Article

Key clinical point: Dupilumab + low-potency topical corticosteroids (TCS) led to rapid and sustained improvement in disease severity in all anatomical regions (head and neck, trunk, upper extremities, and lower extremities) in children with moderate-to-severe atopic dermatitis (AD).

Major finding: The dupilumab + TCS vs placebo + TCS group had a significant improvement in least-squares mean Eczema Area and Severity Index scores in all 4 anatomical regions by week 2 (all P < .0001) that sustained throughout the 16-week treatment.

Study details: This post hoc analysis of the LIBERTY AD PRESCHOOL trial included 162 children (age, 6 months-5 years) with moderate-to-severe AD who were randomly assigned to receive dupilumab + low-potency TCS or placebo + low-potency TCS every 4 weeks.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. Five authors declared being employees or stockholders of Sanofi/Regeneron. The rest declared serving as consultants, investigators, speakers, or advisory board members for and receiving grants or personal fees from various sources, including Sanofi and Regeneron.

Source: Siegfried EC et al. Dupilumab treatment leads to rapid and consistent improvement of atopic dermatitis in all anatomical regions in patients aged 6 months to 5 years. Dermatol Ther (Heidelb). 2023 (Jul 22). doi: 10.1007/s13555-023-00960-w

Key clinical point: Dupilumab + low-potency topical corticosteroids (TCS) led to rapid and sustained improvement in disease severity in all anatomical regions (head and neck, trunk, upper extremities, and lower extremities) in children with moderate-to-severe atopic dermatitis (AD).

Major finding: The dupilumab + TCS vs placebo + TCS group had a significant improvement in least-squares mean Eczema Area and Severity Index scores in all 4 anatomical regions by week 2 (all P < .0001) that sustained throughout the 16-week treatment.

Study details: This post hoc analysis of the LIBERTY AD PRESCHOOL trial included 162 children (age, 6 months-5 years) with moderate-to-severe AD who were randomly assigned to receive dupilumab + low-potency TCS or placebo + low-potency TCS every 4 weeks.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. Five authors declared being employees or stockholders of Sanofi/Regeneron. The rest declared serving as consultants, investigators, speakers, or advisory board members for and receiving grants or personal fees from various sources, including Sanofi and Regeneron.

Source: Siegfried EC et al. Dupilumab treatment leads to rapid and consistent improvement of atopic dermatitis in all anatomical regions in patients aged 6 months to 5 years. Dermatol Ther (Heidelb). 2023 (Jul 22). doi: 10.1007/s13555-023-00960-w

Key clinical point: Dupilumab + low-potency topical corticosteroids (TCS) led to rapid and sustained improvement in disease severity in all anatomical regions (head and neck, trunk, upper extremities, and lower extremities) in children with moderate-to-severe atopic dermatitis (AD).

Major finding: The dupilumab + TCS vs placebo + TCS group had a significant improvement in least-squares mean Eczema Area and Severity Index scores in all 4 anatomical regions by week 2 (all P < .0001) that sustained throughout the 16-week treatment.

Study details: This post hoc analysis of the LIBERTY AD PRESCHOOL trial included 162 children (age, 6 months-5 years) with moderate-to-severe AD who were randomly assigned to receive dupilumab + low-potency TCS or placebo + low-potency TCS every 4 weeks.

Disclosures: This study was funded by Sanofi and Regeneron Pharmaceuticals, Inc. Five authors declared being employees or stockholders of Sanofi/Regeneron. The rest declared serving as consultants, investigators, speakers, or advisory board members for and receiving grants or personal fees from various sources, including Sanofi and Regeneron.

Source: Siegfried EC et al. Dupilumab treatment leads to rapid and consistent improvement of atopic dermatitis in all anatomical regions in patients aged 6 months to 5 years. Dermatol Ther (Heidelb). 2023 (Jul 22). doi: 10.1007/s13555-023-00960-w

Key clinical point: Emollient bathing at 2 months is significantly associated with the development of atopic dermatitis (AD) by 2 years of age.

Major finding: The odds of developing AD were significantly higher among infants who had emollient baths and frequent (> 1 time weekly) emollient application at 2 months of age compared with infants who had neither at 6 months (adjusted odds ratio [aOR] 1.74; P =  .038), 12 months (aOR 2.59; P < .001), and 24 months (aOR 1.87; P = .009) of age.

