Panelists discuss how the future of atopic dermatitis treatments is evolving with novel biologics, Janus kinase inhibitors, and precision medicine targeting immune pathways. Advances in gene therapy, microbiome modulation, and personalized treatments offer promising long-term management options.
Panelists discuss how shared decision-making in atopic dermatitis care involves collaboration between health care providers and patients, considering individual preferences, values, and treatment goals. This approach enhances treatment adherence and improves outcomes through personalized, informed choices.
Panelists discuss how standard first-line treatments for nonresponsive patients often include systemic therapies like corticosteroids or immunomodulators. Second-line options may involve biologics or advanced systemic agents. Patient input is crucial in tailoring treatments to preferences, needs, and risks.
Panelists discuss how the JADE EXTEND study (Shi 2022) found that most patients who achieved EASI-75 with dupilumab also responded to abrocitinib. Even some dupilumab nonresponders achieved EASI-75. Adverse events (AEs) included nausea, acne, and headache.
Panelists discuss how the JADE COMPARE study (Bieber 2021) found similar EASI-75 response rates at 16 weeks for abrocitinib (71.0% at 200 mg, 60.3% at 100 mg) and dupilumab (65.5%). Abrocitinib had more nausea/acne; dupilumab had more conjunctivitis. Adverse effect (AE) withdrawal rates were low.
Panelists discuss how the Measure Up 1 and 2 studies (Simpson 2022) showed that at 52 weeks, 82.0% to 84.9% of upadacitinib patients achieved EASI-75. Common adverse effects (AEs) included acne, cough, and headache, with 4.5% to 7.2% withdrawal rates.
Panelists discuss how Janus kinase (JAK) inhibitors such as upadacitinib, abrocitinib, and baricitinib offer rapid, oral treatment for moderate to severe atopic dermatitis, differing from injectable biologics in administration, broader immunosuppression, and risk of adverse events like thromboembolism. They provide effective symptom control but require safety monitoring.
Panelists discuss how the 2-year ECZTEND study found tralokinumab effective for atopic dermatitis, with 82.5% achieving EASI-75 and 59.8%, EASI-90. Common adverse effects (AEs) included upper respiratory tract infections, dermatitis, headache, and conjunctivitis. The treatment-emergent adverse event (TEAE) withdrawal rate was 1.6%.
Panelists discuss how The LIBERTY AD OLE study (Beck 2024) showed sustained efficacy of treatment in atopic dermatitis, with 96.9% achieving EASI-50; 88.9%, EASI-75; and 80.7%, EASI-90 over 260 weeks. Common adverse events (AEs) included nasopharyngitis, atopic dermatitis (AD) worsening, upper respiratory tract infections, herpes infections, and conjunctivitis. Treatment-emergent adverse event (TEAE)–related withdrawal was 3.8%.
Panelists discuss how common adverse effects impact treatment decisions, requiring adjustments. Experienced adverse reactions are managed with tailored interventions, monitoring, and patient education to ensure optimal care.
Panelists discuss how primary care awareness of biologics and Janus kinase (JAK) inhibitors for atopic dermatitis (AD) remain limited, with outreach efforts by dermatology groups and industry partners showing mixed success in education. While patients on biologics generally report significant symptom improvement, measured through validated tools like EASI, SCORAD, and patient-reported outcome measures, ongoing efforts are needed to bridge the knowledge gap in primary care settings.
Panelists discuss how the emergence of targeted biologics has revolutionized atopic dermatitis treatment by offering effective alternatives to traditional therapies. These agents, including IL-4/IL-13 inhibitors like dupilumab and others targeting specific inflammatory pathways, have provided new options for moderate to severe cases resistant to conventional treatments.
Panelists discuss how upcoming topical therapeutics for atopic dermatitis include corticosteroid-sparing treatments like topical calcineurin inhibitors (eg, tacrolimus, pimecrolimus), Janus kinase (JAK) inhibitors (eg, ruxolitinib), and phosphodiesterase-4 inhibitors (eg, crisaborole) for effective symptom management.
Panelists discuss how primary care physicians often serve as the first point of contact for patients with atopic dermatitis symptoms. Dermatologist referral is typically considered when patients show severe or persistent symptoms despite initial treatment, have unclear diagnosis, require specialized therapies, or experience significant impact on quality of life.
Panelists discuss how atopic dermatitis severity classification relies on multiple assessment tools including EASI, SCORAD, POEM, and BSA measurements. Special attention is given to sensitive areas (hands, feet, genitals) as they significantly impact quality of life. Disease extent, intensity of symptoms, and functional impairment guide categorization into mild, moderate, or severe cases.
Panelists discuss how they assess atopic dermatitis across all age groups by evaluating clinical history, symptom severity, and physical examination. They consider factors like age-specific presentations, comorbid conditions, and response to treatment for individualized management.
Panelists discuss how adult atopic dermatitis diagnosis relies on clinical presentation of chronic, pruritic, and eczematous lesions with characteristic distribution patterns. Unlike children, adults show more lichenified plaques and predominant hand/foot involvement. Key diagnostic criteria include personal/family history of atopy and chronic/relapsing course. No definitive test exists.
