Atopic dermatitis, a chronic inflammatory skin condition, has long lagged behind psoriasis in terms of treatment options. However, recent developments in the field have sparked excitement among dermatologists. In this article, we will discuss the emergence of new and upcoming treatments for atopic dermatitis patients, with a particular focus on the differences in the mechanism of action between tralokinumab (Adbry) and dupilumab (Dupixent).
For years, dermatologists treating atopic dermatitis were like eager puppies looking through a glass, patiently waiting for their turn to have access to groundbreaking treatments. The field of psoriasis had witnessed an influx of innovative therapies, each surpassing the previous one in terms of efficacy and safety. But finally, in 2017, came the introduction of the first biologic treatment for atopic dermatitis. This marked a significant milestone for the dermatology community, offering patients a glimmer of hope. However, the thrill was somewhat dulled by the fact that only one biologic agent was available at the time.
A New Wave of Possibilities
The introduction of a second biologic treatment for atopic dermatitis brings renewed optimism among dermatologists. While tralokinumab arrived on the scene more recently compared to dupilumab, what truly excites experts like Dr. Peter Lio of Northwestern University Feinberg School of Medicine in Chicago is the prospect of exploring new pathways for treatment. The emergence of an interleukin-31 inhibitor and the development of OX40 inhibitors indicate that there are multiple avenues to target these pathways. The use of biologics, known for their safety and targeted approach, holds promise for the future of atopic dermatitis management.
Imagine having an artist’s palette, being able to select the most suitable treatment option for each patient based on their individual needs. This is the future that dermatologists envision for the management of atopic dermatitis. While it is true that dupilumab and tralokinumab have similar mechanisms of action, targeting the same pathway, they do exhibit some subtle differences. Dupilumab acts on IL-4 and IL-13, whereas tralokinumab directly binds to IL-13. Although they may appear clinically comparable, minor variations in their mechanisms of action may result in different outcomes for patients.
Dr. Lio shares that, in his clinical experience, he might not be able to reliably differentiate between dupilumab and tralokinumab if conducting a blinded study. This suggests that, in terms of efficacy, they may be quite similar. Furthermore, their safety profiles and side effects are also comparable. Some initial hopes that tralokinumab would not cause conjunctivitis, as seen with dupilumab, were soon dashed when a few patients developed the same issue. Thus, from a clinical standpoint, the two biologics appear quite similar.
Despite the similarities, Dr. Lio emphasizes that tralokinumab and dupilumab do have their distinctions. Some patients who experienced adverse effects with dupilumab subsequently found success with tralokinumab. This highlights the importance of having more treatment options, even if they operate on the same pathway. Tralokinumab’s efficacy has positioned it as a viable second-line treatment, especially considering dupilumab’s additional indications, including its use in pediatric patients as young as 6 months old.
The emergence of new pathways for the treatment of atopic dermatitis has reinvigorated the field and given hope to both dermatologists and patients. With the advent of tralokinumab and ongoing research into various biologic agents, dermatologists are eagerly awaiting the day when they can confidently select the most appropriate treatment option for each individual. As the treatment arsenal expands and new avenues are explored, the future looks bright for individuals living with atopic dermatitis.
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