The prevalence of AD is high, not only in the USA and Europe, but worldwide. An increased understanding of the genetic immune function abnormalities and pathogenesis of underlying AD provides researchers with opportunities to develop more targeted therapies. There is a need for long-term therapies that are safe and effective for chronic atopic dermatitis. Current research and ongoing phase 2 and 3 studies show many promising new agents with increased efficacy and reduced adverse effects, that can be used as monotherapy or as combination oral and topical treatments.
Phase 3 studies in children and adolescents with mild to moderate AD .
Crisaborole has demonstrated clinically significant efficacy in two multicenter, double-blind phase 3 studies in achieving primary endpoint of clear or almost clear skin, with a ≥2 grade improvement from baseline measures.
Reported adverse events (10.2%) included application site pain, and application site infection.
Dupilumab shows promise in the treatment of moderate to severe AD at week 16 through inhibition of IL-4 type 1 and 2 receptors .
This demonstrates the role of IL-4 in AD pathogenesis.
Studies demonstrate efficacy in change in Eczema Area and Severity Index (EASI) score and itch measures from baseline.
The safety profile demonstrated a risk of conjunctivitis (7-12%) and injection site reactions (10-20%).
Combination dupilumab and topical corticosteroids.
Dupilumab can be safely administered in combination with standard topical corticosteroids for the long-term management of moderate-to-severe AD (1 year); clinical studies demonstrate that the addition of topical steroids improves patient outcomes versus administration of dupilumab as monotherapy.
Tralokinumab targets the role of IL-13 in the pathogenesis of AD and has been proven safe and effective in reducing symptoms in phase 2b studies .
Patients with moderate-to-severe AD symptoms demonstrated a clinically significant improvement in EASI score and IGA response over baseline.
The most frequent AE reported was upper respiratory infection .
Nemolizumab targets IL-31 in the treatment of moderate-to-severe AD .
It is indicated for patients who have not achieved adequate control with topical corticosteroids.
Phase 2, randomized, placebo-controlled, double blind studies demonstrate long-term efficacy in EASI score improvement when injected subcutaneously every 4 weeks or every 8 weeks.
Nemolizumab overall was well tolerated.
The symptomatic role of itch in the EASI score is significant.
Tradipitant NK 1R antagonist is a new and emerging therapy for AD shown to reduce symptoms of itch and overall disease severity in phase 2 studies .
Guttman-Yassky E, Silverberg JI, Nemoto O, et al. Baricitinib in adult patients with moderate-to-severe atopic dermatitis: A phase 2 parallel, double-blinded, randomized placebo-controlled multiple-dose study. J Am Acad Dermatol. 2019;80(4):913-921.e919.
Peppers J, Paller AS, Maeda-Chubachi T, et al. A phase 2, randomized dose-finding study of tapinarof (GSK2894512 cream) for the treatment of atopic dermatitis. J Am Acad Dermatol. 2019;80(1):89-98.e83.
Presenter disclosure(s): The presenter has reported relationships with the following companies: Bickel Biotechnology; Celgene; Cutanea Life Sciences; Dermira; Facilitation of International Dermatology Education; Ferndale Laboratories, Inc.; Ferrer; Medimetriks Pharmaceuticals, Inc.; Novartis.
We are pleased to present highlights from the 2019 Annual Meeting of the American Academy of Dermatology (AAD). Our meeting was held from March 1 to March 5, 2019 in Washington, DC. The AAD conference … [ Read all ]