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An Update on Clinical Experiences and Clinical Studies on Novel Pharmaceutical Developments for the Treatment of Atopic Dermatitis

Tatjana Honstein; Thomas Werfel


Curr Opin Allergy Clin Immunol. 2020;20(4):386-394. 

In This Article

Targeting IL-22 for the Treatment of Atopic Dermatitis With Fezakinumab

IL-22 is expressed by T lymphocytes and is mainly expressed on epithelial cells, but not on immune cells. Significantly increased expression levels of IL-22 and of IL-22-producing cells in serum and skin make it a possible therapeutical target for biologicals. In a first phase IIa trial the IL-22-specific antibody fezakinumab was administered intravenously every 14 days for 10 weeks in patients with atopic dermatitis.[35] After 12 weeks, a significant, but overall not very high therapeutic effect was seen with a reduction of the eczema score SCORAD by 14 points in the treatment group and by 8 points in the placebo group. In differentiated subgroup analysis, the therapeutical effect was more pronounced in severely affected patients with a reduction of the SCORAD by 22 points versus 10 points in the placebo group after 12 weeks and 27 points versus 12 points after 20 weeks.

Lesional and nonlesional skin from patients treated with fezakinumab was further investigated using transcriptomic and immunohistochemistry analyses.[36] Baseline median IL-22 mRNA expression was used to stratify for high and low IL-22 expression groups. Much stronger mean transcriptomic improvements were seen with fezakinumab in the IL-22-high drug-treated group than in the respective IL-22-high placebo-treated group, the IL-22-low groups showing significant downregulations of molecules related to TH1, TH2, TH17, and TH22 pathways.