Study details: Findings are from a secondary analysis of the observational Cork BASELINE Birth Cohort Study and included 1505 healthy firstborn term infants who did or did not receive emollient baths and did or did not have emollients applied frequently at 2 months of age.

Disclosures: This study was supported by the Science Foundation Ireland and Johnson & Johnson Santé Beauté France. J O’B Hourihane declared receiving research funding, speaker fees, and consulting fees from various sources.

Source: O'Connor C et al. Early emollient bathing is associated with subsequent atopic dermatitis in an unselected birth cohort study. Pediatr Allergy Immunol. 2023;34(7):e13998 (Jul 18). doi: 10.1111/pai.13998

Key clinical point: Emollient bathing at 2 months is significantly associated with the development of atopic dermatitis (AD) by 2 years of age.

Major finding: The odds of developing AD were significantly higher among infants who had emollient baths and frequent (> 1 time weekly) emollient application at 2 months of age compared with infants who had neither at 6 months (adjusted odds ratio [aOR] 1.74; P =  .038), 12 months (aOR 2.59; P < .001), and 24 months (aOR 1.87; P = .009) of age.

Study details: Findings are from a secondary analysis of the observational Cork BASELINE Birth Cohort Study and included 1505 healthy firstborn term infants who did or did not receive emollient baths and did or did not have emollients applied frequently at 2 months of age.

Disclosures: This study was supported by the Science Foundation Ireland and Johnson & Johnson Santé Beauté France. J O’B Hourihane declared receiving research funding, speaker fees, and consulting fees from various sources.

Source: O'Connor C et al. Early emollient bathing is associated with subsequent atopic dermatitis in an unselected birth cohort study. Pediatr Allergy Immunol. 2023;34(7):e13998 (Jul 18). doi: 10.1111/pai.13998

Key clinical point: Emollient bathing at 2 months is significantly associated with the development of atopic dermatitis (AD) by 2 years of age.

Major finding: The odds of developing AD were significantly higher among infants who had emollient baths and frequent (> 1 time weekly) emollient application at 2 months of age compared with infants who had neither at 6 months (adjusted odds ratio [aOR] 1.74; P =  .038), 12 months (aOR 2.59; P < .001), and 24 months (aOR 1.87; P = .009) of age.

Study details: Findings are from a secondary analysis of the observational Cork BASELINE Birth Cohort Study and included 1505 healthy firstborn term infants who did or did not receive emollient baths and did or did not have emollients applied frequently at 2 months of age.

Disclosures: This study was supported by the Science Foundation Ireland and Johnson & Johnson Santé Beauté France. J O’B Hourihane declared receiving research funding, speaker fees, and consulting fees from various sources.

Source: O'Connor C et al. Early emollient bathing is associated with subsequent atopic dermatitis in an unselected birth cohort study. Pediatr Allergy Immunol. 2023;34(7):e13998 (Jul 18). doi: 10.1111/pai.13998

Key clinical point: The likelihood of using cannabis was significantly higher, whereas that of using e-cigarettes and regular cigarettes was significantly lower, in patients with atopic dermatitis (AD).

Major finding: Patients with AD vs control individuals without AD were significantly more likely to use cannabis (adjusted odds ratio [aOR] 1.49; P < .01) but less likely to use e-cigarettes (aOR 0.71; P < .01) and regular cigarettes (aOR 0.65; P < .01). No significant association was observed between AD and hallucinogen (P = .60), opioid (P = .07), and stimulant (P = .20) use.

Study details: This nested case-control study included 13,756 patients with AD and 55,024 age-, race/ethnicity-, and sex-matched control individuals without AD.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Joshi TP et al. Association of atopic dermatitis with substance use disorders: A case-control study in the All of Us Research Program. J Am Acad Dermatol. 2023 (Jul 13). doi: 10.1016/j.jaad.2023.06.051

Key clinical point: The likelihood of using cannabis was significantly higher, whereas that of using e-cigarettes and regular cigarettes was significantly lower, in patients with atopic dermatitis (AD).

