Dupilumab in the treatment of moderate-to-severe atopic dermatitis

INTRODUCTION: Atopic dermatitis is a common inflammatory skin disease with an increasing prevalence. Treatment of patients suffering from mild or moderate disease includes the use of emollients and topical glucocorticoids or topical calcineurin inhibitors. Patients with chronic and severe atopic dermatitis where topical therapy is usually insufficient require the use of systemic immunosuppressive drugs, which is often limited due to toxicity and severe adverse effects. Areas covered: This review summarizes the literature on the mechanism of action, clinical efficacy and safety of dupilumab, a monoclonal antibody that targets the α-subunit of the interleukin-4 receptor (IL-4Rα) leading to the inhibition of both the IL-4 and IL-13 pathways. A literature search was performed on Pubmed and ClinicalTrials.gov using key words 'dupilumab', 'REGN668', 'IL-4'/'IL-13' and 'atopic dermatitis'. Expert commentary: Dupilumab offers an innovative therapeutic approach for moderate-to-severe atopic dermatitis. It is not approved for clinical use in any country yet; however, due to its excellent clinical efficacy and a favorable safety profile, dupilumab may revolutionize the treatment of moderate-to-severe atopic dermatitis in the next upcoming years.