Dupilumab Treatment in Adults with Moderate-to-Severe Atopic Dermatitis

Dupilumab, a monoclonal antibody that inhibits signal transduction by interleukin-4 and interleukin-13, showed unexpected clinical efficacy in this group of small, randomized, controlled trials involving patients with atopic dermatitis, which were designed predominantly for safety. Atopic dermatitis, which is characterized by a disturbed skin barrier, robust type 2 helper T-cell (Th2)–mediated immune responses to numerous environmental antigens, susceptibility to cutaneous infections, and intractable pruritus, is a common chronic skin condition with a worldwide prevalence of 1 to 20%. 1 Approximately 20% of patients with atopic dermatitis have moderate-to-severe disease, 1 and treatments approved by the Food and Drug Administration for atopic dermatitis, which include emollients, topical glucocorticoids, and calcineurin inhibitors, 2 , 3 have limited efficacy in moderate-to-severe disease. 4 , 5 The Th2 cytokines interleukin-4 and interleukin-13 are believed to play roles in the pathogenesis of atopic dermatitis, 6 , 7 but . . .