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Treating Eczema With Biologics

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Eczema, also known as atopic dermatitis, is a chronic skin disease associated with itching and extreme dryness. The newest advances in the treatment of eczema are biological drugs. Highly advanced, targeted therapies, “biologics” are genetically engineered drugs tailor-made from living cells cultured in a laboratory. They work by suppressing portions of the immune system responsible for allergy-related conditions and have been very successful in treating moderate to severe eczema cases.

In chronic, inflammatory diseases like eczema, the immune system overreacts to certain irritants. This response leads to red, itchy patches forming on the skin. Biologics are essentially designed to stop the immune system from overreacting, thus lessening the severity of atopic dermatitis symptoms. These drugs are intended for and approved to treat moderate to severe cases of atopic dermatitis, or cases that can’t be managed successfully using topical medications or other treatments. 

Biologics offer a customized approach to treatment that targets the specific immune cells functioning irregularly in the skin. Dupilumab (Dupixent) was the first biologic drug approved for use in treating atopic dermatitis, and it’s been shown to drastically reduce symptoms of itchiness, rashes, swelling and thickened skin. This drug works by blocking certain proteins in the immune system from attacking your own body. Some side effects for this drug are eye inflammation problems such as pink eye, and reactions at the injection site like mild rashes.

The newest biologic drug for eczema known as Adbry (Tralokinumab-ldrm) was released in 2021. It was shown to be superior to placebo and well tolerated in up to 52 weeks of treatment. With the addition of this drug, there are now two FDA-approved biologics specifically for eczema (dupilumab and tralokinumab)

Omalizumab (Xolair) is another biological drug originally developed to lower patients’ sensitivity to allergens; it is primarily used to treat severe cases of asthma. Because allergies and eczema outbreaks are often related, this drug is also used, in some cases, to treat patients with moderate to severe eczema. Some side effects include nausea, dizziness, joint pain, and mild rashes.

Biologics can be given using intravenous (IV) injections or subcutaneous (through the skin) injections. For dupilumab, injections can be self-administered and taken in combination with or without topical corticosteroids for treating atopic dermatitis. Omalizumab injections are administered by your doctor every 2–4 weeks.

Because these drugs are so advanced and highly specialized, biologics are very expensive. Affordability may depend on your insurance provider. However, because moderate to severe eczema is such a debilitating disease both emotionally and physically, the potential positive effects a biologic can have on a patient’s mental health may offset the cost. When biologics relieve the physical symptoms, trials have shown that the mental stress of the patient is eased as well.

With the success biologics have had in treating eczema, research efforts are actively underway to discover newer and even more specific biological medications. If you have moderate to severe eczema and have trouble managing your symptoms, it’s worth talking with your dermatologist about the possibility of biological therapy.