Current atopic dermatitis (AD) systemic therapies were ineffective and sometimes limited by safety issues. Biologics might fill a gap in the market for better Alzheimer’s treatments that have yet to be filled. For a study, researchers had to determine how effective and safe biologic medicines were in treating Alzheimer’s disease. A comprehensive review and meta-analysis of studies assessing Alzheimer’s disease patients treated with biologics were carried out. The Eczema Area and Severity Index (EASI)-75 reaction was the primary objective, with Scoring Atopic Dermatitis (SCORAD)-75, EASI-50, SCORAD-50, Investigator Global Assessment 0/1 responses, change in responses from baseline, and adverse events serving as secondary outcomes.

The researchers looked at nine biologics in 13 randomized controlled trials (RCTs) and ten observational studies. Dupilumab, nemolizumab, and ustekinumab each had high-quality data available. Dupilumab 300 mg every week to every two weeks achieved EASI-75 responses of 55%, superior to placebo [related risk (RR) 3.3, 95% CI 2.9–3.6], according to pooling of five trials [RR 3.3, 95% CI: 2.9–3.6]. Nemolizumab exhibited equal EASI-75 responses to placebo but alleviated pruritus considerably. In online reports, lebrikizumab outperformed placebo in terms of EASI-50 responses (RR 1.3, 95% CI 1.04–1.7), whereas tralokinumab outperformed placebo in terms of SCORAD-50 responses (RR 1.7, 95% CI 0.97–3.1). Omalizumab and ustekinumab were shown to be similar to placebo in two RCTs each, however anti thymic stromal lymphopoietin receptors, infliximab, and rituximab lacked sufficient evidence of effectiveness. All of the drugs exhibited the same level of safety as the placebo.

Dupilumab was the only biologic with strong evidence of effectiveness in Alzheimer’s disease. Although nemolizumab, lebrikizumab, and tralokinumab had shown promise, further research is needed. Their safety profile will be established through longer follow-up and bigger investigations.