit of the receptors for IL-4 and IL-13 [13]. This results in downregulation of receptor signaling downstream of the JAK/STAT pathway, which CCT007093 regulates the expression of many genes involved in the pathogenesis of AD [14]. In March 2017, dupilumab received its first national approval, from the USA, for its use in the treatment of adult patients with moderate-to-severe AD whose disease is not adequately controlled with topical therapies, or when those therapies are not advisable. In September 2017, it was also approved in Europe by EMA as a systemic first-line treatment for adults suffering from AD [9]. Dupilumab is supplied in a single-dose pre-filled syringe and is administered by subcutaneous injection into the thigh, abdomen, or upper arm. The recommended dosage is a loading dose of 600?mg (two 300-mg injections at different sites) followed by 300?mg every other week, with rotation of the injection site. Dupilumab can be used with CCT007093 or without concomitant topical corticosteroids (TCS) [15]. It has also showed efficacy in patients with persistent asthma and elevated eosinophils, where it improved lung function, reduced exacerbations, and decreased Th2 biomarkers [16]. Randomized, double-blind, placebo-controlled trials involving adults who had moderate-to-severe AD were performed to check the applicability of dupilumab in the treatment of adults with moderate-to-severe AD. The first two clinical trials, SOLO 1 (“type”:”clinical-trial”,”attrs”:”text”:”NCT02277743″,”term_id”:”NCT02277743″NCT02277743) and SOLO 2 (“type”:”clinical-trial”,”attrs”:”text”:”NCT02277769″,”term_id”:”NCT02277769″NCT02277769), investigated the safety and efficacy of the dupilumab dosage regimen compared with placebo [17]. Patients were randomly assigned in a 1:1:1 Rabbit polyclonal to Caspase 6 ratio to receive weekly (qw) subcutaneous injections of dupilumab (300?mg) or placebo or the same dose of dupilumab every other week (q2w) alternating with placebo for 16?weeks. Significantly, more of the CCT007093 patients receiving dupilumab showed an improvement of at least 75% in the Eczema Area and Severity Index (EASI) score compared to the placebo group. The percentages of the patients who reached EASI-50 and EASI-90 as well as the improvement in the Scoring Atopic Dermatitis (SCORAD) and the decrease in the affected body surface area were all significantly higher in the dupilumab groups than in the placebo group (Table?1). A further phase III trial, LIBERTY AD CHRONOS, aimed to analyze the long-term management of moderate-to-severe AD with dupilumab and concomitant topical corticosteroids [18] (Table?1). At week?52, more of the patients who received dupilumab plus topical corticosteroids achieved the co-primary endpoints of IGA 0/1 and EASI-75 compared to the other two groups (Table?1). The efficacy of dupilumab has been demonstrated in adult patients CCT007093 with a history of inadequate response to/intolerance of CsA [19]. In the LIBERTY AD CAF trial, 390 patients with an inadequate response to/intolerance of CsA or for whom CsA treatment was medically inadvisable were screened [19]. The proportion of the patients achieving EASI-75 at week?16 was significantly higher in the dupilumab qw?+?TCS and q2w?+?TCS groups compared to placebo?+?TCS. In all of the clinical studies performed in this field to date, dupilumab has shown a favorable safety profile with no dose-limiting toxicity and few adverse effects. The most common adverse events (AEs) associated with dupilumab are injection-site reactions, which mainly consist of transient erythema or edema. Conjunctivitis seems the only specific side effect, and this can be.