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. 2024 Jul-Aug;99(4):546-567.
doi: 10.1016/j.abd.2023.10.002. Epub 2024 Mar 22.

Targeted therapy for immune mediated skin diseases. What should a dermatologist know?

Edinson López  1 , Raúl Cabrera  2 , Cristóbal Lecaros  1
Affiliations

Targeted therapy for immune mediated skin diseases. What should a dermatologist know?

Edinson López et al. An Bras Dermatol. 2024 Jul-Aug.

Abstract

Background: Molecularly targeted therapies, such as monoclonal antibodies (mAbs) and Janus Kinase inhibitors (JAKis), have emerged as essential tools in the treatment of dermatological diseases. These therapies modulate the immune system through specific signaling pathways, providing effective alternatives to traditional systemic immunosuppressive agents. This review aims to provide an updated summary of targeted immune therapies for inflammatory skin diseases, considering their pathophysiology, efficacy, dosage, and safety profiles.

Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search was conducted on PubMed over the past 10 years, focusing on randomized clinical trials, case reports, and case series related to targeted immune therapies in dermatology. Eligibility criteria were applied, and data were extracted from each study, including citation data, study design, and results.

Results: We identified 1360 non-duplicate articles with the initial search strategy. Title and abstract review excluded 1150, while a full-text review excluded an additional 50 articles. The review included 143 studies published between 2012 and 2022, highlighting 39 drugs currently under investigation or in use for managing inflammatory skin diseases.

Study limitations: The heterogeneity of summarized information limits this review. Some recommendations originated from data from clinical trials, while others relied on retrospective analyses and small case series. Recommendations will likely be updated as new results emerge.

Conclusion: Targeted therapies have revolutionized the treatment of chronic skin diseases, offering new options for patients unresponsive to standard treatments. Paradoxical reactions are rarely observed. Further studies are needed to fully understand the mechanisms and nature of these therapies. Overall, targeted immune therapies in dermatology represent a promising development, significantly improving the quality of life for patients with chronic inflammatory skin diseases.

Keywords: Atopic dermatitis; Biologics; Immune modulators; Inflammatory skin diseases; Jak inhibitors; Psoriasis; Targeted therapy.

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Figures

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Fig. 1
Approved treatments of targeted immune therapies by the FDA for inflammatory skin diseases.
Fig. 2
Fig. 2
PRISMA Flowchart.
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