Atopic Dermatitis

Key clinical point: The overall risk for hospital-diagnosed acne is significantly higher in patients with atopic dermatitis (AD), highlighting the need to address comorbid skin diseases simultaneously along with the management of AD.

Major finding: Patients with AD vs control individuals had a 3-fold higher overall risk for hospital-diagnosed acne at ≤18 years (adjusted odds ratio [aOR] 3.44; 95% CI 3.13-3.78) and ≤30 years (aOR 3.15; 95% CI 2.90-3.42) of age.

Study details: The data come from a retrospective registry study that included 70,584 patients with AD aged ≤18 years at the time of their first AD diagnosis and 270,783 matched control individuals without AD.

Disclosures: This study did not receive any funding. Some authors declared serving as investigators and receiving educational grants, consulting fees, or speaker honoraria from various organizations.

Source: Sinikumpu SP et al. The association between atopic dermatitis and acne: A retrospective Finnish nationwide registry study. Br J Dermatol. 2023 (Mar 22). Doi: 10.1093/bjd/ljad086

Key clinical point: The overall risk for hospital-diagnosed acne is significantly higher in patients with atopic dermatitis (AD), highlighting the need to address comorbid skin diseases simultaneously along with the management of AD.

Major finding: Patients with AD vs control individuals had a 3-fold higher overall risk for hospital-diagnosed acne at ≤18 years (adjusted odds ratio [aOR] 3.44; 95% CI 3.13-3.78) and ≤30 years (aOR 3.15; 95% CI 2.90-3.42) of age.

Study details: The data come from a retrospective registry study that included 70,584 patients with AD aged ≤18 years at the time of their first AD diagnosis and 270,783 matched control individuals without AD.

Disclosures: This study did not receive any funding. Some authors declared serving as investigators and receiving educational grants, consulting fees, or speaker honoraria from various organizations.

Source: Sinikumpu SP et al. The association between atopic dermatitis and acne: A retrospective Finnish nationwide registry study. Br J Dermatol. 2023 (Mar 22). Doi: 10.1093/bjd/ljad086

Key clinical point: The overall risk for hospital-diagnosed acne is significantly higher in patients with atopic dermatitis (AD), highlighting the need to address comorbid skin diseases simultaneously along with the management of AD.

Major finding: Patients with AD vs control individuals had a 3-fold higher overall risk for hospital-diagnosed acne at ≤18 years (adjusted odds ratio [aOR] 3.44; 95% CI 3.13-3.78) and ≤30 years (aOR 3.15; 95% CI 2.90-3.42) of age.

Study details: The data come from a retrospective registry study that included 70,584 patients with AD aged ≤18 years at the time of their first AD diagnosis and 270,783 matched control individuals without AD.

Disclosures: This study did not receive any funding. Some authors declared serving as investigators and receiving educational grants, consulting fees, or speaker honoraria from various organizations.

Source: Sinikumpu SP et al. The association between atopic dermatitis and acne: A retrospective Finnish nationwide registry study. Br J Dermatol. 2023 (Mar 22). Doi: 10.1093/bjd/ljad086

Key clinical point: Among malignancies, including breast cancer, melanoma, lymphoma, and non-melanoma skin cancer (NMSC), patients with moderate-to-severe atopic dermatitis (AD) had the highest incidence rate (IR) for NMSC followed by breast cancer and melanoma; NMSC incidence increased with age among patients with moderate but not severe AD.

Major finding: In patients with moderate and severe AD, the IR per 1000 person-years were 4.6 (95% CI 3.9-5.5) and 5.9 (95% CI 3.8-9.2) for NMSC, 2.2 (95% CI 1.6-3.0) and 0.5 (95% CI 0.1-3.9) for breast cancer, and 0.4 (95% CI 0.2-0.7) and 0.6 (95% CI 0.1-2.3) for melanoma, respectively. The NMSC IR increased with increasing age in patients with moderate AD (18-39 vs ≥65 years: 0.1 [95% CI 0.0-0.7] vs 18.0 [95% CI 13.9-23.2]).

Study details: This retrospective study analyzed the data of 7050 adults with moderate-to-severe AD from the Kaiser Permanente Northern California database.

Disclosures: This study was sponsored by Pfizer Inc. Some authors reported ties with various organizations, including Pfizer.

Source: Hedderson MM et al. Rates of malignancies among patients with moderate to severe atopic dermatitis: A retrospective cohort study. BMJ Open. 2023;13(3):e071172 (Mar 10). Doi: 10.1136/bmjopen-2022-071172

Key clinical point: Among malignancies, including breast cancer, melanoma, lymphoma, and non-melanoma skin cancer (NMSC), patients with moderate-to-severe atopic dermatitis (AD) had the highest incidence rate (IR) for NMSC followed by breast cancer and melanoma; NMSC incidence increased with age among patients with moderate but not severe AD.

