Selective IL-13 inhibitors for the treatment of atopic dermatitis

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Abstract

Background: Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases worldwide. AD pathogenesis is multifactorial, involving environmental and genetic factors. IL-13 stands out as one of the main cytokines in the pathophysiology of AD. Currently, dupilumab, which targets both IL-4 and IL-13 signalling, is the only biologic agent approved for the treatment of moderate-to-severe AD. New targeted biologic therapies are being developed, such as lebrikizumab and tralokinumab, two selective IL-13 inhibitors. This article reviews the role of IL-13 in AD and the most recent data on lebrikizumab and tralokinumab.

Methods: A narrative review of the literature was written after retrieving relevant articles in the PubMed database (up until December 2020) using the following keywords present in the title, abstract or body: atopic dermatitis; interleukin 13; IL-13; tralokinumab; lebrikizumab, biologic therapy.

Discussion: A phase IIb trial showed that all three dosing regimens evaluated (lebrikizumab 125 mg every 4 weeks (Q4W), 250 mg Q4W or 250 mg every 2 weeks) achieved rapid and dose-dependent efficacy concerning the signs and symptoms of AD, with a statistically significant improvement, at week 16. Tralokinumab was studied in three phase III clinical trials and reached its primary endpoints at week 16 (ECZTRA 1 and 2 in monotherapy and ECZTRA 3 with concomitant topical corticosteroids), with response maintained over time. Both lebrikizumab and tralokinumab exhibited good safety profiles in AD trials, with adverse effects usually being comparable between the control and treatment groups.

Conclusion: The evidence supports the hypothesis that selective antagonism of IL-13 is sufficient to control AD, providing an improvement in the patient’s quality of life. Therefore, the development of lebrikizumab and tralokinumab represents a new and exciting phase in the management of AD.

Keywords: atopic dermatitis, interleukin-13, lebrikizumab, IL-13, tralokinumab.

Citation: Gonçalves F, Freitas E, Torres T. Selective IL-13 inhibitors for the treatment of atopic dermatitis. Drugs in Context 2021; 10: 2021-1-7. DOI: 10.7573/dic.2021-1-7

Contributions: All the authors contributed equally to the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: Francisca Gonçalves has no conflicts of interest. Egídio Freitas has no conflicts of interest. Tiago Torres is a scientific consultant/speaker/clinical study investigator for AbbVie, Almirall, Amgen, Arena Pharmaceuticals, Biocad, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Fresenius Kabi Pharma, Janssen, Leo Pharma, MSD, Mylan, Novartis, Pfizer, Samsung-Bioepis, Sandoz, Sanofi, UCB and Viatris. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2021/03/dic.2021-1-7-COI.pdf

Acknowledgements: None.

Funding declaration: No sources of funding were used to conduct this study or prepare this manuscript.

Copyright: Copyright © 2021 Gonçalves F, Freitas E, Torres T. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Gonçalves F, Freitas E, Torres T. https://doi.org/10.7573/dic.2021-1-7. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/selective-il-13-inhibitors-for-the-treatment-of-atopic-dermatitis

Correspondence: Tiago Torres, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal; Department of Dermatology, Centro Hospitalar do Porto, Porto, Portugal; and Dermatology Research Unit, Centro Hospitalar do Porto, Porto, Portugal. Email: torres.tiago@outlook.com

Provenance: Invited; externally peer reviewed.

Submitted: 26 January 2021; Accepted: 26 February 2021; Publication date: 30 March 2021.

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