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New Therapy for Atopic Eczema


During winter, the dry and cold weather can easily trigger eczema, especially when taking hot showers or being in centrally heated rooms, which can dry out the skin and worsen the condition.

Eczema patients often wake up with damaged skin, and in severe cases, experience bleeding and oozing. The extreme itching caused by eczema can also interfere with daily life, making it hard to concentrate at school or work. Severe eczema can cause significant mental stress, which can in turn worsen the condition, leading to a vicious cycle that makes it difficult to control. Traditional treatments for eczema include steroid creams, non-steroidal creams, oral immunosuppressants, moisturizing creams, and antihistamine drugs.

The causes and pathology of eczema are very complex. Factors that contribute to its development include immune dysfunction, which leads to an excessive production of immunoglobulin E (IgE), allergic inflammation, and secondary epidermal barrier damage. In healthy skin, there is a balance between the subgroups Th1, Th2, Th17, and Th22 in T cells of the immune system. However, in eczema skin, this balance is disrupted, and Th2 cells dominate, resulting in an increase in type 2 cytokines such as interleukin (IL)-4, IL-5, and IL-13, which stimulate the production of IgE.

In recent years, there have been significant advances in biomedical research, and many diseases can now be treated using biological agents. These new drugs can target specific immune molecules without harming unrelated cells or tissues. Biological agents have been effective in treating cancer, immune system disorders, psoriasis, and many other conditions. In 2017, the US Food and Drug Administration (FDA) approved the subcutaneous injection of Dupilumab (Dupixent), a biological agent, as the latest therapy for eczema. Dupilumab is an interleukin-4 (IL-4) receptor α antagonist, which blocks the IL-4Rα subunit and inhibits the response induced by IL-4 and IL-13 cytokines, reducing cytokines and IgE and suppressing inflammation.

In three clinical trials, Dupixent was studied in over 2,100 adults with moderate to severe eczema that was difficult to control. These patients included:

  • 52% with moderate atopic dermatitis
  • 48% with severe atopic dermatitis
  • average age of about 38 years
  • average duration of disease of about 28 years
  • average accumulated surface area of about 55%

In two 16-week clinical trials comparing Dupixent to a placebo, almost half of the patients showed a 75% improvement in their skin, and some even saw a 90% improvement.