Many cytokines, including IL-4, function in the pathogenesis of atopic dermatitis. New molecular target therapies, such as biologics and small molecule inhibitors, are emerging to block these cytokines. Recently, dupilumab, an anti-IL-4Ra antibody, became available. Dupilumab, when used as a single agent, significantly improved the Investigator Global Assessment (IGA) score and increased the number of patients who meet the criterion for EASI-75 compared to the placebo. When used concomitantly with steroid ointment, dupilumab remained highly effective for at least one year. Nemolizumab, an anti-IL-31R antibody, significantly improved pruritus associated with atopic dermatitis in a phase II trial. Topical therapies are also under development. Several phosphodiesterase 4 (PDE4) inhibitors, such as crisaborole, OPA-15406, and E6005, are also promising topical agents. Tofacitinib and JTE-052, which are JAK kinase inhibitors, were also effective in phase II trials, and further clinical trials are expected.
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