“Unfortunately, many patients suffer for many years with atopic dermatitis symptoms before seeking this kind of treatment,” says Emily Wood, MD, a dermatologist at Westlake Dermatology in Austin, Texas.
Here are the top misconceptions that dermatologists hear about biologics, along with the facts.
1. Misconception: Biologics Are Not Safe
This seems to be the most common misconception around biologics, says Dr. Wood. Some patients believe that biologics are unproven, or lack research and clinical trials that establish their efficacy and safety.
2. Fact: Biologics Are FDA-Approved
- dupilumab (Dupixent)
- tralokinumab-ldrm (Adbry)
- lebrikizumab-lbkz (Ebglyss)
- nemolizumab-ilto (Nemluvio)
In order to receive FDA approval, a drug must undergo three phases of testing, including large clinical trials that show the drug’s benefits and risks.
“There is ample data to support the safety of biologic therapy for atopic dermatitis,” says Wood. “In fact, the biologics we use today are much safer than taking prednisone or some of the older therapies that were previously used for atopic dermatitis treatment.”
3. Misconception: Biologics Are Temporary
Another misconception tends to be that biologics are a stop-gap measure, possibly used only during an intense flare, says Wood. The misconception is that biologics calm the person’s immune response, and then they’re switched back to a non-biologic therapy.
4. Fact: Biologics Are an Ongoing Treatment
With moderate to severe atopic dermatitis, treatment requires addressing the chronic nature of the condition, Wood says. That means targeting any systemic inflammation that occurs, even when there aren’t visible symptoms.
“Because of the need to control this inflammation, biologics would be used as a consistent treatment, and would be utilized for long-term management,” she says. In some cases, you may need to stop a biologic drug if it isn’t working well for you, but even then, you’d likely switch to a different biologic medication.
5. Misconception: Biologics Lower Your Immune Function
6. Fact: Your Immune System Is Not Suppressed
There are some drugs called immunosuppressants that actually do reduce immune function as a way to address specific conditions, but biologics for atopic dermatitis work differently, says Tanya Evans, MD, a dermatologist and the medical director of the skin cancer program at the melanoma clinic at MemorialCare Saddleback Medical Center in Laguna Hills, California.
Instead of suppressing the entire immune system, these biologics target only certain inflammatory pathways, which leaves the rest of your immune system functioning to protect against potential threats like viruses, she says. That reduces inflammation without making you vulnerable to the potential risks that come with immunosuppression.
7. Misconception: Biologics Can’t Be Combined With Other Medications
Because biologics can prompt a significant response, one misconception is that they can’t be used with other medications. This incorrect assumption would mean you’d have to stop all other treatment — including some prescription topicals — and rely only on your biologic, says Dr. Evans.
8. Fact: You’ll Likely Take a Combined Medication Approach
The good news is that biologics play well with others, Evans says. That means if your biologic medication is mostly effective but not controlling symptoms entirely, it’s likely your dermatologist will consider adding other treatments for more relief.
“An atopic dermatitis management plan usually involves several components,” she says. “In addition to a biologic, if that’s being used, you may be prescribed a different topical ointment, or something like light therapy may be suggested. Lifestyle factors will also be considered with this.”
She says that a conversation about better atopic dermatitis management will also usually involve talking about reducing environmental triggers like dust or pet dander, as well as optimizing your bathing and moisturizing routine for better skin health.
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