Dupilumab (Dupixent) and tralokinumab (Adbry) are immunotherapy drugs approved to treat moderate to severe eczema. Other potential treatments are undergoing clinical trials.
Immunotherapy is a treatment option for moderate or severe atopic dermatitis (eczema) that doesn’t respond to other treatments. This class of drugs uses your body’s immune system to alter reactions that contribute to eczema flare-ups and symptoms.
While immunotherapy may be a viable solution for some cases, only a few types are approved to treat eczema. Consider the following information when talking with a doctor about immunotherapy for eczema and what you can expect from your treatment.
Immunotherapy vs. immunosuppressants
Immunotherapy can target and activate a specific part of your immune system. It can also increase or enhance your immune system.
Immunosuppressants decrease your immune system function overall.
Immunotherapy is a systemic treatment, meaning it is a medication that travels throughout your body to make changes to your immune system.
With eczema, immunotherapy may work by reducing the underlying inflammation that causes flare-ups and severe symptoms.
As of 2023, the Food and Drug Administration (FDA) has approved two immunotherapy treatments for eczema: Dupixent and Adbry.
Both are injectable biologics. These contain lab-made proteins derived from living organisms that target your immune system and reduce inflammation.
Allergy shots are another type of immunotherapy that doctors may consider for people with both allergies and eczema.
Dupixent is approved for people 6 months and older with moderate to severe eczema that doesn’t respond to topical medications alone. When used together, both medications may significantly reduce skin itchiness and rashes.
Adbry is the second biologic approved to treat moderate to severe eczema. Unlike Dupixent, this injection is approved for adults only.
Also called allergen immunotherapy, allergy shots work by injecting small amounts of a particular allergen to help increase your body’s tolerance.
This is a long-term treatment, with doses of the selected substances increasing gradually. You can expect weekly or twice-weekly shots for about 7 months, followed by shots every 2 to 4 weeks for about 3 to 5 years.
According to a 2023 review of 23 randomized controlled trials, the exact connection between allergies and eczema flare-ups isn’t clear. However, the authors note that some people experience improved symptoms with allergy shots — especially those with dust mite allergies.
Researchers are also studying certain monoclonal antibodies (mAbs) as potential immunotherapy options for eczema treatment. These are subtypes of biologics that target specific cellular proteins and include:
Lebrikizumab blocks interleukin-13 (IL-13) cytokines, which are linked to eczema severity. According to a 2023 study of two recently completed phase 3 trials, researchers reported a high efficacy rate of this mAb after 16 weeks of use in adolescents and adults.
It’s important to note that while this study shows promise, it was funded by the manufacturer.
Nemolizumab works by blocking interleukin-31 (IL-31) receptors. According to a
This agent is undergoing phase 2 and phase 3 trials to evaluate safety and efficacy.
Possible side effects of immunotherapy vary by type. You should discuss these with a doctor before starting treatment.
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Healthcare professionals may prescribe allergy shots for children over the age of 5. Severe reactions are rare, though it’s possible to experience:
Eczema management involves a combination of:
- skin care
- trigger avoidance
- topical medications like steroids, calcineurin inhibitors, and JAK inhibitors, among others
A doctor may prescribe immunotherapy in conjunction with these other treatment methods.
Doctors will usually reserve immunotherapy for cases of moderate to severe eczema. They’ll also use them as a last resort when other medications, such as topical steroids or oral immunosuppressants, fail to improve your symptoms.
Does immunotherapy cure eczema?
Currently, there’s no cure for eczema. This includes immunotherapy. You may have fewer flares and experience remissions with this treatment, but eczema is still a chronic condition that requires lifelong management.
Eczema is a common condition that affects children and adults. Though doctors may try other treatment options first, moderate to severe cases of eczema may require systemic treatments such as immunotherapy.
If your eczema frequently flares and interferes with sleep and overall quality of life, you may consider talking with a doctor about whether immunotherapy can help alleviate your symptoms. It’s also important to keep in mind that researchers are still studying new drugs in this class that may help treat eczema.