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EADV 2016

Emerging Therapies and Future Considerations for Treating Moderate-to-Severe Atopic Dermatitis

The 4-part lecture, “Practical Application of Novel Targeted Strategies in Moderate-to-Severe Atopic Dermatitis” covered the pathogenesis of atopic dermatitis (AD), new insights into the pathophysiology in AD, considerations for change in the treatment of AD, and the latest developments in treatment.
Deleuran went on to say that in order for future treatments to meet this unmet need, they should target key drivers of persistent inflammation, be administered systemically, deliver a broad range of efficacy (eg, long-term disease control, reduced inflammation, improved quality-of-life), and provide a positive safety profile. Deleuran was confident that emerging targeted therapies have the potential to meet these recommendations, and better treat moderate-to-severe AD.

In “Latest Developments in the Treatment of Patients with Moderate-to-Severe Atopic Dermatitis,” Simpson continued Deleuran’s coverage of current treatments for AD and new developments in treating the disease. “AD is a complex, heterogeneous disease leading to variable treatment responses … there are broad ranges of symptom burdens and pathobiologies,” Simpson explained. 

He first gave a quick overview of established topical treatments and systemic therapies, including phototherapy and oral immunosuppressives. The core of Simpson’s lecture, however, was his discussion about 2 new pathways under investigation. One such pathway is the use of intracellular target treatments. These are administered through small molecule inhibitors like PDE4 inhibitors, JAX inhibitors, and H4R antagonists. 

There are also opportunities in extracellular target treatments, Simpson explained, highlighting biologic agents that target IL receptors. Two such drugs are nemoluzimab and ustekinumab (brand name Stelara), which target IL-31 receptors, and IL- 12 and IL-23 receptors, respectively. 

One drug, however, received special attention in Simpson’s lecture. Results from a Phase 3 study, just published in The New England Journal of Medicine, substantiate the safety and efficacy of dupilumab (brand name Dupixent) in treating moderate-to-severe AD. Dupilumab is a monoclonal antibody that targets the IL-4 alpha subunit (IL-4Ra). During the LIBERTY AD SOLO 1 and SOLO 2 studies, 2 identical placebo-controlled trials, dupilumab showed clinically significant improvements in overall disease activity compared to placebo at weeks 16 and 52. The drug also demonstrated a positive safety and tolerability profile, and improvements in quality-of-life. The FDA recently accepted Dupixent for priority review with a target action of March 29, 2017.

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