Decoding Biological Drug Names in Dermatology: The Post-2022 WHO Nomenclature Revision and Its Implications for Clinical Practice.

Abstract

The WHO International Nonproprietary Names (INN) system for monoclonal antibodies underwent its most fundamental revision in 2021-2022, retiring the universal -mab suffix and replacing it with four structure-based stems (-tug, -bart, -ment, -mig). Simultaneously, new stems for JAK inhibitors (-citinib), BTK inhibitors (-brutinib), and oral peptide receptor antagonists (-kinra) have entered dermatological practice. These changes are not yet systematically addressed in dermatology education. Dermatologists prescribe the broadest range of biologic drug classes of any specialty, spanning anti-TNF, anti-interleukin, checkpoint inhibitor, JAK/TYK2/BTK inhibitor, and oral peptide antagonist therapies. This review provides a practical, disease-organized framework for decoding biological drug names, with a three-step algorithm, reference tables covering 26 approved agents, and guidance on biosimilar naming across FDA, EMA, and CDSCO systems. The post-2022 structural stems carry direct pharmacokinetic implications, and two currently used agents (sonelokimab and certolizumab pegol) are structurally misclassified under their legacy -mab names. Nomenclature literacy directly affects adverse event attribution, biosimilar substitution decisions, and pipeline evaluation. Understanding this evolving system is a patient safety competency for practicing dermatologists.