Major finding: In patients with moderate and severe AD, the IR per 1000 person-years were 4.6 (95% CI 3.9-5.5) and 5.9 (95% CI 3.8-9.2) for NMSC, 2.2 (95% CI 1.6-3.0) and 0.5 (95% CI 0.1-3.9) for breast cancer, and 0.4 (95% CI 0.2-0.7) and 0.6 (95% CI 0.1-2.3) for melanoma, respectively. The NMSC IR increased with increasing age in patients with moderate AD (18-39 vs ≥65 years: 0.1 [95% CI 0.0-0.7] vs 18.0 [95% CI 13.9-23.2]).

Study details: This retrospective study analyzed the data of 7050 adults with moderate-to-severe AD from the Kaiser Permanente Northern California database.

Disclosures: This study was sponsored by Pfizer Inc. Some authors reported ties with various organizations, including Pfizer.

Source: Hedderson MM et al. Rates of malignancies among patients with moderate to severe atopic dermatitis: A retrospective cohort study. BMJ Open. 2023;13(3):e071172 (Mar 10). Doi: 10.1136/bmjopen-2022-071172

Key clinical point: Among malignancies, including breast cancer, melanoma, lymphoma, and non-melanoma skin cancer (NMSC), patients with moderate-to-severe atopic dermatitis (AD) had the highest incidence rate (IR) for NMSC followed by breast cancer and melanoma; NMSC incidence increased with age among patients with moderate but not severe AD.

Major finding: In patients with moderate and severe AD, the IR per 1000 person-years were 4.6 (95% CI 3.9-5.5) and 5.9 (95% CI 3.8-9.2) for NMSC, 2.2 (95% CI 1.6-3.0) and 0.5 (95% CI 0.1-3.9) for breast cancer, and 0.4 (95% CI 0.2-0.7) and 0.6 (95% CI 0.1-2.3) for melanoma, respectively. The NMSC IR increased with increasing age in patients with moderate AD (18-39 vs ≥65 years: 0.1 [95% CI 0.0-0.7] vs 18.0 [95% CI 13.9-23.2]).

Study details: This retrospective study analyzed the data of 7050 adults with moderate-to-severe AD from the Kaiser Permanente Northern California database.

Disclosures: This study was sponsored by Pfizer Inc. Some authors reported ties with various organizations, including Pfizer.

Source: Hedderson MM et al. Rates of malignancies among patients with moderate to severe atopic dermatitis: A retrospective cohort study. BMJ Open. 2023;13(3):e071172 (Mar 10). Doi: 10.1136/bmjopen-2022-071172

Key clinical point: Compared with conventional treatment, enhanced treatment with topical corticosteroids (TCS) significantly reduced the incidence of hen’s egg allergy among infants with atopic dermatitis (AD) but retarded their growth.

Major finding: Infants receiving enhanced vs conventional treatment had a significantly lower incidence of hen’s egg allergy (31.4% vs 41.9%; P = .0028), but demonstrated lower body weight (mean difference −422 g; 95% CI −553 to −292 g) and height (mean difference −0.8 cm; 95% CI −1.22 to −0.33 cm) at 28 weeks of age.

Study details: This randomized controlled trial included 640 infants aged 7-13 weeks with AD who were randomly assigned to receive enhanced therapy (alclometasone dipropionate for the whole face and betamethasone valerate for whole body except face and scalp) followed by maintenance therapy (n = 318) or conventional therapy (alclometasone dipropionate and betamethasone valerate for the affected skin; n = 322).

Disclosures: This study was supported by the Japan Agency for Medical Research and Development (AMED). Some authors reported ties with various organizations, including AMED.

Source: Yamamoto-Hanada K et al on behalf of PACI Study Collaborators. Enhanced early skin treatment for atopic dermatitis in infants reduces food allergy. J Allergy Clin Immunol. 2023 (Mar 22). Doi: 10.1016/j.jaci.2023.03.008

Key clinical point: Compared with conventional treatment, enhanced treatment with topical corticosteroids (TCS) significantly reduced the incidence of hen’s egg allergy among infants with atopic dermatitis (AD) but retarded their growth.

Major finding: Infants receiving enhanced vs conventional treatment had a significantly lower incidence of hen’s egg allergy (31.4% vs 41.9%; P = .0028), but demonstrated lower body weight (mean difference −422 g; 95% CI −553 to −292 g) and height (mean difference −0.8 cm; 95% CI −1.22 to −0.33 cm) at 28 weeks of age.

Study details: This randomized controlled trial included 640 infants aged 7-13 weeks with AD who were randomly assigned to receive enhanced therapy (alclometasone dipropionate for the whole face and betamethasone valerate for whole body except face and scalp) followed by maintenance therapy (n = 318) or conventional therapy (alclometasone dipropionate and betamethasone valerate for the affected skin; n = 322).

Disclosures: This study was supported by the Japan Agency for Medical Research and Development (AMED). Some authors reported ties with various organizations, including AMED.

