title: The use of biologicals in cutaneous allergies - present and future.
abstract: OBJECTIVE
  Up-to-date biologicals in cutaneous allergies play - unfortunately - only a minor role. However, this situation might change. Recently, omalizumab was licensed for chronic urticaria; this article reviews recent advances in the use of biologicals in cutaneous allergies.
  
  
  RESULTS
  Interestingly, the mechanism of omalizumab appears to be different in urticaria and allergic asthma for which the drug has been licensed previously. In urticaria dosage is not dependent on serum IgE-levels and response is seen very often after only 12 h. Other indications in cutaneous allergy in which biologicals have been investigated, at least in case reports or small studies, are TNF-α-antagonists and rituximab in chronic urticaria, omalizumab, rituximab and TNF-α-antagonists in atopic dermatitis as well as mepolizumab in this disease. However, all these studies appear to show a benefit for individual patients but not a clear breakthrough for the whole group of patients involved. This, however, might also be one of the future approaches that sub-groups of patients who have different responses to biologicals may be identified, as apparently different cytokine patterns are predominantly involved in the individual patient.
  
  
  CONCLUSIONS
  In conclusion, although currently only one biological is approved in chronic urticaria, there is hope that a rapid better understanding of individual disease factors will support the development of other novel drugs in this field.
authors.affiliation: aAllergy Unit 'D. Kalogeromitros' b2nd Dpt. Of Dermatology and Venereology, University of Athens Medical School, University General Hospital 'Attikon', Athens, Greece cDpt. of Dermatology and Allergy, Allergy Centre Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Makris
authors.forename: Evangelia
authors.initials: E
authors.lastname: Papadavid
authors.forename: Torsten
authors.initials: T
authors.lastname: Zuberbier
mesh_terms: D000818:Animals; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001249:Asthma / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use*; D001691:Biological Therapy; D003876:Dermatitis, Atopic / Q000628:therapy*; D055808:Drug Discovery; D006801:Humans; D000069444:Omalizumab; D057285:Precision Medicine; D000069283:Rituximab; D012867:Skin / Q000187:drug effects / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014581:Urticaria / Q000628:therapy*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D001688:Biological Products; D014409:Tumor Necrosis Factor-alpha; D000069444:Omalizumab; D000069283:Rituximab