The efficacy and safety of IL-13 inhibitors in atopic dermatitis: A systematic review and updated meta-analysis

Background: Therapeutic options for moderate-to-severe atopic dermatitis (AD) remain limited due to limited efficacy and long-term adverse effects. Interleukin-13 (IL-13) inhibitors represent a promising new targeted approach, requiring further evaluation of their efficacy and safety. This study evaluates the efficacy and safety of IL-13 inhibitors in moderate-to-severe AD. Methods: A search of PubMed, Medline, Clinicaltrials.gov, and Scopus (up to June 2025) identified randomized controlled trials and clinical trials of lebrikizumab, tralokinumab, and eblasakimab. Outcomes included clinical efficacy (EASI, POEM, IGA, BSA, DLQI, PROMIS, SCORAD, pruritus NRS, sleep disturbance) and safety. The analysis was performed using RevMan 5.4 (MD or OR, I² heterogeneity). PROSPERO registration: CRD420251043758. Results: Lebrikizumab demonstrated significant superiority over placebo (MD -2.79; 95% CI: -3.79 to -1.78; p = 0.00001; I² = 0%). It reduced affected body surface area (MD -26.86; p = 0.00002; I² = 97%) and pruritus severity (MD -26.19; p < 0.00001; I² = 27%). The effects on sleep and pediatric PROMIS scores were not significant. Conclusion: IL-13 inhibitors, including lebrikizumab and tralokinumab, appear effective in reducing AD burden and improving quality of life, but longer-term studies are needed.