Monoclonal antibodies against interleukin 13 and interleukin 31RA in development for atopic dermatitis - 21/02/18

Doi : 10.1016/j.jaad.2017.12.018

Carsten R. Hamann, MD ^⁎ , Jacob P. Thyssen, MD, PhD, DMSc
Department of Dermatology and Allergy and the Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

^∗Reprint requests: Carsten R. Hamann, MD, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark.Department of Dermatology and AllergyHerlev and Gentofte HospitalUniversity of CopenhagenHellerup2900Denmark

Abstract

The interleukin 13 (IL-13) and IL-31 cytokines and inflammatory pathways have been identified as important for the pathophysiology of atopic dermatitis (AD). Monoclonal antibodies against IL-13 have been studied for the treatment of asthma since 2011. More recently, 2 phase 2 trials have been completed with these antibodies in AD treatment. In both trials, significant reductions of Eczema Area and Severity Index scores were seen. IL-31 is thought to play a role transmitting itch sensation to the central nervous system, and blocking IL-31 activity reduces itch in patients with AD. One phase 2 trial has been completed for a humanized antibody against IL-31 receptor alpha, which is 1 subunit of the IL-31 receptor complex. This study showed significant dose-dependent reductions in pruritus, Eczema Area and Severity Index scores, and markers of sleep quality. Initial clinical trials for monoclonal antibodies against IL-13 and IL-31 receptor A all show promise, although long-term safety and efficacy data are lacking. Nevertheless, these medications will likely play a role in the treatment of moderate-to-severe AD.

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Key words : atopic dermatitis, dipeptidyl peptidase-4, Eczema Area and Severity Index, interleukin, IL-31RA, Investigator's Global Assessment, Janus kinase, c-Jun N-terminal kinase, mitogen-activated protein kinase, oncostatin M receptor β, STAT signal transducer and activator of transcription, T helper, topical corticosteroids, Visual Analogue Scale

Abbreviations used : AD, EASI, IGA, IL, JAK, STAT, TCS, Th2

Plan

	Publication of this article was supported by Leo Pharma, Bayer, and Sanofi/Regeneron.
	Funding sources: Supported by Bayer (grant #19670), LEO Pharma, and Sanofi Genzyme (grant #IME-2017-11043).
	Disclosure: Dr Thyssen is supported by an unrestricted grant from the Lundbeck Foundation; he has attended advisory boards for Roche and Sanofi-Genzyme and received speaker honoraria from LEO Pharma and Sanofi-Genzyme, and he is an investigator for LEO Pharma on their phase 3 tralokinumab study. Dr Hamann disclosed no conflicts of interest.