Source: Yamamoto-Hanada K et al on behalf of PACI Study Collaborators. Enhanced early skin treatment for atopic dermatitis in infants reduces food allergy. J Allergy Clin Immunol. 2023 (Mar 22). Doi: 10.1016/j.jaci.2023.03.008

Key clinical point: Compared with conventional treatment, enhanced treatment with topical corticosteroids (TCS) significantly reduced the incidence of hen’s egg allergy among infants with atopic dermatitis (AD) but retarded their growth.

Major finding: Infants receiving enhanced vs conventional treatment had a significantly lower incidence of hen’s egg allergy (31.4% vs 41.9%; P = .0028), but demonstrated lower body weight (mean difference −422 g; 95% CI −553 to −292 g) and height (mean difference −0.8 cm; 95% CI −1.22 to −0.33 cm) at 28 weeks of age.

Study details: This randomized controlled trial included 640 infants aged 7-13 weeks with AD who were randomly assigned to receive enhanced therapy (alclometasone dipropionate for the whole face and betamethasone valerate for whole body except face and scalp) followed by maintenance therapy (n = 318) or conventional therapy (alclometasone dipropionate and betamethasone valerate for the affected skin; n = 322).

Disclosures: This study was supported by the Japan Agency for Medical Research and Development (AMED). Some authors reported ties with various organizations, including AMED.

Source: Yamamoto-Hanada K et al on behalf of PACI Study Collaborators. Enhanced early skin treatment for atopic dermatitis in infants reduces food allergy. J Allergy Clin Immunol. 2023 (Mar 22). Doi: 10.1016/j.jaci.2023.03.008

Key clinical point: Children living closer to highly trafficked segments (HTS) are at a greater risk of developing atopic dermatitis (AD).

Major finding: Children living at ≥1,000 vs <500 m from an HTS had 27% lower odds of developing AD (P = .0009). The odds of AD decreased by 21% (P = .0002) with each factor of 10 increase in the distance from an HTS.

Study details: The data come from a retrospective cross-sectional analysis of 7247 children aged 0-18 years with AD and 7247 age- and sex-matched control individuals without AD.

Disclosures: This study was supported by the Department of Pediatrics, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado, and Eugene F and Easton M Crawford Charitable Lead Unitrust, Chicago, Illinois. D Leung reported ties with various organizations.

Source: Nevid MZ et al. The association of residential distance from highly trafficked roads with atopic dermatitis risk. J Allergy Clin Immunol Pract. 2023 (Mar 20). Doi: 10.1016/j.jaip.2023.03.021

Key clinical point: Children living closer to highly trafficked segments (HTS) are at a greater risk of developing atopic dermatitis (AD).

Major finding: Children living at ≥1,000 vs <500 m from an HTS had 27% lower odds of developing AD (P = .0009). The odds of AD decreased by 21% (P = .0002) with each factor of 10 increase in the distance from an HTS.

Study details: The data come from a retrospective cross-sectional analysis of 7247 children aged 0-18 years with AD and 7247 age- and sex-matched control individuals without AD.

Disclosures: This study was supported by the Department of Pediatrics, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado, and Eugene F and Easton M Crawford Charitable Lead Unitrust, Chicago, Illinois. D Leung reported ties with various organizations.

Source: Nevid MZ et al. The association of residential distance from highly trafficked roads with atopic dermatitis risk. J Allergy Clin Immunol Pract. 2023 (Mar 20). Doi: 10.1016/j.jaip.2023.03.021

Key clinical point: Children living closer to highly trafficked segments (HTS) are at a greater risk of developing atopic dermatitis (AD).

Major finding: Children living at ≥1,000 vs <500 m from an HTS had 27% lower odds of developing AD (P = .0009). The odds of AD decreased by 21% (P = .0002) with each factor of 10 increase in the distance from an HTS.

Study details: The data come from a retrospective cross-sectional analysis of 7247 children aged 0-18 years with AD and 7247 age- and sex-matched control individuals without AD.

Disclosures: This study was supported by the Department of Pediatrics, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado, and Eugene F and Easton M Crawford Charitable Lead Unitrust, Chicago, Illinois. D Leung reported ties with various organizations.

Source: Nevid MZ et al. The association of residential distance from highly trafficked roads with atopic dermatitis risk. J Allergy Clin Immunol Pract. 2023 (Mar 20). Doi: 10.1016/j.jaip.2023.03.021

Key clinical point: An induction treatment of 200 mg abrocitinib followed by dose reduction (100 mg) or continuous dosing (200 mg) is efficacious and safe in adults and adolescents with moderate-to-severe atopic dermatitis (AD).

Major finding: In the 200 mg abrocitinib, 100 mg abrocitinib, and placebo arms, similar proportions of adolescents and adults experienced disease flare (14.9% and 16.9%, 42.9% and 38.9%, and 75.5% and 78.0%, respectively) and the Eczema Area and Severity Index response was recaptured by 28.6%, 25.0%, and 52.9% of adolescents and 34.3%, 33.7%, and 58.0% of adults, respectively. The safety profile was consistent in adolescents and adults.

