Dupilumab, Tralokinumab Supported by Review of Nummular Eczema Treatments
Key Takeaways
- A systematic review identified 10 studies evaluating biologics and small-molecule inhibitors for nummular eczema (NE).
- Evidence provided grade B support for dupilumab and tralokinumab and grade C support for roflumilast and delgocitinib.
- The authors found grade B evidence against apremilast and called for randomized controlled trials to better define treatment strategies.
A new systematic review found evidence supporting several biologic and small-molecule treatment options for nummular eczema despite a lack of FDA-approved therapies.
Dupilumab, Tralokinumab Show Strongest Evidence for Nummular Eczema
Researchers conducted a systematic review of biologics and small-molecule inhibitors for NE, a chronic pruritic dermatitis associated with substantial patient burden. The investigators searched PubMed, Embase, and the Cochrane Library for English-language human clinical studies and case reports. Among 219 records identified, 10 met the review’s inclusion criteria. Dupilumab and tralokinumab received grade B recommendations supporting their use in NE. The review found grade C evidence supporting roflumilast and delgocitinib in selected cases. Apremilast received a grade B recommendation against its use for NE.
The available evidence remains limited by the small number of eligible studies, and the authors emphasized the need for randomized controlled trials to establish optimal treatment approaches.
“Current evidence supports dupilumab and tralokinumab for the treatment of NE,” the authors wrote. “Roflumilast and delgocitinib should be reserved for selected cases, and apremilast is not recommended. Randomized controlled trials are needed to establish optimal treatment for patients with NE.”
Source
Joerg L, et al. Journal of Drugs in Dermatology. 2026. 25(10):9756.