Dr Robert Sidbury Discusses Utilization, Efficacy of Biologics for Atopic Dermatitis

Robert Sidbury, MD, MPH, chief, Division of Dermatology, Seattle Children's Hospital, speaks on the efficacy of biologics in the treatment of atopic dermatitis and other recently approved therapeutics.

Biologics have been revolutionary in the treatment of atopic dermatitis, with several other recently approved therapies showing promise as well, said Robert Sidbury, MD, MPH, chief, Division of Dermatology, Seattle Children's Hospital.


Can you speak on the current use of biologics in atopic dermatitis and any unmet needs that can be improved through these therapies?

These therapies have been really revolutionary. I finished my fellowship in 2000 so I've been doing this for 22 years or so. And until 2017, for the first 17 years of posttraining work in this field for me, there were really no new molecules approved for treating eczema.

Around 2000 was when the topical calcineurin inhibitors came out. So, since then, until 2017, there really wasn't anything that was fundamentally novel in the way it worked until dupilumab. Dupilumab is a biologic medication, which has been life altering for a good number of my patients.

So, you ask about unmet needs. Really, the biggest unmet need was the ability to effectively treat itch, since that's sort of the core symptom and the problem from which so many other challenges stem in these patients. And dupilumab is very effective at treating itch; it's been effective in decreasing the risk of skin infections, presumably because the skin barrier is in better shape and improved. It has been a really remarkable drug.

Since then, really just in the last few months, another biologic has been approved, an interleukin [IL]-13 blocker. Dupilumab is an IL-4 and IL-13 blocker. Some small molecules, some Janus kinase [JAK] inhibitors, have been approved, 2 different oral medications—not biologics, but systemic medications for atopic dermatitis, which also seem like they're going to raise the bar and really increase the ability for providers to offer good therapeutic options for patients with eczema.

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