Study details: This post hoc analysis of the JADE REGIMEN study included 246 adolescents (12-17 years) and 987 adults with moderate-to-severe AD who received 200 mg abrocitinib induction treatment; responders were randomly assigned to receive 40-week abrocitinib (200/100 mg) or placebo maintenance treatment and rescue treatment (if disease flared).

Disclosures: Pfizer Inc funded the study. Some authors reported various ties, including employment and stock ownership, with Pfizer or others.

Source: Flohr C et al. Efficacy and safety of abrocitinib monotherapy in adolescents and adults: A post hoc analysis of the phase 3 JAK1 atopic dermatitis efficacy and safety (JADE) REGIMEN clinical trial. J Dermatolog Treat. 2023;1-13 (Apr 10). Doi: 10.1080/09546634.2023.2200866

Key clinical point: An induction treatment of 200 mg abrocitinib followed by dose reduction (100 mg) or continuous dosing (200 mg) is efficacious and safe in adults and adolescents with moderate-to-severe atopic dermatitis (AD).

Major finding: In the 200 mg abrocitinib, 100 mg abrocitinib, and placebo arms, similar proportions of adolescents and adults experienced disease flare (14.9% and 16.9%, 42.9% and 38.9%, and 75.5% and 78.0%, respectively) and the Eczema Area and Severity Index response was recaptured by 28.6%, 25.0%, and 52.9% of adolescents and 34.3%, 33.7%, and 58.0% of adults, respectively. The safety profile was consistent in adolescents and adults.

Study details: This post hoc analysis of the JADE REGIMEN study included 246 adolescents (12-17 years) and 987 adults with moderate-to-severe AD who received 200 mg abrocitinib induction treatment; responders were randomly assigned to receive 40-week abrocitinib (200/100 mg) or placebo maintenance treatment and rescue treatment (if disease flared).

Disclosures: Pfizer Inc funded the study. Some authors reported various ties, including employment and stock ownership, with Pfizer or others.

Source: Flohr C et al. Efficacy and safety of abrocitinib monotherapy in adolescents and adults: A post hoc analysis of the phase 3 JAK1 atopic dermatitis efficacy and safety (JADE) REGIMEN clinical trial. J Dermatolog Treat. 2023;1-13 (Apr 10). Doi: 10.1080/09546634.2023.2200866

Key clinical point: An induction treatment of 200 mg abrocitinib followed by dose reduction (100 mg) or continuous dosing (200 mg) is efficacious and safe in adults and adolescents with moderate-to-severe atopic dermatitis (AD).

Major finding: In the 200 mg abrocitinib, 100 mg abrocitinib, and placebo arms, similar proportions of adolescents and adults experienced disease flare (14.9% and 16.9%, 42.9% and 38.9%, and 75.5% and 78.0%, respectively) and the Eczema Area and Severity Index response was recaptured by 28.6%, 25.0%, and 52.9% of adolescents and 34.3%, 33.7%, and 58.0% of adults, respectively. The safety profile was consistent in adolescents and adults.

Study details: This post hoc analysis of the JADE REGIMEN study included 246 adolescents (12-17 years) and 987 adults with moderate-to-severe AD who received 200 mg abrocitinib induction treatment; responders were randomly assigned to receive 40-week abrocitinib (200/100 mg) or placebo maintenance treatment and rescue treatment (if disease flared).

Disclosures: Pfizer Inc funded the study. Some authors reported various ties, including employment and stock ownership, with Pfizer or others.

Source: Flohr C et al. Efficacy and safety of abrocitinib monotherapy in adolescents and adults: A post hoc analysis of the phase 3 JAK1 atopic dermatitis efficacy and safety (JADE) REGIMEN clinical trial. J Dermatolog Treat. 2023;1-13 (Apr 10). Doi: 10.1080/09546634.2023.2200866

Key clinical point: Maternal atopic dermatitis (AD) significantly increases the risk for both childhood- and adult-onset AD, and active smoking is the main lifestyle risk factor for adult-onset AD.

Major finding: Compared with non-atopic and atopic control individuals, individuals with a maternal AD family history had a significantly higher risk for childhood-onset (adjusted odds ratio [aOR] 4.36, 95% CI 1.18-16.17; and aOR 32.97, 95% CI 4.03-269.68, respectively) and adult-onset AD (aOR 15.79, 95% CI 1.81-137.74; and aOR 34.15, 95% CI 3.15-370.28, respectively) and active smokers had an increased risk for adult-onset AD (aOR 5.54, 95% CI 1.06-29.01; and aOR 4.03, 95% CI 1.20-13.45, respectively).