Major finding: Patients with AD vs control individuals without AD were significantly more likely to use cannabis (adjusted odds ratio [aOR] 1.49; P < .01) but less likely to use e-cigarettes (aOR 0.71; P < .01) and regular cigarettes (aOR 0.65; P < .01). No significant association was observed between AD and hallucinogen (P = .60), opioid (P = .07), and stimulant (P = .20) use.

Study details: This nested case-control study included 13,756 patients with AD and 55,024 age-, race/ethnicity-, and sex-matched control individuals without AD.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Joshi TP et al. Association of atopic dermatitis with substance use disorders: A case-control study in the All of Us Research Program. J Am Acad Dermatol. 2023 (Jul 13). doi: 10.1016/j.jaad.2023.06.051

Key clinical point: The likelihood of using cannabis was significantly higher, whereas that of using e-cigarettes and regular cigarettes was significantly lower, in patients with atopic dermatitis (AD).

Major finding: Patients with AD vs control individuals without AD were significantly more likely to use cannabis (adjusted odds ratio [aOR] 1.49; P < .01) but less likely to use e-cigarettes (aOR 0.71; P < .01) and regular cigarettes (aOR 0.65; P < .01). No significant association was observed between AD and hallucinogen (P = .60), opioid (P = .07), and stimulant (P = .20) use.

Study details: This nested case-control study included 13,756 patients with AD and 55,024 age-, race/ethnicity-, and sex-matched control individuals without AD.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Joshi TP et al. Association of atopic dermatitis with substance use disorders: A case-control study in the All of Us Research Program. J Am Acad Dermatol. 2023 (Jul 13). doi: 10.1016/j.jaad.2023.06.051

Key clinical point: Switching to abrocitinib after failing to respond to other Janus kinase inhibitors (JAKs) or biologics improved clinical outcomes in patients with moderate-to-severe atopic dermatitis (AD), without compromising safety.

Major finding: At a median follow-up of 28 weeks, abrocitinib led to a significant decrease in median Eczema Area and Severity Index and Investigator’s Global Assessment scores (both P < .0001). At least one adverse event, generally mild, occurred in 60.9% of patients.

Study details: This prospective observational study included 41 adult patients with moderate-to-severe AD previously treated with conventional immunosuppressants, targeted therapies, or both, with most having failed to respond with biologics or other JAKi; the patients received 100 mg or 200 mg abrocitinib once daily.

Disclosures: This study did not receive any funding. D Hijnen declared serving as an investigator and consultant for various organizations. The other authors declared no conflicts of interest.

Source: Olydam JI et al. Real-world effectiveness of abrocitinib treatment in patients with difficult-to-treat atopic dermatitis. J Eur Acad Dermatol Venereol. 2023 (Jul 21). doi: 10.1111/jdv.19378

Key clinical point: Switching to abrocitinib after failing to respond to other Janus kinase inhibitors (JAKs) or biologics improved clinical outcomes in patients with moderate-to-severe atopic dermatitis (AD), without compromising safety.

Major finding: At a median follow-up of 28 weeks, abrocitinib led to a significant decrease in median Eczema Area and Severity Index and Investigator’s Global Assessment scores (both P < .0001). At least one adverse event, generally mild, occurred in 60.9% of patients.

Study details: This prospective observational study included 41 adult patients with moderate-to-severe AD previously treated with conventional immunosuppressants, targeted therapies, or both, with most having failed to respond with biologics or other JAKi; the patients received 100 mg or 200 mg abrocitinib once daily.

Disclosures: This study did not receive any funding. D Hijnen declared serving as an investigator and consultant for various organizations. The other authors declared no conflicts of interest.

Source: Olydam JI et al. Real-world effectiveness of abrocitinib treatment in patients with difficult-to-treat atopic dermatitis. J Eur Acad Dermatol Venereol. 2023 (Jul 21). doi: 10.1111/jdv.19378

Key clinical point: Switching to abrocitinib after failing to respond to other Janus kinase inhibitors (JAKs) or biologics improved clinical outcomes in patients with moderate-to-severe atopic dermatitis (AD), without compromising safety.

Major finding: At a median follow-up of 28 weeks, abrocitinib led to a significant decrease in median Eczema Area and Severity Index and Investigator’s Global Assessment scores (both P < .0001). At least one adverse event, generally mild, occurred in 60.9% of patients.

