• The FDA has approved two biologics for eczema, but many others are under development.
  • Biologics are derived from living organisms rather than chemicals.
  • Biologics for eczema target specific proteins in the body, which can help reduce overactivity in the immune system and calm eczema symptoms.
Biologics, or targeted treatments, are one of the newest ways to treat eczema, a chronic inflammatory condition also known as atopic dermatitis. Eczema affects an estimated 16.5 million adults in the United States. Unlike traditional drugs, which are made from chemical compounds, biologics for eczema are made from living organisms. These injectable medications affect a specific immune response to help reduce the inflammation that causes eczema symptoms. According to the National Eczema Association, results of clinical trials have shown that targeted treatments for eczema can help:
  • reduce itch
  • clear skin
  • improve sleep
  • boost overall quality of life
So far, the Food and Drug Administration (FDA) has approved two targeted treatments for eczema, but more than 25 other biologics are in development and may become available in the future. Here’s a closer look at biologics for eczema, including how they work in the body, potential side effects, and more.

What are biologics for eczema?

Both FDA-approved biologics for eczema belong to a class of medications called monoclonal antibodies. They work by binding to a specific protein or receptor in the body and inactivating it, which helps slow or stop inflammation.

Dupixent (dupilumab)

The FDA approved the use of Dupixent for the treatment of moderate to severe eczema in adults in 2017. More recently, this biologic for eczema has been approved for use in children ages 6 and up. It is primarily recommended for people who haven’t responded well to topical medications (like creams and ointments), or can’t use those medications. According to the National Eczema Association, clinical trial participants who were treated with Dupixent for 16 weeks as opposed to a placebo experienced:
  • clearer skin
  • less itching
  • improved sleep
  • improved quality of life
The majority of participants continued to experience these benefits after 52 weeks of continued therapy with Dupixent.

Adbry (tralokinumab-ldrm)

Adbry is the newest biologic for eczema, having gained FDA-approval in December 2021. Adbry is recommended for: According to the National Eczema Association, a clinical trial showed that Adbry was better than a placebo at helping adults with eczema experience:
  • clear or almost clear skin
  • reduction in itching severity
  • improved sleep
  • improved quality of life
After a year of continued treatment on Adbry, the majority of clinical trial participants maintained these benefits.

How current biologics work in the body to fight atopic dermatitis

Biologics for eczema work by modifying the activity of interleukins, a type of protein that regulates responses in the immune system. While it’s unclear why some people develop eczema, interleukins play a role in two potential causes of the condition:
  • an overactive immune response to pathogens
  • decreased skin barrier functions
Interleukins and their receptors act like a sort of key and lock. In people with eczema and other inflammatory conditions, an overactive immune response occurs when the key enters the lock. Biologics act kind of like a coin covering the keyhole (or receptor) so the key (or interleukin) can’t enter the hole. In other words, biologics for eczema tone down the immune response that causes symptoms like itching and patches of dry, discolored skin. Each biologic for eczema works on a very specific interleukin. Adbry prevents interleukin-13 from binding to its cell receptors, while Dupixent works on both interleukin-13 and interleukin-4. Some individuals may see better results with one biologic for eczema compared to another, depending on the immune response that could be causing their symptoms.

How do other treatments compare to biologics?

Biologics for eczema can be very effective, but they’re typically offered only when a person has moderate to severe symptoms that haven’t gone away with other treatments. Dermatologists typically prescribe at-home measures, like applying moisturizer or topical calcineurin inhibitors and avoiding known eczema triggers. They may also recommend short-term courses of corticosteroid cream or ointment as the first-line treatment for eczema. Over-the-counter antihistamines can also help relieve itching. For many people, that can be enough to ease occasional flare-ups and soothe symptoms. If those eczema treatments don’t work, a dermatologist may prescribe a systemic treatment, such as:
  • JAK inhibitors
  • azathioprine
  • cyclosporine
  • methotrexate
  • mycophenolate mofetil
Most systemic therapies work by suppressing the immune system. While that can help reduce eczema symptoms, it can make it harder for your body to fight other illnesses and infections. Biologics for eczema are different in that they target a specific component of the immune system, rather than the entire system. They also don’t contain steroids. However, biologics can also cause some side effects, so it’s important to weigh the risks and benefits of any medication with a healthcare professional. While taking biologics, you can still use topical corticosteroids as needed. You can also use topical calcineurin inhibitors on parts of the skin affected by eczema. Be sure to speak with your doctor before taking other medications.

How are biologics for eczema administered?

Biologics for eczema are given by injection beneath the skin. They come in pre-filled syringes that you can administer yourself at home. The recommended dose of a biologic for eczema can depend on your age and weight, as well as the specific medication you’ve been prescribed. Adults on Dupixent will typically start with an initial dose of two 300-mg injections, followed by a single injection every other week. With Adbry, adults usually need four 150-mg injections to start, followed by two more injections every other week. Your doctor may recommend reducing your dosage to a single injection every 4 weeks if your skin is almost clear after four months of treatment.

Side effects

Like any medication, biologics for eczema come with a potential risk of side effects. These reactions tend to be mild and go away over time. Some of the most common side effects of Dupixent are:
  • injection site reaction (such as pain)
  • pink eye
  • inflammation of the eyelids or cornea
  • dry or itchy eyes
  • cold sores (if the herpes virus is already in your body)
Some of the most common side effects of Adbry are:
  • upper respiratory tract infection
  • pink eye
  • injection site reaction
  • higher-than-normal level of eosinophils (a type of white blood cell)
Before taking a biologic for eczema, be sure to tell your doctor if:
  • you’re taking other medications
  • you’re pregnant or breastfeeding
  • you need any vaccinations

Outlook

While eczema can be a lifelong disease, many medications are available to manage symptoms and reduce flares. Biologics are among the newest treatment options on the market. While just two have earned FDA approval so far, more than two dozen others are in the works. As new biologics for eczema become available, people will have even more options to choose from. Eczema can affect people in different ways. If you have chronic symptoms that haven’t responded to at-home remedies or medications, get in touch with a dermatologist or healthcare professional. They can provide personalized recommendations, help you narrow down potential triggers, and prescribe other treatments.

Takeaway

The FDA has approved two biologics for eczema in recent years. These targeted therapies are made from a mixture of natural proteins derived from living tissues. Biologics don’t suppress the entire immune system in the same way as traditional steroids and immunosuppressive medications. Instead, they act on specific components of the immune system. That can help calm an overactive immune response and reduce common symptoms of eczema, like itching. However, biologics for eczema can weaken the immune system, so it’s important to discuss that and other risks with a healthcare professional. New biologics for eczema are also in the works, so keep your eye out for other FDA approvals in the coming years.