Study details: This study analyzed the cross-sectional data of 736 adult individuals with childhood-onset (<18 years) or adult-onset (≥18 years) AD and 76 non-atopic and 91 atopic control individuals without AD.

Disclosures: This study was funded by the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Switzerland. Some authors declared various ties, including employment, with CK-CARE or others.

Source: Maintz L et al. Atopic dermatitis: Correlation of distinct risk factors with age of onset in adulthood compared to childhood. Allergy. 2023 (Mar 22). Doi: 10.1111/all.15721

Key clinical point: Maternal atopic dermatitis (AD) significantly increases the risk for both childhood- and adult-onset AD, and active smoking is the main lifestyle risk factor for adult-onset AD.

Major finding: Compared with non-atopic and atopic control individuals, individuals with a maternal AD family history had a significantly higher risk for childhood-onset (adjusted odds ratio [aOR] 4.36, 95% CI 1.18-16.17; and aOR 32.97, 95% CI 4.03-269.68, respectively) and adult-onset AD (aOR 15.79, 95% CI 1.81-137.74; and aOR 34.15, 95% CI 3.15-370.28, respectively) and active smokers had an increased risk for adult-onset AD (aOR 5.54, 95% CI 1.06-29.01; and aOR 4.03, 95% CI 1.20-13.45, respectively).

Study details: This study analyzed the cross-sectional data of 736 adult individuals with childhood-onset (<18 years) or adult-onset (≥18 years) AD and 76 non-atopic and 91 atopic control individuals without AD.

Disclosures: This study was funded by the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Switzerland. Some authors declared various ties, including employment, with CK-CARE or others.

Source: Maintz L et al. Atopic dermatitis: Correlation of distinct risk factors with age of onset in adulthood compared to childhood. Allergy. 2023 (Mar 22). Doi: 10.1111/all.15721

Key clinical point: Maternal atopic dermatitis (AD) significantly increases the risk for both childhood- and adult-onset AD, and active smoking is the main lifestyle risk factor for adult-onset AD.

Major finding: Compared with non-atopic and atopic control individuals, individuals with a maternal AD family history had a significantly higher risk for childhood-onset (adjusted odds ratio [aOR] 4.36, 95% CI 1.18-16.17; and aOR 32.97, 95% CI 4.03-269.68, respectively) and adult-onset AD (aOR 15.79, 95% CI 1.81-137.74; and aOR 34.15, 95% CI 3.15-370.28, respectively) and active smokers had an increased risk for adult-onset AD (aOR 5.54, 95% CI 1.06-29.01; and aOR 4.03, 95% CI 1.20-13.45, respectively).

Study details: This study analyzed the cross-sectional data of 736 adult individuals with childhood-onset (<18 years) or adult-onset (≥18 years) AD and 76 non-atopic and 91 atopic control individuals without AD.

Disclosures: This study was funded by the Christine Kühne-Center for Allergy Research and Education (CK-CARE), Switzerland. Some authors declared various ties, including employment, with CK-CARE or others.

Source: Maintz L et al. Atopic dermatitis: Correlation of distinct risk factors with age of onset in adulthood compared to childhood. Allergy. 2023 (Mar 22). Doi: 10.1111/all.15721

Key clinical point: Long-term topical corticosteroid (TCS) and tacrolimus (TAC) treatments had similar efficacy and impact on airway hyperresponsiveness or inflammation in children with moderate-to-severe atopic dermatitis (AD).

Major finding: At month 36, children treated with TCS and TAC had no significant difference in the mean body surface area (P  =  .12), mean Eczema Area and Severity Index score (P  =  .2), mean Investigator’s Global Assessment Score (P  =  .12), mean transepidermal water loss at eczema site (P  =  .96) and control site (P  =  .19), median exhaled nitric oxide level (P  =  .71), or median bronchial hyperresponsiveness to methacholine (P  =  .7).

Study details: Findings are from a single-center 3-year follow-up study including 152 children aged 1-3 years with moderate-to-severe AD who were randomly assigned to receive TCS (n = 75) or TAC (n = 77).

Disclosures: This study was supported by the Foundation for Paediatric Research, Finland, Orion Research Foundation, Finland, Orion Pharma, Finland, Astellas Pharma, Japan, and others. Orion and Astellas are commercial manufacturers of the TCS used in this study.

Source: Perälä M et al. Topical tacrolimus versus corticosteroids in childhood moderate-to-severe atopic dermatitis with impact on airways: A long-term randomized open-label study. Clin Exp Dermatol. 2023 (Mar 14). Doi: 10.1093/ced/llad098

Key clinical point: Long-term topical corticosteroid (TCS) and tacrolimus (TAC) treatments had similar efficacy and impact on airway hyperresponsiveness or inflammation in children with moderate-to-severe atopic dermatitis (AD).