Study details: This prospective observational study included 41 adult patients with moderate-to-severe AD previously treated with conventional immunosuppressants, targeted therapies, or both, with most having failed to respond with biologics or other JAKi; the patients received 100 mg or 200 mg abrocitinib once daily.

Disclosures: This study did not receive any funding. D Hijnen declared serving as an investigator and consultant for various organizations. The other authors declared no conflicts of interest.

Source: Olydam JI et al. Real-world effectiveness of abrocitinib treatment in patients with difficult-to-treat atopic dermatitis. J Eur Acad Dermatol Venereol. 2023 (Jul 21). doi: 10.1111/jdv.19378

Key clinical point: Interruption of upadacitinib treatment caused rapid loss of skin clearance response and upadacitinib retreatment led to rapid recovery or improvement in the response in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A dose of 30 mg upadacitinib vs placebo led to a 72.9% least-squares mean percentage improvement in the Eczema Area and Severity Index (EASI) score by week 16, which decreased to 24.6% within 4 weeks of upadacitinib withdrawal; however, an 8-week rescue therapy (30 mg upadacitinib) improved the mean percentage EASI score (pre- vs post-therapy: 2.8% vs 84.7%).

Study details: This post hoc analysis of a phase 2b study included 167 patients with moderate-to-severe AD who were randomly assigned to receive upadacitinib (7.5, 15, or 30 mg) or placebo; at week 16, each group was reassigned to receive upadacitinib (same dose) or placebo, with rescue therapy (30 mg upadacitinib) initiated in those with < 50% EASI response at week 20.

Disclosures: This study was sponsored by AbbVie, Inc. Six authors declared being employees of or holding stock or stock options in AbbVie. Several authors reported ties with AbbVie and others.

Source: Guttman-Yassky E et al. Upadacitinib treatment withdrawal and retreatment in patients with moderate-to-severe atopic dermatitis: Results from a phase 2b, randomized, controlled trial. J Eur Acad Dermatol Venereol. 2023 (Aug 1). doi: 10.1111/jdv.19391

Key clinical point: Interruption of upadacitinib treatment caused rapid loss of skin clearance response and upadacitinib retreatment led to rapid recovery or improvement in the response in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A dose of 30 mg upadacitinib vs placebo led to a 72.9% least-squares mean percentage improvement in the Eczema Area and Severity Index (EASI) score by week 16, which decreased to 24.6% within 4 weeks of upadacitinib withdrawal; however, an 8-week rescue therapy (30 mg upadacitinib) improved the mean percentage EASI score (pre- vs post-therapy: 2.8% vs 84.7%).

Study details: This post hoc analysis of a phase 2b study included 167 patients with moderate-to-severe AD who were randomly assigned to receive upadacitinib (7.5, 15, or 30 mg) or placebo; at week 16, each group was reassigned to receive upadacitinib (same dose) or placebo, with rescue therapy (30 mg upadacitinib) initiated in those with < 50% EASI response at week 20.

Disclosures: This study was sponsored by AbbVie, Inc. Six authors declared being employees of or holding stock or stock options in AbbVie. Several authors reported ties with AbbVie and others.

Source: Guttman-Yassky E et al. Upadacitinib treatment withdrawal and retreatment in patients with moderate-to-severe atopic dermatitis: Results from a phase 2b, randomized, controlled trial. J Eur Acad Dermatol Venereol. 2023 (Aug 1). doi: 10.1111/jdv.19391

Key clinical point: Interruption of upadacitinib treatment caused rapid loss of skin clearance response and upadacitinib retreatment led to rapid recovery or improvement in the response in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A dose of 30 mg upadacitinib vs placebo led to a 72.9% least-squares mean percentage improvement in the Eczema Area and Severity Index (EASI) score by week 16, which decreased to 24.6% within 4 weeks of upadacitinib withdrawal; however, an 8-week rescue therapy (30 mg upadacitinib) improved the mean percentage EASI score (pre- vs post-therapy: 2.8% vs 84.7%).

Study details: This post hoc analysis of a phase 2b study included 167 patients with moderate-to-severe AD who were randomly assigned to receive upadacitinib (7.5, 15, or 30 mg) or placebo; at week 16, each group was reassigned to receive upadacitinib (same dose) or placebo, with rescue therapy (30 mg upadacitinib) initiated in those with < 50% EASI response at week 20.

