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Dr April Armstrong: How Recent Biologics Advancements Improved AD Treatment


April Armstrong, MD, MPH, of University of California, Los Angeles, discussed how recent biologics advancements improved moderate-to-severe atopic dermatitis (AD) treatment.

April Armstrong, MD, MPH, professor and chief of dermatology at University of California, Los Angeles, discussed the 2 FDA-approved biologics for atopic dermatitis (AD) treatment and how they helped improve treatment of patients with moderate to severe AD. Armstrong also touched on how to best implement these new treatments, using a patient by patient approach.


How have recent advancements in biologics improved your ability to treat patients with moderate to severe atopic dermatitis?

I think the area of biologics development in atopic dermatitis is very exciting. I think, currently, as you know, we have 2 FDA-approved biologics to treat patients with moderate to severe atopic dermatitis: dupilumab and tralokinumab. Both of them have really revolutionized the way in which our AD patients are being managed and cared for in our clinics.

That being said, we still have room to go in terms of making sure that more patients can benefit from advanced treatments, and there is 1 molecule in late phase development: lebrikizumab, which is an IL [interleukin]-13 inhibitor that is also targeting one of the key cytokines for atopic dermatitis. The clinical data on that have shown good efficacy, a good safety profile, and I think it will be very promising as a new option for patients with atopic dermatitis.

I think, overall, one of the things as clinicians that we want to recognize is that, as these newer therapies become available, I think patient selection is one of the key areas that we want to figure out. Right now, we don't have an easily accessible way of determining which patient may respond to one therapy or another, so it's a little bit of a guessing game sometimes.

When we look at atopic dermatitis, which is a very heterogeneous disease, we oftentimes may experience some patients responding well to one therapy but may not respond as well to another therapy. I think the complement of biologics with oral therapies; for example, JAK [janus kinase] inhibitors, which can actually hit also multiple targets. I think both of those classes being available for patients is critical because we will see that not everyone responds to 1 type of medication, and having multiple choices will allow us to figure out over time which may be the best for our patients.

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