Major finding: At month 36, children treated with TCS and TAC had no significant difference in the mean body surface area (P  =  .12), mean Eczema Area and Severity Index score (P  =  .2), mean Investigator’s Global Assessment Score (P  =  .12), mean transepidermal water loss at eczema site (P  =  .96) and control site (P  =  .19), median exhaled nitric oxide level (P  =  .71), or median bronchial hyperresponsiveness to methacholine (P  =  .7).

Study details: Findings are from a single-center 3-year follow-up study including 152 children aged 1-3 years with moderate-to-severe AD who were randomly assigned to receive TCS (n = 75) or TAC (n = 77).

Disclosures: This study was supported by the Foundation for Paediatric Research, Finland, Orion Research Foundation, Finland, Orion Pharma, Finland, Astellas Pharma, Japan, and others. Orion and Astellas are commercial manufacturers of the TCS used in this study.

Source: Perälä M et al. Topical tacrolimus versus corticosteroids in childhood moderate-to-severe atopic dermatitis with impact on airways: A long-term randomized open-label study. Clin Exp Dermatol. 2023 (Mar 14). Doi: 10.1093/ced/llad098

Key clinical point: Long-term topical corticosteroid (TCS) and tacrolimus (TAC) treatments had similar efficacy and impact on airway hyperresponsiveness or inflammation in children with moderate-to-severe atopic dermatitis (AD).

Major finding: At month 36, children treated with TCS and TAC had no significant difference in the mean body surface area (P  =  .12), mean Eczema Area and Severity Index score (P  =  .2), mean Investigator’s Global Assessment Score (P  =  .12), mean transepidermal water loss at eczema site (P  =  .96) and control site (P  =  .19), median exhaled nitric oxide level (P  =  .71), or median bronchial hyperresponsiveness to methacholine (P  =  .7).

Study details: Findings are from a single-center 3-year follow-up study including 152 children aged 1-3 years with moderate-to-severe AD who were randomly assigned to receive TCS (n = 75) or TAC (n = 77).

Disclosures: This study was supported by the Foundation for Paediatric Research, Finland, Orion Research Foundation, Finland, Orion Pharma, Finland, Astellas Pharma, Japan, and others. Orion and Astellas are commercial manufacturers of the TCS used in this study.

Source: Perälä M et al. Topical tacrolimus versus corticosteroids in childhood moderate-to-severe atopic dermatitis with impact on airways: A long-term randomized open-label study. Clin Exp Dermatol. 2023 (Mar 14). Doi: 10.1093/ced/llad098

Key clinical point: Baricitinib offers the flexibility of dose down-titration and improvement in atopic dermatitis (AD) signs and symptoms up to treatment week 104 in patients with moderate-to-severe AD.

Major finding: Among patients receiving 4 mg baricitinib, 51.2% and 47.6% achieved or maintained a validated Investigator’s Global Assessment for AD score of 0 or 1 and 82.1%, and 73.8% maintained an Eczema Area and Severity Index 75 response at weeks 52 and 104, respectively. The clinical response was maintained after down-titration to 2 mg baricitinib.

Study details: This sub-study of the BREEZE-AD3 trial included 168 patients with moderate-to-severe AD who were responders or partial responders to 4 mg baricitinib in originating studies and were re-assigned (1:1) to receive 4 or 2 mg baricitinib at week 52.

Disclosures: This study was funded by Eli Lilly and Company under license from Incyte Corporation. Some authors reported ties with various organizations, including Eli Lilly. Four authors declared being employees and stockholders of Eli Lilly.

Source: Thyssen JP et al. Maintained improvement in physician- and patient-reported outcomes with baricitinib in adults with moderate-to-severe atopic dermatitis who were treated for up to 104 weeks in a randomized trial. J Dermatolog Treat. 2023;34(1):2190430 (Apr 5). Doi: 10.1080/09546634.2023.2190430

Key clinical point: Baricitinib offers the flexibility of dose down-titration and improvement in atopic dermatitis (AD) signs and symptoms up to treatment week 104 in patients with moderate-to-severe AD.

Major finding: Among patients receiving 4 mg baricitinib, 51.2% and 47.6% achieved or maintained a validated Investigator’s Global Assessment for AD score of 0 or 1 and 82.1%, and 73.8% maintained an Eczema Area and Severity Index 75 response at weeks 52 and 104, respectively. The clinical response was maintained after down-titration to 2 mg baricitinib.

Study details: This sub-study of the BREEZE-AD3 trial included 168 patients with moderate-to-severe AD who were responders or partial responders to 4 mg baricitinib in originating studies and were re-assigned (1:1) to receive 4 or 2 mg baricitinib at week 52.

Disclosures: This study was funded by Eli Lilly and Company under license from Incyte Corporation. Some authors reported ties with various organizations, including Eli Lilly. Four authors declared being employees and stockholders of Eli Lilly.