Disclosures: This study was sponsored by AbbVie, Inc. Six authors declared being employees of or holding stock or stock options in AbbVie. Several authors reported ties with AbbVie and others.

Source: Guttman-Yassky E et al. Upadacitinib treatment withdrawal and retreatment in patients with moderate-to-severe atopic dermatitis: Results from a phase 2b, randomized, controlled trial. J Eur Acad Dermatol Venereol. 2023 (Aug 1). doi: 10.1111/jdv.19391

Key clinical point: Amlitelimab is well-tolerated and improves disease signs and symptoms in patients with moderate-to-severe atopic dermatitis (AD) that is inadequately controlled by topical therapies.

Major finding: At week 16, the least-squares mean percentage change in Eczema Area and Severity Index score was significantly higher in low-dose (−80.12%; P = .009) and high-dose (−69.97%; P = .072) amlitelimab groups vs the placebo group (−49.37%). Overall, 62%, 47%, and 69% of patients reported ≥1 treatment-emergent adverse events with low- and high-dose amlitelimab and placebo groups, respectively.

Study details: This phase 2a study included 88 adult patients with moderate-to-severe AD and inadequate response to or inadvisability of topical treatments who were randomly assigned to receive low-dose (200 mg) or high-dose (500 mg) amlitelimab or placebo, followed by maintenance doses every 4 weeks.

Disclosures: This study was funded by Kymab Ltd., a Sanofi company. Some authors declared receiving research grants or consultancy fees or other ties with various sources, including Kymab and Sanofi. Six authors declared being employees or stockholders of Kymab or Sanofi.

Source: Weidinger S et al. Safety and efficacy of amlitelimab, a fully human, non-depleting, non-cytotoxic anti-OX40Ligand monoclonal antibody, in atopic dermatitis: Results of a phase IIa randomised placebo-controlled trial. Br J Dermatol. 2023 (Jul 18). doi: 10.1093/bjd/ljad240

Key clinical point: Amlitelimab is well-tolerated and improves disease signs and symptoms in patients with moderate-to-severe atopic dermatitis (AD) that is inadequately controlled by topical therapies.

Major finding: At week 16, the least-squares mean percentage change in Eczema Area and Severity Index score was significantly higher in low-dose (−80.12%; P = .009) and high-dose (−69.97%; P = .072) amlitelimab groups vs the placebo group (−49.37%). Overall, 62%, 47%, and 69% of patients reported ≥1 treatment-emergent adverse events with low- and high-dose amlitelimab and placebo groups, respectively.

Study details: This phase 2a study included 88 adult patients with moderate-to-severe AD and inadequate response to or inadvisability of topical treatments who were randomly assigned to receive low-dose (200 mg) or high-dose (500 mg) amlitelimab or placebo, followed by maintenance doses every 4 weeks.

Disclosures: This study was funded by Kymab Ltd., a Sanofi company. Some authors declared receiving research grants or consultancy fees or other ties with various sources, including Kymab and Sanofi. Six authors declared being employees or stockholders of Kymab or Sanofi.

Source: Weidinger S et al. Safety and efficacy of amlitelimab, a fully human, non-depleting, non-cytotoxic anti-OX40Ligand monoclonal antibody, in atopic dermatitis: Results of a phase IIa randomised placebo-controlled trial. Br J Dermatol. 2023 (Jul 18). doi: 10.1093/bjd/ljad240

Key clinical point: Amlitelimab is well-tolerated and improves disease signs and symptoms in patients with moderate-to-severe atopic dermatitis (AD) that is inadequately controlled by topical therapies.

Major finding: At week 16, the least-squares mean percentage change in Eczema Area and Severity Index score was significantly higher in low-dose (−80.12%; P = .009) and high-dose (−69.97%; P = .072) amlitelimab groups vs the placebo group (−49.37%). Overall, 62%, 47%, and 69% of patients reported ≥1 treatment-emergent adverse events with low- and high-dose amlitelimab and placebo groups, respectively.

Study details: This phase 2a study included 88 adult patients with moderate-to-severe AD and inadequate response to or inadvisability of topical treatments who were randomly assigned to receive low-dose (200 mg) or high-dose (500 mg) amlitelimab or placebo, followed by maintenance doses every 4 weeks.

