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Dr Raj Chovatiya Summarizes Clinical Implications of Type 2 Inflammation


Raj Chovatiya, MD, PhD, assistant professor of dermatology at Northwestern University's Feinberg School of Medicine, discussed type 2 inflammation in atopic dermatitis, prurigo nodularis, and chronic spontaneous urticaria.

Raj Chovatiya, MD, PhD, assistant professor of dermatology at Northwestern University's Feinberg School of Medicine, summarized his 2023 Fall Clinical Dermatology Conference session about type 2 inflammation in atopic dermatitis (AD), prurigo nodularis (PN), and chronic spontaneous urticaria (CSU); he also discussed treating type 2 inflammation with dupilumab.


What were some key clinical implications mentioned in "Diving Below the Surface of Type 2 Inflammation in AD, PN, and CSU: Implications for Clinical Practice"?

One of the most fun things over the last handful of years has really been seeing the advancements we've made in the treatment of not only [AD] but other type 2 inflammatory diseases, essentially conditions that all seem to share common pathophysiologic mechanisms.

That was one of the most fun parts of our discussion where we were really able to highlight in a primo lecture spot everything that you need to think about when it comes to diseases like [AD], [PN], and [CSU], particularly shared symptoms, unique signs, and overall potentially shared treatment strategies based on the pathophysiology of each of these different conditions.

What are some new treatments in these areas?

One thing that we've learned is that IL-4 and IL-13 form perhaps one of the cruxes of many different types of conditions. They seem to be pretty central in the case of [AD]. We've learned that they matter quite a bit in [PN], as well. Finally, we're learning that they seem to play key roles in several different axes related to mast cells in [CSU]. So, the implications are pretty obvious.

We've had a lot of therapeutic development in terms of biologics that target IL-4 and IL-13 signaling. In fact, we have a biologic dupilumab that's approved for the treatment of [AD] and [PN], as well.

Based on a lot of the clinical trials, basic science, and overall clinical observations that have been made, it seems like this treatment may perhaps be one that is actually quite efficacious for [CSU], a disease that historically hasn't had that many great treatment options. The cool part of this is that we've learned about a lot of this because of clinical observation. Some years ago, dupilumab as a blocker of the IL-4 receptor α protein subunit was a great treatment for [AD], but a lot of people clinically used it for a variety of different pruritic conditions. That's kind of how we learned about [PN] and [CSU], so I'm really excited to see what we may learn about next in terms of the real world.

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