Melinda Gooderham, MSc, MD, FRCPC, dermatologist and clinical researcher at Peterborough Regional Health Centre, discusses emerging topical and biologic therapies expected to be available later this year.
Emerging therapies in atopic dermatitis will be especially benefical to patients who want an alternative to using topical steroids, says Melinda Gooderham, MSc, MD, FRCPC, dermatologist and clinical researcher at Peterborough Regional Health Centre in Ontario, Canada.
Can you talk about your session on emerging therapies for atopic dermatitis (AD), and what is expected to be available in 2023?
We've been really lucky in atopic dermatitis with new therapies coming in the pipeline, and next year, it's no different. There's going to be probably 4 new approvals—we have 2 new topical agents that are likely to get approved, both nonsteroidal. One is topical tapinarof, which we know as VTAMA, which is a 1% cream that's already approved for psoriasis in adults.
The studies are currently ongoing for atopic dermatitis in children and adults, and the results are very promising. We're still waiting for the final readout, but I'm also an investigator in that trial, so I've seen some great responses in patients and good tolerability.
Also, topical roflumilast; we have zoryve, a 0.3% cream that's approved for psoriasis. The atopic dermatitis program is a different product in that it's 0.15% cream. The trial also ongoing for children and adults, again with very good tolerability, good efficacy, and I think this is really important for patients to have more nonsteroidal topicals. Most patients, especially if they've had atopic dermatitis for years, they're not interested in using topical steroids because of perceived safety concerns [or] inefficacy, and to be able to have something new to offer them that's not a steroid and is not likely to have a box warning that would cause more concern or anxiety in a patient; I think is really going to change the way we manage the majority of our AD patients.
We also have 2 new biologic agents. Interleukin-13 inhibition, which is a well-known target, dupilumab blocks the receptor for interleukin-13. We have tralokinumab that blocks interleukin-13. A new interleukin 13 monoclonal antibody will become available next year, called lebrikizumab, which has high affinity and very good results as far as IgA clearance[and] EASI [Eczema Area and Severity Index] 75 clearance in our patients—providing patients with another option. They may have not responded to dupilumab or had some side effects. To be able to have another option to block interleukin-13 effectively and safely, I think also will expand our options for our patients in that space.
We will also have a new mechanism of action coming with nemolizumab, which is an interleukin-31 receptor antagonist blocking the itch cytokine interleukin-31; and as you know, itch is the most burdensome symptom in our atopic dermatitis patients. We are able to improve the itch, improve the quality of life by improving things like sleep and skin symptoms. So, another new option for patients who may have itch-predominant atopic dermatitis, or maybe they failed other therapies. But to have a safe option that blocks the itch in these patients is really going to be another win for our patients.