Disclosures: This study was funded by Kymab Ltd., a Sanofi company. Some authors declared receiving research grants or consultancy fees or other ties with various sources, including Kymab and Sanofi. Six authors declared being employees or stockholders of Kymab or Sanofi.

Source: Weidinger S et al. Safety and efficacy of amlitelimab, a fully human, non-depleting, non-cytotoxic anti-OX40Ligand monoclonal antibody, in atopic dermatitis: Results of a phase IIa randomised placebo-controlled trial. Br J Dermatol. 2023 (Jul 18). doi: 10.1093/bjd/ljad240

Key clinical point: Nemolizumab is safe and effectively reduces pruritus in pediatric patients with atopic dermatitis (AD) whose pruritus has not been sufficiently improved with topical corticosteroids/calcineurin inhibitors or antihistamines.

Major finding: At week 16, the nemolizumab vs placebo group had a significantly greater improvement in the weekly mean 5-level itch score (−1.3 vs −0.5; P < .0001), with a significantly higher proportion of patients achieving a weekly mean 5-level itch score ≤ 1 (24.4% vs 2.3%; P = .0035). Most adverse events were mild in severity and none led to treatment discontinuation or death.

Study details: Findings are a from multicenter phase 3 study including patients age 6-12 years with AD and inadequately controlled moderate-to-severe pruritus who were randomly assigned to receive nemolizumab (n = 45) or placebo (n = 44) with concomitant topical agents.

Disclosures: This study was sponsored by Maruho Co. Ltd., Osaka, Japan. Two authors declared receiving grants and honoraria from various sources, including Maruho, and other two authors declared being employees of Maruho.

Source: Igarashi A et al. Efficacy and safety of nemolizumab in paediatric patients aged 6-12 years with atopic dermatitis with moderate-to-severe pruritus: Results from a phase III, randomised, double-blind, placebo-controlled, multicentre study. Br J Dermatol. 2023 (Jul 31). doi: 10.1093/bjd/ljad268

Key clinical point: Nemolizumab is safe and effectively reduces pruritus in pediatric patients with atopic dermatitis (AD) whose pruritus has not been sufficiently improved with topical corticosteroids/calcineurin inhibitors or antihistamines.

Major finding: At week 16, the nemolizumab vs placebo group had a significantly greater improvement in the weekly mean 5-level itch score (−1.3 vs −0.5; P < .0001), with a significantly higher proportion of patients achieving a weekly mean 5-level itch score ≤ 1 (24.4% vs 2.3%; P = .0035). Most adverse events were mild in severity and none led to treatment discontinuation or death.

Study details: Findings are a from multicenter phase 3 study including patients age 6-12 years with AD and inadequately controlled moderate-to-severe pruritus who were randomly assigned to receive nemolizumab (n = 45) or placebo (n = 44) with concomitant topical agents.

Disclosures: This study was sponsored by Maruho Co. Ltd., Osaka, Japan. Two authors declared receiving grants and honoraria from various sources, including Maruho, and other two authors declared being employees of Maruho.

Source: Igarashi A et al. Efficacy and safety of nemolizumab in paediatric patients aged 6-12 years with atopic dermatitis with moderate-to-severe pruritus: Results from a phase III, randomised, double-blind, placebo-controlled, multicentre study. Br J Dermatol. 2023 (Jul 31). doi: 10.1093/bjd/ljad268

Key clinical point: Nemolizumab is safe and effectively reduces pruritus in pediatric patients with atopic dermatitis (AD) whose pruritus has not been sufficiently improved with topical corticosteroids/calcineurin inhibitors or antihistamines.

Major finding: At week 16, the nemolizumab vs placebo group had a significantly greater improvement in the weekly mean 5-level itch score (−1.3 vs −0.5; P < .0001), with a significantly higher proportion of patients achieving a weekly mean 5-level itch score ≤ 1 (24.4% vs 2.3%; P = .0035). Most adverse events were mild in severity and none led to treatment discontinuation or death.

Study details: Findings are a from multicenter phase 3 study including patients age 6-12 years with AD and inadequately controlled moderate-to-severe pruritus who were randomly assigned to receive nemolizumab (n = 45) or placebo (n = 44) with concomitant topical agents.