Source: Thyssen JP et al. Maintained improvement in physician- and patient-reported outcomes with baricitinib in adults with moderate-to-severe atopic dermatitis who were treated for up to 104 weeks in a randomized trial. J Dermatolog Treat. 2023;34(1):2190430 (Apr 5). Doi: 10.1080/09546634.2023.2190430

Key clinical point: Baricitinib offers the flexibility of dose down-titration and improvement in atopic dermatitis (AD) signs and symptoms up to treatment week 104 in patients with moderate-to-severe AD.

Major finding: Among patients receiving 4 mg baricitinib, 51.2% and 47.6% achieved or maintained a validated Investigator’s Global Assessment for AD score of 0 or 1 and 82.1%, and 73.8% maintained an Eczema Area and Severity Index 75 response at weeks 52 and 104, respectively. The clinical response was maintained after down-titration to 2 mg baricitinib.

Study details: This sub-study of the BREEZE-AD3 trial included 168 patients with moderate-to-severe AD who were responders or partial responders to 4 mg baricitinib in originating studies and were re-assigned (1:1) to receive 4 or 2 mg baricitinib at week 52.

Disclosures: This study was funded by Eli Lilly and Company under license from Incyte Corporation. Some authors reported ties with various organizations, including Eli Lilly. Four authors declared being employees and stockholders of Eli Lilly.

Source: Thyssen JP et al. Maintained improvement in physician- and patient-reported outcomes with baricitinib in adults with moderate-to-severe atopic dermatitis who were treated for up to 104 weeks in a randomized trial. J Dermatolog Treat. 2023;34(1):2190430 (Apr 5). Doi: 10.1080/09546634.2023.2190430

Key clinical point: A dose of 4 mg baricitinib plus topical corticosteroids (TCS) demonstrated superior efficacy compared to placebo+TCS in pediatric patients with moderate-to-severe atopic dermatitis (AD), with the safety profile being consistent with previous studies involving adults with moderate-to-severe AD.

Major finding: At week 16, a significantly higher proportion of patients receiving 4 mg baricitinib+TCS vs placebo+TCS achieved a validated Investigator’s Global Assessment for AD score of 0 or 1 with a ≥2-point improvement (41.7% vs 16.4%; P < .0001); no significant difference was observed between the 2 mg/1 mg baricitinib and placebo groups. No new safety signals were reported.

Study details: This multicenter phase 3 study, BREEZE-AD-PEDS, included 483 pediatric patients aged 2 to <18 years with moderate-to-severe AD and inadequate response to TCS or systemic treatments who were randomly assigned to receive 4 mg baricitinib+TCS, 2 mg baricitinib+TCS, 1 mg baricitinib+TCS, or placebo+TCS.

Disclosures: Baricitinib was developed by Eli Lilly and Company, under license from Incyte Corporation. Some authors reported various ties, including employment and stock ownership, with Eli Lilly or others.

Source: Torrelo A et al. Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: Results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS). Br J Dermatol. 2023 (Mar 31). Doi: 10.1093/bjd/ljad096

Key clinical point: A dose of 4 mg baricitinib plus topical corticosteroids (TCS) demonstrated superior efficacy compared to placebo+TCS in pediatric patients with moderate-to-severe atopic dermatitis (AD), with the safety profile being consistent with previous studies involving adults with moderate-to-severe AD.

Major finding: At week 16, a significantly higher proportion of patients receiving 4 mg baricitinib+TCS vs placebo+TCS achieved a validated Investigator’s Global Assessment for AD score of 0 or 1 with a ≥2-point improvement (41.7% vs 16.4%; P < .0001); no significant difference was observed between the 2 mg/1 mg baricitinib and placebo groups. No new safety signals were reported.

Study details: This multicenter phase 3 study, BREEZE-AD-PEDS, included 483 pediatric patients aged 2 to <18 years with moderate-to-severe AD and inadequate response to TCS or systemic treatments who were randomly assigned to receive 4 mg baricitinib+TCS, 2 mg baricitinib+TCS, 1 mg baricitinib+TCS, or placebo+TCS.

Disclosures: Baricitinib was developed by Eli Lilly and Company, under license from Incyte Corporation. Some authors reported various ties, including employment and stock ownership, with Eli Lilly or others.

Source: Torrelo A et al. Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: Results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS). Br J Dermatol. 2023 (Mar 31). Doi: 10.1093/bjd/ljad096

Key clinical point: A dose of 4 mg baricitinib plus topical corticosteroids (TCS) demonstrated superior efficacy compared to placebo+TCS in pediatric patients with moderate-to-severe atopic dermatitis (AD), with the safety profile being consistent with previous studies involving adults with moderate-to-severe AD.

Major finding: At week 16, a significantly higher proportion of patients receiving 4 mg baricitinib+TCS vs placebo+TCS achieved a validated Investigator’s Global Assessment for AD score of 0 or 1 with a ≥2-point improvement (41.7% vs 16.4%; P < .0001); no significant difference was observed between the 2 mg/1 mg baricitinib and placebo groups. No new safety signals were reported.

