How Biologics are Reshaping Dermatology

Hridkamal Roy, Assistant Editor, India Pharma Outlook

 Hridkamal Roy, Assistant Editor, India Pharma Outlook

The Psoriasis Treatment Center of New Jersey, part of Schweiger Dermatology Group, announced positive results from an open-label clinical trial of VTAMA (tapinarof) cream for the treatment of plaque psoriasis according to a report published by PRNewswire. Biologics have become the preferred medications for dermatologists owing to their effectiveness of treatment towards specific dermatological conditions. Market Research reports suggest that the global biologics market size is expected to reach 562.14 Bn USD by 2028. Treatment through biologics has heavily emerged in the last two decades through a range of advanced dermatology treatment programs for various kinds of conditions. These programs have made a significant impression on dermatological treatments and have immensely helped clinicians understand new methodologies in going about treatments especially in the cases of psoriasis and atopic dermatitis most recently.

“Biologics have revolutionized dermatological treatments by targeting specific immune pathways involved in chronic skin conditions like psoriasis, atopic dermatitis, urticaria and hidradenitis suppurativa amongst many other skin disorders whose list continues to expand. These advanced therapies offer remarkable efficacy, often achieving long-lasting results and improved quality of life for patients who were earlier battling with chronic skin conditions with suboptimal outcomes. While potential side effects exist, their targeted approaches make biologics an extremely valuable option in dermatology”, mentions Dr. Mahima Agarwal, Consultant, Dermatology, Fortis Hospital.

For one to understand the future possibilities of biologics, it is important to know the specific kinds of dermatological conditions can be very effectively treated through biologics.

Psoriasis Management

The US Food and Drug Administration (FDA) has approved several biologics because of their effectiveness that will work both on psoriasis and psoriatic arthritis. Some biologics have even been approved for the treatment of psoriasis in children. Etanercept, Ustekinumab and Sekukinumab are the biologics that have been approved by the FDA for psoriasis treatment in children. However several side effects have also been observed by the use of biologics that might include upper respiratory tract infection, skin reaction where the biologic is injected, flu-like symptoms, urinary tract infection and headache. It is proven that a biologic works by calming down part of the body’s immune system, anyone using a biologic is automatically exposed to various risks. In case the patient has a history of infections, chews tobacco or smokes or is diabetic, that person might develop serious infections from the use of biologics. It is always advisable for patients to inform a dermatologist regarding these if there is need for moderate treatment through biologics. “If your symptoms bother you every day, you should see a dermatologist who is comfortable prescribing biologics and ask about that option”, mentioned Dr. John Minni, Board Member, Water’s Edge Dermatology.

Systemic biologics treatment was found more effective on a 48 year old male with Plaque Psoriasis with severe symptoms. According to the panel of dermatologists who inspected the patient condition found out that treatment through biologics were found to be more fruitful than treatment by corticosteroids.

Atopic Dermatitis (Eczema) Management

Biologics have emerged as one of newest dermatological treatments for Atopic dermatitis or Eczema. FDA approvals for these medications were pending until 2017 owing to the effect they can have on the human immune system. Currently, two biologics are in place and have been approved which are dupilumab and tralokinumab. Several other biologics that have monoclonal identity are under being studied and can get the FDA approvals very soon. “With numerous new emerging drugs expanding the clinical practice of AD healthcare in recent years, the approval of dupilumab, represented a major breakthrough in the therapy of patients with moderate to severe AD”, states Simon Schneider, Department of Dermatology and Allergy, Munich, Germany.

Dupilumab has been an effective mode of treatment for a 22 year old female patient with severe Atopic Dermatitis. The patient study has revealed that she was treated with narrow-band ultraviolet B (NB-UVB) but had discontinued the treatment soon after. On observation of the patient condition, the concerned had strongly suggested on dupilumab injection 300 mg/2 ml along with other medications.

Urticaria Management

The usage of biologics has immensely reshaped the management procedures for chronic resistant urticaria (CRU) and is often preferred in CSU resistant to other treatment options. Omalizumab and ligelizumab are commonly used biologicals in urticaria that have FDA approvals because of their better efficacy and safety profile. The primary modes of treatment for chronic urticaria are second-generation non-sedating antihistamines (AHs). The European Academy of Allergy and Clinical Immunology (EAACI/2021) has recommended increasing the dose of AHs up to 4 times if the response received is unsatisfactory after 2–4 weeks of standardized dosage of the second-generation AHs. If no further improvement can be seen after 2–4 weeks of increasing the dosage, omalizumab  or ciclosporin can be prescribed. Biologicals are large complex glycoproteins manufactured from living organisms such as microorganisms, humans, plants, or animals. Monoclonal antibodies (mAbs) are biologicals that target the specific antigen or epitope. 

Dermatological treatments have been revolutionized and reshaped by the widespread usage of biologics and many ongoing investigations are in process to develop better formulations in order to take this segment forward. The biologics industry is poised for extensive growth in the years to come.

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