REVIEW article
Front. Drug Discov.
Sec. Dermatologic Drugs
Bispecific and Trispecific Antibodies in Atopic Dermatitis: A Review of the Emerging Clinical Pipeline
Gili Amid-Toby 1
Omar Alani 2
Christopher G Bunick 3
1. University of Miami Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami, United States
2. Icahn School of Medicine at Mount Sinai, New York, United States
3. Yale School of Medicine Department of Dermatology, New Haven, United States
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Abstract
Biologic therapies have reshaped treatment of atopic dermatitis, yet most available agents target only one cytokine or receptor and many patients still do not reach minimal disease activity. Data from real world practice shows that most individuals treated with current monospecific biologics fail to achieve Eczema Area and Severity Index 90 (EASI 90), clear or almost clear global assessments, or itch scores of 0 or 1. Janus kinase inhibitors reach higher clearance and itch targets because they concurrently block multiple cytokine pathways, exposing an efficacy gap and prompting development of multi-specific biologics. This review links atopic dermatitis endotypes and neuroimmune itch pathways to emerging multi target designs and provides a focused overview of the growing pipeline of bispecific and trispecific antibodies, nanobody constructs, and antibody cocktails. Agents discussed inlcude NM26-2198 (JNJ-5939), PX128, PX130, ZL-1503, BBT001, ATTO-002, PF-07264660, PF-07275315, GB12-09, APG279 (APG777+APG990), Galvokimig (UCB9741), Donzakimig (UCB1381), TRIV-509, TRIV-573, SAR443765 (Lunsekimig), CM512, ATI-052, and ZW1572. Early clinical data suggests the potential for faster improvement, reliable itch control, and longer dosing intervals. This review aims to highlight the potential for shifting treatment options in atopic dermatitis.
Summary
Keywords
atopic dermatitis, biologics, Multispecific antibodies, neuroimmune pathways, Pruritus
Received
11 December 2025
Accepted
18 February 2026
Copyright
© 2026 Amid-Toby, Alani and Bunick. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Christopher G Bunick
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.