Atopic Dermatitis Biologic Treatment with Nemolizumab

Anti-Interleukin-31 Receptor A Antibody for Atopic Dermatitis.
Ruzicka T, Hanifin JM, Furue M, Pulka G, Mlynarczyk I, Wollenberg A, Galus R, Etoh T, Mihara R, Yoshida H, Stewart J, Kabashima K; XCIMA Study Group..
N Engl J Med. 2017 Mar 2;376(9):826-835. doi: 10.1056/NEJMoa1606490.

Atopic Dermatitis is a chronic itch inflammatory dermatosis which can be very difficult to treat and the arrival of biologic therapy (and small molecules) from the pipeline will give the dermatologist a new therapeutical armamentarium.
Il-31 blocking has been shown to be effective to abolish itch in monkeys (see link here: https://telemedskin.com/atopic-dermatitis-treating-itch-and-biologics-review-2017/) and this study confirms this finding in humans in a phase 2 study performed in 264 patients.

Dosing: subcutaneous injection once every 4 weeks at a dose of 0.1 mg/kg, 0.5 mg/kg, and 2.0 mg/kg (or 2.0 mg/kg for 8 weeks)

Over 12 weeks, comparing to placebo there was a reduction of pruritus ranging from 43% to 63% (placebo 20%). The results comparing the drug with the Eczema Area and Severity Index (EASI) were less conclusive.

Comment: Il-31 has been shown in pre-clinical studies and here to have a fundamental role in itch. In order to evaluate the safety of the drug phase 3 studies and patient monitoring are still required.

-The abstract of the article can be viewed here: https://www.ncbi.nlm.nih.gov/pubmed/28249150
-Review of the current biologics in AD & the Il-31 “story”: https://telemedskin.com/atopic-dermatitis-treating-itch-and-biologics-review-2017/

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