Disclosures: This study was sponsored by Maruho Co. Ltd., Osaka, Japan. Two authors declared receiving grants and honoraria from various sources, including Maruho, and other two authors declared being employees of Maruho.

Source: Igarashi A et al. Efficacy and safety of nemolizumab in paediatric patients aged 6-12 years with atopic dermatitis with moderate-to-severe pruritus: Results from a phase III, randomised, double-blind, placebo-controlled, multicentre study. Br J Dermatol. 2023 (Jul 31). doi: 10.1093/bjd/ljad268

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Nonradiographic axial spondyloarthritis (nr-axSpA) is a chronic, immune-mediated, inflammatory disease characterized by active inflammation of the spine and the sacroiliac joints. There is no cure for nr-axSpA, although tumor necrosis factor inhibitors (TNFi) have been established as the recommended standard treatment. Nevertheless, a considerable portion of patients either have an inadequate response to TNFi or are intolerant of the side effects of these agents. 

Dr Eric Ruderman, of Northwestern University Feinberg School of Medicine, Chicago, Illinois, discusses treatment goals for patients with active nr-axSpA, which include symptom control, preservation of function, and suppression of symptoms that interfere with daily activities. He also highlights treatment options for patients who have an inadequate response to or are intolerant of TNFi therapy. These therapies include interleukin-17 inhibitors (IL-17i), ixekizumab and secukinumab, and the Janus kinase inhibitor (JAKi) upadacitinib. 

IL-17i therapy carries a lower risk for infection compared with TNFi but is contraindicated in patients with irritable bowel disease. Dr Ruderman also notes that IL-17i are administered by subcutaneous injection while JAKi are taken orally, and these factors may influence patient preference.

--

Eric M. Ruderman, MD, Professor, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; Associate Chief, Clinical Affairs, Department of Rheumatology, Northwestern Medical Group, Chicago, Illinois 

Eric M. Ruderman, MD, has disclosed the following relevant financial relationships: 

Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Amgen; Aurinia; Bristol Myers Squibb; Exagen; Janssen; Lilly; Novartis; Selecta 

Key clinical point: Severe obesity (body mass index [BMI] > 40 kg/m²) and postmenopausal status were associated with a significantly higher migraine frequency, with severe obesity also being associated with higher migraine severity.

Major finding: Migraine headache index scores (165.5 vs 105.5; P  =  .01) and the number of migraine headaches per month (P  =  .007) were significantly higher in patients with severe obesity vs those with healthy weight (BMI 18.5-24.9 kg/m²), with the number of migraine headaches per month being significantly higher among postmenopausal vs premenopausal women (mean 23 vs 19 days; P  =  .02).

Study details: Findings are from a retrospective cohort study including 223 patients with refractory migraine.

Disclosures: This study did not receive any specific funding. The authors declared no competing interests.

Source: Saffari TM et al. Severe obesity is associated with increased migraine severity and frequency: A retrospective cohort study. J Clin Neurosci. 2023;115:8-13 (Jul 14). doi: 10.1016/j.jocn.2023.07.007

Key clinical point: Severe obesity (body mass index [BMI] > 40 kg/m²) and postmenopausal status were associated with a significantly higher migraine frequency, with severe obesity also being associated with higher migraine severity.

Major finding: Migraine headache index scores (165.5 vs 105.5; P  =  .01) and the number of migraine headaches per month (P  =  .007) were significantly higher in patients with severe obesity vs those with healthy weight (BMI 18.5-24.9 kg/m²), with the number of migraine headaches per month being significantly higher among postmenopausal vs premenopausal women (mean 23 vs 19 days; P  =  .02).

Study details: Findings are from a retrospective cohort study including 223 patients with refractory migraine.

Disclosures: This study did not receive any specific funding. The authors declared no competing interests.

Source: Saffari TM et al. Severe obesity is associated with increased migraine severity and frequency: A retrospective cohort study. J Clin Neurosci. 2023;115:8-13 (Jul 14). doi: 10.1016/j.jocn.2023.07.007

Key clinical point: Severe obesity (body mass index [BMI] > 40 kg/m²) and postmenopausal status were associated with a significantly higher migraine frequency, with severe obesity also being associated with higher migraine severity.

