1-Minute Summary: Functional interaction between sensory neurons and mast cells in the early stage of house dust mite-induced type 2 inflammation and itch: a novel therapeutic target of allergic disease

Expert Name
Miranda Sin-Man Tsang and Chun Kwok Wong

The interaction between the nervous system and immune cells has been reported in fungal-infected skin inflammation and psoriasis, but not in atopic dermatitis (AD) [1-3]. Antihistamines are not always effective in treating pruritus in chronic skin inflammation [4]. A recent study by Serhan et al. unraveled how house dust mite allergens can trigger peripheral nociceptive sensory neurons and how these…

Good response and pruritus reduction in AD with novel selective JAK1 inhibitor

Expert Name
Dr Melinda Gooderham

The JADE Mono-2 study in adolescent and adult patients with atopic dermatitis (AD) investigated the efficacy and safety of abrocitinib. The results demonstrated significant advantages in clinical signs and symptoms over placebo [1,2]. The randomised, controlled, double-blind, phase 3 trial included 391 patients aged ≥12 years with moderate-to-severe AD from 115 centres worldwide and was presented by Dr Melinda Gooderham…

Baricitinib beneficial in head and neck AD

New data from a pooled analysis of phase 3 trials demonstrated substantial efficacy of JAK-inhibition with baricitinib for head and neck lesions in atopic dermatitis (AD) [1]. The oral JAK1/JAK2 inhibitor baricitinib has already proven its efficacy versus placebo in treating moderate-to-severe AD in the identical, double-blind, randomised, controlled, phase 3 BREEZE-AD1 and BREEZE-AD2 trials. Patients with AD often experience…

IL-4/IL-13 blocker dupilumab effective in children with severe AD

Expert Name
Prof. Amy S. Paller

The IL-4/IL-13 blocker dupilumab leads to rapid symptom control and itch reduction in children with severe atopic dermatitis (AD), as was demonstrated in the phase 3 LIBERTY AD PEDS study [1]. Previous trials have already shown that dupilumab is effective in adults and adolescents ≥12 years with moderate-to-severe AD inadequately controlled with topical prescription therapies. However, there is also an…

IL-13 blocker tralokinumab effective in AD

Expert Name
Prof. Eric Simpson

IL-13 plays a key role in pathogenesis of atopic dermatitis (AD). The phase 3 ECZTRA trials demonstrated the remarkable efficacy of the IL-13 blocker tralokinumab in adult patients with moderate-to-severe AD [1]. AD is a chronic inflammatory skin disease. Tralokinumab is a fully human monoclonal antibody designed specifically to neutralise IL-13, a key driver of the underlying inflammation in AD,…

IL-1⍺ blockade: a new treatment option in AD

Expert Name
Prof. Alice Gottlieb

IL-1⍺ blockade is a novel interesting target in atopic dermatitis (AD). In a proof-of-concept study, an IL-1 blocker improved AD in all disease measures [1]. “The rationale behind targeting IL-1⍺ is that Th1 immunity plays a signifying role in adults with chronic AD,” said Prof. Alice Gottlieb (Icahn School of Medicine at Mount Sinai, USA). Under the influence of a…

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JAK inhibition plus TCS lead to high clearance rates in AD

Expert Name
Prof. Kristian Reich

In addition to skin clearance, baricitinib in combination with topical corticosteroid (TCS) showed to be particularly effective in pruritus reduction and improvement of sleep in adult patients with moderate-to-severe atopic dermatitis (AD) [1]. Baricitinib is a selective Janus kinase (JAK) 1 and 2 inhibitor that has previously shown to be effective in moderate-to-severe AD when given as monotherapy. The BREEEZE-AD7…

Biologics: increasingly used in paediatric dermatology

Expert Name
Prof. Marieke Seyger

Biologics and cytokine blockers are increasingly used in children and adolescents with moderate-to-severe psoriasis and atopic dermatitis (AD). Data shows that they cause less side effects than systemic conventional therapies [1]. In adults, biologics targeting specific cytokines are effective, well tolerated, and a safe alternative to conventional systemic treatments. At present, 3 biologics (i.e. etanercept, adalimumab, and ustekinumab) are approved…

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IL-4/IL-13 blockade leads to rapid itch reduction in adolescents

Expert Name
Prof. Eric Simpson

A post-hoc analysis of the phase 3 trial LIBERTY AD ADOL showed that dupilumab entails a rapid itch reduction after only 5 days in adolescents with moderate-to-severe atopic dermatitis (AD) [1]. Itch is the moth bothersome symptom for patients with AD most and it is furthermore associated with sleep loss, reduced quality of life, and reduced productivity. “With our analysis,…

Can JAK inhibitors close the current therapeutic gap in AD?

Expert Name
Prof. Eric Simpson

Immune dysfunction and epidermal barrier dysfunction are two key factors in the atopic dermatitis (AD) pathogenesis. “In my belief, the most promising approach is not improving the barrier function, but primarily using anti-inflammatory agents,” said Prof. Eric Simpson (Oregon Health & Science University, USA) [1]. At present, there are two important therapeutic gaps: “We need a more efficacious topical therapy…