{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:34:21Z","timestamp":1793637261774,"version":"4.5.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Several clinical trials have evaluated the efficacy and safety of interleukin-13 (IL-13)\u00a0with lebrikizumab and tralokinumab in patients with moderate to severe atopic dermatitis (AD).\u00a0However, the safety and efficacy of IL-13 inhibitors as a potent biologic for AD remain elusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the efficacy and safety of IL-13 inhibitors in moderate to severe AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Randomized clinical trials (RCTs), comparing IL-13 inhibitors vs placebo treatment in patients with moderate to severe AD, were identified from public database from its inception to November 9\n                      <jats:sup>th<\/jats:sup>\n                      , 2021. The study was registered in PROSPERO (CRD42021254920).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies reporting 7 RCTs involving 2946 patients with moderate-to-severe AD were included for the pooled analysis. Compared with placebo, antagonizing IL-13 with lebrikizumab and tralokinumab showed a greater improvement in percentage change of EASI (MD -20.37, 95%CI -32.28,\u00a0-8.47), and a larger proportion of patients achieving numerical rating scale (NRS) with more than 4-points improvement (RR 1.59, 95%CI 1.23, 2.05). Additionally, IL-13 inhibitors also improved impaired dermatology life quality index (DLQI) (MD -14.49, 95%CI -19.23, -9.75). In terms of safety, both lebrikizumab and tralokinumab were well tolerated, with the except that they were linked to an increased risk of conjunctivitis\u00a0compared to placebo treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antagonizing IL-13 with lebrikizumab and tralokinumab have demonstrated encouraging clinical efficacy against moderate-to-severe AD with excellent safety profile, albeit they did come with a higher risk of conjunctivitis\u00a0than placebo treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>\n                      , identifier ID=CRD42021254920.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2022.923362","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T05:59:35Z","timestamp":1658901575000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":39,"title":["The efficacy and safety of IL-13 inhibitors in atopic dermatitis: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danrong","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minxue","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13401","article-title":"Epidemiology of atopic dermatitis in adults: Results from an international survey","volume":"73","author":"Barbarot","year":"2018","journal-title":"Allergy"},{"key":"B2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/all.12270","article-title":"New insights into the epidemiology of childhood atopic dermatitis","volume":"69","author":"Flohr","year":"2014","journal-title":"Allergy"},{"key":"B3","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1159\/000370220","article-title":"Atopic dermatitis: global epidemiology and risk factors","volume":"66","author":"Nutten","year":"2015","journal-title":"Ann Nutr Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2147\/jaa.S317009","article-title":"Atopic dermatitis and patient perspectives: Insights of bullying at school and career discrimination at work","volume":"14","author":"Stingeni","year":"2021","journal-title":"J Asthma Allergy"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.08.028","article-title":"Atopic dermatitis in America study: A cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population","volume":"139","author":"Chiesa Fuxench","year":"2019","journal-title":"J Invest Dermatol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.jid.2016.07.012","article-title":"The burden of atopic dermatitis: Summary of a report for the national eczema association","volume":"137","author":"Drucker","year":"2017","journal-title":"J Invest Dermatol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.01.009","article-title":"Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the joint task force practice parameter and American academy of dermatology guidelines","volume":"139","author":"Eichenfield","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.01.010","article-title":"Assessing the current treatment of atopic dermatitis: Unmet needs","volume":"139","author":"Leung","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1016\/j.jaci.2017.04.015","article-title":"Efficacy and safety of dupilumab for the treatment of adult atopic dermatitis: A meta-analysis of randomized clinical trials","volume":"140","author":"Han","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.05.075","article-title":"Abrocitinib induction, randomized withdrawal, and retreatment in patients with moderate-to-severe atopic dermatitis: Results from the JAK1 atopic dermatitis efficacy and safety (JADE) REGIMEN phase 3 trial","volume":"86","author":"Blauvelt","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/aci.0000000000000094","article-title":"Recent developments in atopic dermatitis","volume":"14","author":"Peng","year":"2014","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1111\/all.13954","article-title":"Interleukin-13: Targeting an underestimated cytokine in atopic dermatitis","volume":"75","author":"Bieber","year":"2020","journal-title":"Allergy"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1016\/j.jaip.2019.05.030","article-title":"The safety and efficacy of anti-IL-13 treatment with tralokinumab (CAT-354) in moderate to severe asthma: A systematic review and meta-analysis","volume":"7","author":"Zhang","year":"2019","journal-title":"J Allergy