Clinical Edge Journal Scan

Key clinical point: Abrocitinib improved signs of atopic dermatitis (AD) rapidly and consistently in difficult-to-treat or cosmetically important anatomical regions, such as the head and neck area.

Major finding: Eczema Area and Severity Index (EASI) score of the head and neck region improved significantly as early as at 2 weeks with 200 mg abrocitinib (least square mean % change from baseline [Δ] 52.5%) and 100 mg abrocitinib (Δ 47.8%) vs. placebo (0.1%; both P < .0001) and improvements were sustained up to 16 weeks (both P ≤ .0002).

Study details: Findings are from a post hoc analysis of the phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 16 weeks of treatment with 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, all with background topical therapy.

Disclosures: This study was funded by Pfizer Inc. Five authors declared being current/former employees and shareholders of Pfizer and other authors reported ties with various sources, including Pfizer.

Source: Alexis A et al. Rapidity of improvement in signs/symptoms of moderate-to-severe atopic dermatitis by body region with abrocitinib in the phase 3 JADE COMPARE study. Dermatol Ther (Heidelb). 2022;12:771-785 (Mar 17). Doi: 10.1007/s13555-022-00694-1

Key clinical point: Abrocitinib improved signs of atopic dermatitis (AD) rapidly and consistently in difficult-to-treat or cosmetically important anatomical regions, such as the head and neck area.

Major finding: Eczema Area and Severity Index (EASI) score of the head and neck region improved significantly as early as at 2 weeks with 200 mg abrocitinib (least square mean % change from baseline [Δ] 52.5%) and 100 mg abrocitinib (Δ 47.8%) vs. placebo (0.1%; both P < .0001) and improvements were sustained up to 16 weeks (both P ≤ .0002).

Study details: Findings are from a post hoc analysis of the phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 16 weeks of treatment with 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, all with background topical therapy.

Disclosures: This study was funded by Pfizer Inc. Five authors declared being current/former employees and shareholders of Pfizer and other authors reported ties with various sources, including Pfizer.

Source: Alexis A et al. Rapidity of improvement in signs/symptoms of moderate-to-severe atopic dermatitis by body region with abrocitinib in the phase 3 JADE COMPARE study. Dermatol Ther (Heidelb). 2022;12:771-785 (Mar 17). Doi: 10.1007/s13555-022-00694-1

Key clinical point: Abrocitinib improved signs of atopic dermatitis (AD) rapidly and consistently in difficult-to-treat or cosmetically important anatomical regions, such as the head and neck area.

Major finding: Eczema Area and Severity Index (EASI) score of the head and neck region improved significantly as early as at 2 weeks with 200 mg abrocitinib (least square mean % change from baseline [Δ] 52.5%) and 100 mg abrocitinib (Δ 47.8%) vs. placebo (0.1%; both P < .0001) and improvements were sustained up to 16 weeks (both P ≤ .0002).

Study details: Findings are from a post hoc analysis of the phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 16 weeks of treatment with 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, all with background topical therapy.

Disclosures: This study was funded by Pfizer Inc. Five authors declared being current/former employees and shareholders of Pfizer and other authors reported ties with various sources, including Pfizer.

Source: Alexis A et al. Rapidity of improvement in signs/symptoms of moderate-to-severe atopic dermatitis by body region with abrocitinib in the phase 3 JADE COMPARE study. Dermatol Ther (Heidelb). 2022;12:771-785 (Mar 17). Doi: 10.1007/s13555-022-00694-1

Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455