Jonathan Silverberg, MD, PhD: How to Help Manage Autoimmune Comorbidities of Atopic Dermatitis

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In an interview at RAD 2024, Silverberg discusses ways to help patients navigate such comorbidities associated with eczema.

During this interview with the HCPLive editorial team, Jonathan Silverberg, MD, PhD, MPH, the director of clinical research at George Washington University’s School of Medicine and Health Sciences, spoke on the biggest takeaways from his talk ‘Two for one: managing autoimmune comorbidities of atopic dermatitis.’

This talk by Silverberg was presented at the Revolutionizing Atopic Dermatitis (RAD) 2024 Annual Meeting in Chicago, Illinois. In his discussion with HCPLive, Silverberg spoke on some highlights from his talk.

“This is an area that I think is often completely underappreciated or under-recognized in the clinical world, because we're so used to thinking about the atopic comorbidities: asthma, hay fever, the food allergies, etc,” Silverberg said. “But we've got a wealth of data that has shown that there's also increased risk, for a variety of different autoimmune disorders, including inflammatory bowel disease, Crohn's disease, ulcerative colitis…I covered a number of the studies that demonstrated that epidemiologic link between atopic dermatitis and the autoimmune comorbidities, but I also address some of the therapeutic relevance around this.”

Silverberg noted that dermatologists are currently in an era of what he describes as precision medicine, during which clinicians are attempting to match targeted therapies to the right individual disorders and patients.

“What do you do when you've got a patient who's got mixed immune signaling, so to speak?” Silverberg explained. “Where they've got systemic activation or activation in different organ systems of both Th2 and Th1, or Th2 and Th17. Do we consider doing 2 biologics in the same patient? Do we go with broader treatment options? How do we navigate that? I covered a lot of those different treatment considerations, which are really very clinical ones in these clinical scenarios.”

Silverberg was also asked to comment on any specific data he highlights in his presentation at RAD 2024.

“I think there's some fascinating data that that I touched upon showing that for dupilumab, for example…patients have increased incidence of Th17-mediated disorders as adverse events,” Silverberg said. “So when I have a patient who has both atopic dermatitis plus rheumatoid arthritis, it becomes a complicated situation to navigate and there isn't a one size fits all solution.”

Silverberg noted that if clinicians are concerned about the potential for developing some of those Th17-mediated disorders, then it may be worth considering the use of a combination therapy to address or potentially considering a JAK-inhibitor.

For additional information on this presentation, view the interview posted above.

The quotes contained in this summary were edited for clarity.

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