Study details: This multicenter phase 3 study, BREEZE-AD-PEDS, included 483 pediatric patients aged 2 to <18 years with moderate-to-severe AD and inadequate response to TCS or systemic treatments who were randomly assigned to receive 4 mg baricitinib+TCS, 2 mg baricitinib+TCS, 1 mg baricitinib+TCS, or placebo+TCS.

Disclosures: Baricitinib was developed by Eli Lilly and Company, under license from Incyte Corporation. Some authors reported various ties, including employment and stock ownership, with Eli Lilly or others.

Source: Torrelo A et al. Efficacy and safety of baricitinib in combination with topical corticosteroids in pediatric patients with moderate-to-severe atopic dermatitis with inadequate response to topical corticosteroids: Results from a phase 3, randomized, double-blind, placebo-controlled study (BREEZE-AD PEDS). Br J Dermatol. 2023 (Mar 31). Doi: 10.1093/bjd/ljad096

Key clinical point: Lebrikizumab significantly improved the signs and symptoms of moderate-to-severe atopic dermatitis (AD) in adults and adolescents.

Major finding: At week 16, in the ADvocate1 and ADvocate2 trials, a significantly higher proportion of patients receiving lebrikizumab vs placebo achieved an Investigator’s Global Assessment score of 0 or 1 (43.1% vs 12.7% and 33.2% vs 10.8%, respectively) and a ≥75% improvement in the Eczema Area and Severity Index (58.8% vs 16.2% and 52.1% vs 18.1%, respectively; all P < .001). Most treatment-emergent adverse events were of mild-to-moderate severity.

Study details: Findings are from two identical phase 3 studies, ADvocate1 (n = 424) and ADvocate2 (n = 427), including adults (≥18 years) and adolescents (12 to <18 years) with moderate-to-severe AD who were randomly assigned to receive lebrikizumab or placebo over 16-week induction and 36-week maintenance periods.

Disclosures: This study was sponsored by Dermira, a wholly owned subsidiary of Eli Lilly and Company. Some authors reported various ties, including employment, with Eli Lilly or others.

Source: Silverberg JI et al for the ADvocate1 and ADvocate2 Investigators. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med. 2023;388(12):1080-1091 (Mar 15). Doi: 10.1056/NEJMoa2206714

Key clinical point: Lebrikizumab significantly improved the signs and symptoms of moderate-to-severe atopic dermatitis (AD) in adults and adolescents.

Major finding: At week 16, in the ADvocate1 and ADvocate2 trials, a significantly higher proportion of patients receiving lebrikizumab vs placebo achieved an Investigator’s Global Assessment score of 0 or 1 (43.1% vs 12.7% and 33.2% vs 10.8%, respectively) and a ≥75% improvement in the Eczema Area and Severity Index (58.8% vs 16.2% and 52.1% vs 18.1%, respectively; all P < .001). Most treatment-emergent adverse events were of mild-to-moderate severity.

Study details: Findings are from two identical phase 3 studies, ADvocate1 (n = 424) and ADvocate2 (n = 427), including adults (≥18 years) and adolescents (12 to <18 years) with moderate-to-severe AD who were randomly assigned to receive lebrikizumab or placebo over 16-week induction and 36-week maintenance periods.

Disclosures: This study was sponsored by Dermira, a wholly owned subsidiary of Eli Lilly and Company. Some authors reported various ties, including employment, with Eli Lilly or others.

Source: Silverberg JI et al for the ADvocate1 and ADvocate2 Investigators. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med. 2023;388(12):1080-1091 (Mar 15). Doi: 10.1056/NEJMoa2206714

Key clinical point: Lebrikizumab significantly improved the signs and symptoms of moderate-to-severe atopic dermatitis (AD) in adults and adolescents.

Major finding: At week 16, in the ADvocate1 and ADvocate2 trials, a significantly higher proportion of patients receiving lebrikizumab vs placebo achieved an Investigator’s Global Assessment score of 0 or 1 (43.1% vs 12.7% and 33.2% vs 10.8%, respectively) and a ≥75% improvement in the Eczema Area and Severity Index (58.8% vs 16.2% and 52.1% vs 18.1%, respectively; all P < .001). Most treatment-emergent adverse events were of mild-to-moderate severity.

Study details: Findings are from two identical phase 3 studies, ADvocate1 (n = 424) and ADvocate2 (n = 427), including adults (≥18 years) and adolescents (12 to <18 years) with moderate-to-severe AD who were randomly assigned to receive lebrikizumab or placebo over 16-week induction and 36-week maintenance periods.

Disclosures: This study was sponsored by Dermira, a wholly owned subsidiary of Eli Lilly and Company. Some authors reported various ties, including employment, with Eli Lilly or others.

Source: Silverberg JI et al for the ADvocate1 and ADvocate2 Investigators. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med. 2023;388(12):1080-1091 (Mar 15). Doi: 10.1056/NEJMoa2206714