Major finding: Migraine headache index scores (165.5 vs 105.5; P  =  .01) and the number of migraine headaches per month (P  =  .007) were significantly higher in patients with severe obesity vs those with healthy weight (BMI 18.5-24.9 kg/m²), with the number of migraine headaches per month being significantly higher among postmenopausal vs premenopausal women (mean 23 vs 19 days; P  =  .02).

Study details: Findings are from a retrospective cohort study including 223 patients with refractory migraine.

Disclosures: This study did not receive any specific funding. The authors declared no competing interests.

Source: Saffari TM et al. Severe obesity is associated with increased migraine severity and frequency: A retrospective cohort study. J Clin Neurosci. 2023;115:8-13 (Jul 14). doi: 10.1016/j.jocn.2023.07.007

Key clinical point: Higher dietary intake of zinc was negatively associated with the risk for migraine in adults, with the association being more prominent among those age 20-50 years.

Major finding: Compared with participants in the lowest quintile of dietary zinc consumption (≤ 5.93 mg/day), the risk for migraine was lower among those in the higher quintiles of dietary zinc consumption (5.94-8.38 mg/day: adjusted odds ratio [aOR] 0.73; P  =  .004; 8.39-11.26 mg/day: aOR 0.72; P  =  .02; and 11.27-15.75 mg/day: aOR 0.76; P  =  .04), with a non-linear association observed between zinc intake and migraine in the age 20-50 years group (P < .001).

Study details: This cross-sectional study included 9849 adult participants (age ≥ 20 years), of whom 1963 (19.93%) had migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China, Natural Science Foundation of Jiangxi Province, and Jiangxi Provincial Department of Education Science and Technology Program Project. No potential conflicts of interest were declared.

Source: Zheng H et al. Dietary zinc intake in relation to migraine among adults: A cross sectional study of NHANES 1999-2004. Nutr Neurosci. 2023 (Aug 4). doi: 10.1080/1028415X.2023.2243678

Key clinical point: Higher dietary intake of zinc was negatively associated with the risk for migraine in adults, with the association being more prominent among those age 20-50 years.

Major finding: Compared with participants in the lowest quintile of dietary zinc consumption (≤ 5.93 mg/day), the risk for migraine was lower among those in the higher quintiles of dietary zinc consumption (5.94-8.38 mg/day: adjusted odds ratio [aOR] 0.73; P  =  .004; 8.39-11.26 mg/day: aOR 0.72; P  =  .02; and 11.27-15.75 mg/day: aOR 0.76; P  =  .04), with a non-linear association observed between zinc intake and migraine in the age 20-50 years group (P < .001).

Study details: This cross-sectional study included 9849 adult participants (age ≥ 20 years), of whom 1963 (19.93%) had migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China, Natural Science Foundation of Jiangxi Province, and Jiangxi Provincial Department of Education Science and Technology Program Project. No potential conflicts of interest were declared.

Source: Zheng H et al. Dietary zinc intake in relation to migraine among adults: A cross sectional study of NHANES 1999-2004. Nutr Neurosci. 2023 (Aug 4). doi: 10.1080/1028415X.2023.2243678

Key clinical point: Higher dietary intake of zinc was negatively associated with the risk for migraine in adults, with the association being more prominent among those age 20-50 years.

Major finding: Compared with participants in the lowest quintile of dietary zinc consumption (≤ 5.93 mg/day), the risk for migraine was lower among those in the higher quintiles of dietary zinc consumption (5.94-8.38 mg/day: adjusted odds ratio [aOR] 0.73; P  =  .004; 8.39-11.26 mg/day: aOR 0.72; P  =  .02; and 11.27-15.75 mg/day: aOR 0.76; P  =  .04), with a non-linear association observed between zinc intake and migraine in the age 20-50 years group (P < .001).

Study details: This cross-sectional study included 9849 adult participants (age ≥ 20 years), of whom 1963 (19.93%) had migraine.

Disclosures: This study was supported by the National Natural Science Foundation of China, Natural Science Foundation of Jiangxi Province, and Jiangxi Provincial Department of Education Science and Technology Program Project. No potential conflicts of interest were declared.

Source: Zheng H et al. Dietary zinc intake in relation to migraine among adults: A cross sectional study of NHANES 1999-2004. Nutr Neurosci. 2023 (Aug 4). doi: 10.1080/1028415X.2023.2243678