Biologic treatments are a new option for people with moderate to severe eczema oratopic dermatitis.
If this applies to you, it might be worth considering a biologic bang out treatment.
This article discusses biologics for eczema, how they work, and how they are administered.
Shiny family / Getty Images
It also talks about some of the potential side effects.
Shiny family / Getty Images
What Is Eczema?
Atopic dermatitis is the most common form of eczema.
Atopic dermatitis is what most people who are not medical professionals mean when they talk about eczema.
There are, however, some other medical conditions that also have the word eczema in the name.
One of these isseborrheic eczema, also called seborrheic dermatitis.
Eczema is not contagious.
Eczema-like rashes can sometimes be sparked by infectious microorganisms, however.
These types of rashes are less common.
Symptoms of atopic dermatitis include:
Sometimes symptoms can become so severe that the skin cracks and oozes.
Symptoms may wax and wane over time.
If severe, the lesions may bleed and cause scarring.
Painful symptoms can also interfere with your quality of life.
Researchers dont fully understand the causes of atopic dermatitis.
Both environmental and genetic factors seem to play a role.
Many people with atopic dermatitis also haveasthmaorallergic rhinitis(nasal allergies).
People with atopic dermatitis may have a more fragileepidermis, the outer layer of skin.
This can cause the immune response that leads to eczema symptoms.
This is how biologic treatments can help.
Available Biologic Treatments
Biologic treatmentsare developed from some part of a living substance.
They are different from traditional pharmaceutical drugs manufactured in a laboratory from non-living chemicals.
Biological treatments have recently become available for several conditions that affect the immune system.
These conditions include:
Biologic treatments provide targeted treatment to a specific part of a persons immune system.
These treatments have revolutionized the treatment of these diseases.
In some cases, they can radically improve symptoms.
Dupixent (dupilumab)
Dupixent (dupilumab)was the first biologic treatment approved for atopic dermatitis.
It became available in 2017.
It iscurrently approved for adults, adolescents, and infants6 months and older with moderate to severe atopic dermatitis.
Adbry (tralokinumab-ldrm)
Adbry (tralokinumab-ldrm) was approved by the FDA in 2021.
It is available for people 12 and older with moderate to severe atopic dermatitis.
Other Biologic Treatments Are Being Studied
Other biologic treatments for atopic dermatitis are being studied.
Some of these treatments have similar immune targets to the currently approved options, while others work differently.
It is possible that the FDA will approve some of these biologic treatments in the future.
For example, the biologic nemolizumab has completed successful phase two and/or three clinical trials.
Other biologic treatments are also under investigation.
Eventually, there may be many different biologic treatment options for this condition.
Off-Label Biologics
In the past, some healthcare providers have prescribed off-label biologics for atopic dermatitis.
Off-label treatments for atopic dermatitis haven’t undergone the full set of clinical trials required for FDA approval.
There are FDA-approved biologic treatments for some inflammatory conditions like psoriasis.
One of these is a TNF inhibitor called Enbrel (etanercept).
Dupixent, Adbry, and Ebglyss are FDA-approved only for the atopic dermatitis form of eczema.
How Biologics Work
Dupixent, Adbry, and Ebglyss are monoclonal antibodies.
Unlike the antibodies your body produces in response to certain infections, these medications are made in a laboratory.
Other biologics under development have been designed to target these immune pathways or similar immune pathways.
Treatment Alternatives
Biologics aren’t usually a first-line treatment for eczema.
This means that before starting one, your healthcare provider will want you to try other treatment options.
These might include avoiding disease triggers and using emollients, which help keep the skin moist.
Some people can control their symptoms with topical corticosteroids orUV therapy.
Other prescription options for atopic dermatitis are topical medications calledcalcineurin inhibitors.
Most people with eczema will respond to corticosteroids or calcineurin inhibitors and will not need a biologic.
There are also a number of non-biologic drugs that have been used off-label in the past.
These have included:
Many people have to stop taking these medications because they can cause significant side effects.
Biologics require less monitoring than these treatments, and they tend to have fewer side effects.
How Biologics Are Administered
Most biologic treatments cannot be taken orally.
This includes Dupixent, Adbry, and Ebglyss.
These medications are injected into the fatty area beneath your skin.Typically, these treatments are given every other week.
You may be able to administer these medications yourself.
If so, your healthcare provider will give you specific instructions on how to do this.
Most people are able togive themselves the injectionafter they learn how.
The injection is typically given into a fatty area around the belly or thighs.
Always clean and dry the area before injection.
Never inject into an area that is scarred, tender, or otherwise damaged.
Be sure to follow carefully all storage and administration instructions.
Biologic treatments are more sensitive than traditional drug treatments.
Many need to be stored in the refrigerator.
They may not work correctly if they are not handled and stored properly.
Can You Take Biologics with Other Treatments?
Ideally, you will be able to decrease the use of other medicines once you add a biologic.
For example, you might be able to stop using steroid creams.
As always, consult with your healthcare provider to check that you understand your complete treatment plan.
Potential Side Effects
Like all treatments, biologics have possible side effects.
Some of the more common side effects with Dupixent include:
Allergic reactions are also possible.
In rare cases, these might be severe.
Precautions
Some people cant take certain biologics safely.
Your healthcare provider will consider your specific medical situation before prescribing this treatment.
Biologics may make you more likely to get certain types of infections.
This means they might not be a good option for you if you have certain immune problems.
Caution should also be used in people who are pregnant or breastfeeding.
These treatments have not been studied in this group of people.
You may need to talk to your healthcare provider about your vaccination history before starting the treatment.
Adbry and Ebglyss are not approved for people under the age of 12.
Similarly, Dupixent isnt currently approved for children under the age of 6 months.
This is because these medications haven’t been thoroughly tested in children.
In some cases, however, your child’s healthcare provider might recommend these treatments off-label.
Summary
Biologics are a relatively new treatment for people with eczema.
They are prescribed for people with moderate to severe eczema who have not responded well to other treatments.
Biologics target certain proteins involved in the process of inflammation.
Biologics are administered every other week.
They are injected under the skin.
Side effects may include irritation at the injection site or eye problems.
You may be able to combine a biologic with other eczema treatments.
Berke R, Singh A, Guralnick M.Atopic dermatitis: an overview.Am Fam Physician.
2012;86(1):35-42.
2013;12(5):575-9. doi:10.1016/j.autrev.2012.10.020
National Eczema Association.FAQ Adbry (tralokinumab-ldrm).
Montes-Torres A, Llamas-Velasco M, Perez-Plaza A, et al.Biological treatments in atopic dermatitis.J Clin Med.
2015;4(4):593613. doi:10.3390/jcm4040593
Food and Drug Administration.Dupixent label.
Junttila IS.Tuning the cytokine responses: an update on interleukin (IL)-4 and IL-13 receptor complexes.Front Immunol.