Clin Immunol In Practice"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/sj.gene.6363985","article-title":"Genetic variants of the IL13 and IL4 genes and atopic diseases in at-risk children","volume":"4","author":"He","year":"2003","journal-title":"Genes Immunity"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-004-0455-6","article-title":"Relative importance of IL-4 and IL-13 in lesional skin of atopic dermatitis","volume":"295","author":"Tazawa","year":"2004","journal-title":"Arch Dermatol Res"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2016.09.037","article-title":"An integrated model of atopic dermatitis biomarkers highlights the systemic nature of the disease","volume":"137","author":"Ungar","year":"2017","journal-title":"J Invest Dermatol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2005.00733.x","article-title":"CD4(+)IL-13(+) cells in peripheral blood well correlates with the severity of atopic dermatitis in children","volume":"60","author":"La Grutta","year":"2005","journal-title":"Allergy"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.0079","article-title":"Efficacy and safety of lebrikizumab, a high-affinity interleukin 13 inhibitor, in adults with moderate to severe atopic dermatitis: A phase 2b randomized clinical trial","volume":"156","author":"Guttman-Yassky","year":"2020","journal-title":"JAMA Dermatol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19573","article-title":"Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial","volume":"184","author":"Silverberg","year":"2021","journal-title":"Br J Dermatol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"8","author":"Moher","year":"2010","journal-title":"Int J Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/j.jaad.2018.01.017","article-title":"Efficacy and safety of lebrikizumab (an anti-IL-13 monoclonal antibody) in adults with moderate-to-severe atopic dermatitis inadequately controlled by topical corticosteroids: A randomized, placebo-controlled phase II trial (TREBLE)","volume":"78","author":"Simpson","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19574","article-title":"Tralokinumab for moderate-to-severe atopic dermatitis: results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2)","volume":"184","author":"Wollenberg","year":"2021","journal-title":"Br J Dermatol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2018.05.029","article-title":"Treatment of atopic dermatitis with tralokinumab, an anti-IL-13 mAb","volume":"143","author":"Wollenberg","year":"2019","journal-title":"J Allergy Clin Immunol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.20832","article-title":"Tralokinumab plus topical corticosteroids in adults with severe atopic dermatitis and inadequate response to or intolerance of ciclosporin a: a placebo-controlled, randomized, phase III clinical trial (ECZTRA 7)","volume":"186","author":"Gutermuth","year":"2022","journal-title":"Br J Dermatol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17956","article-title":"Patient-reported outcomes in adult atopic dermatitis are useful in both clinical trials and real-life clinical practice","volume":"36","author":"Stingeni","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.08.051","article-title":"Real-world evidence of dupilumab efficacy and risk of adverse events: A systematic review and meta-analysis","volume":"84","author":"Halling","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/09546634.2021.1961997","article-title":"Efficacy and safety of abrocitinib for the treatment of moderate-to-severe atopic dermatitis: a meta-analysis of randomized clinical trials","author":"Meher","year":"2021","journal-title":"J Dermatol Treat"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2018.39.4149","article-title":"Meta-analysis of randomized controlled trials for the efficacy and safety of anti-interleukin-13 therapy with lebrikizumab in patients with uncontrolled asthma","volume":"39","author":"Liu","year":"2018","journal-title":"Allergy Asthma Proc"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1159\/000448400","article-title":"Stratum corneum tape stripping: Monitoring of inflammatory mediators in atopic dermatitis patients using topical therapy","volume":"170","author":"Koppes","year":"2016","journal-title":"Int Arch Allergy Immunol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.11.037","article-title":"Bidirectional association between atopic dermatitis, conjunctivitis, and other ocular surface diseases: A systematic review and meta-analysis","volume":"85","author":"Ravn","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/all.14610","article-title":"Treatment-emergent adverse events in dupilumab-treated patients with allergic diseases: A meta-analysis","volume":"76","author":"Chen","year":"2021","journal-title":"Allergy"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17538","article-title":"Goblet cell scarcity and conjunctival inflammation during treatment with dupilumab in patients with atopic dermatitis","volume":"180","author":"Bakker","year":"2019","journal-title":"Br J Dermatol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17869","article-title":"Conjunctivitis in dupilumab clinical trials","volume":"181","author":"Akinlade","year":"2019","journal-title":"Br J Dermatol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.923362\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T05:59:40Z","timestamp":1658901580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.923362\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,27]]},"references-count":33,"alternative-id":["10.3389\/fimmu.2022.923362"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.923362","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,27]]},"article-number":"923362"}}