Dupilumab (anti-IL-4Rα) has been approved for atopic dermatitis with good patient outcomes. However, the effect on inhibiting pruritus is moderate, and more than 50% of patients require improved treatment options. Nemolizumab, which blocks the IL-31/IL-31RA pathway, inhibits pruritus through a direct pathway on sensory nerves, which results in a rapid and robust onset of activity in patients with a reduction of itching and improvement of sleep quality. PM1268 is a bispecific antibody with Fc-silencing and half-life extension, which targets IL-4Rα and IL-31 simultaneously. This design provides a faster onset of efficacy and a potentially larger effect through the concomitant modulation of both pathways.