MDedge Dermatology

Key clinical point: Patients with moderate to severe atopic dermatitis (AD) who initially responded to a 12-week induction with 200 mg abrocitinib had a low risk for flares during the 40-week maintenance period, irrespective of whether the dose was continued or stepped down to 100 mg.

Major finding: The range of probabilities of not flaring were 6%-82%, 31%-92%, and 14%-34% in patients who received 100 mg abrocitinib, 200 mg abrocitinib, and placebo, respectively. An increased percentage change in the Eczema Area and Severity Index score from baseline to randomization and an Investigator's Global Assessment score of 0 at randomization (both P < .001) were predictors of not flaring.

Study details: This post hoc analysis of the JADE REGIMEN trial included 798 patients with moderate to severe AD who responded to 200 mg abrocitinib induction therapy and were randomly assigned to receive abrocitinib (200 or 100 mg) or placebo during the maintenance period.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer Inc. Other authors declared having other ties with various sources, including Pfizer Inc.

Source: Thyssen JP, Silverberg JI, Ruano J, et al. Optimizing maintenance therapy in responders to abrocitinib induction: A post hoc analysis of JADE REGIMEN. J Eur Acad Dermatol Venereol. 2024 (May 16). doi: 10.1111/jdv.20095 Source

Key clinical point: Patients with moderate to severe atopic dermatitis (AD) who initially responded to a 12-week induction with 200 mg abrocitinib had a low risk for flares during the 40-week maintenance period, irrespective of whether the dose was continued or stepped down to 100 mg.

Major finding: The range of probabilities of not flaring were 6%-82%, 31%-92%, and 14%-34% in patients who received 100 mg abrocitinib, 200 mg abrocitinib, and placebo, respectively. An increased percentage change in the Eczema Area and Severity Index score from baseline to randomization and an Investigator's Global Assessment score of 0 at randomization (both P < .001) were predictors of not flaring.

Study details: This post hoc analysis of the JADE REGIMEN trial included 798 patients with moderate to severe AD who responded to 200 mg abrocitinib induction therapy and were randomly assigned to receive abrocitinib (200 or 100 mg) or placebo during the maintenance period.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer Inc. Other authors declared having other ties with various sources, including Pfizer Inc.

Source: Thyssen JP, Silverberg JI, Ruano J, et al. Optimizing maintenance therapy in responders to abrocitinib induction: A post hoc analysis of JADE REGIMEN. J Eur Acad Dermatol Venereol. 2024 (May 16). doi: 10.1111/jdv.20095 Source

Key clinical point: Patients with moderate to severe atopic dermatitis (AD) who initially responded to a 12-week induction with 200 mg abrocitinib had a low risk for flares during the 40-week maintenance period, irrespective of whether the dose was continued or stepped down to 100 mg.

Major finding: The range of probabilities of not flaring were 6%-82%, 31%-92%, and 14%-34% in patients who received 100 mg abrocitinib, 200 mg abrocitinib, and placebo, respectively. An increased percentage change in the Eczema Area and Severity Index score from baseline to randomization and an Investigator's Global Assessment score of 0 at randomization (both P < .001) were predictors of not flaring.

Study details: This post hoc analysis of the JADE REGIMEN trial included 798 patients with moderate to severe AD who responded to 200 mg abrocitinib induction therapy and were randomly assigned to receive abrocitinib (200 or 100 mg) or placebo during the maintenance period.

Disclosures: This study was funded by Pfizer Inc. Four authors declared being employees and shareholders of Pfizer Inc. Other authors declared having other ties with various sources, including Pfizer Inc.

Source: Thyssen JP, Silverberg JI, Ruano J, et al. Optimizing maintenance therapy in responders to abrocitinib induction: A post hoc analysis of JADE REGIMEN. J Eur Acad Dermatol Venereol. 2024 (May 16). doi: 10.1111/jdv.20095 Source

Key clinical point: Children with atopic dermatitis (AD) have a significantly higher likelihood of increased body mass index (BMI) corresponding to overweight or obesity, with a positive correlation observed between increased BMI and AD severity.

Major finding: Patients with AD had a three times higher risk for overweight (odds ratio [OR] 3.61; P < .01) and a six times higher risk for obesity (OR 6.61; P < .05) than control participants. Furthermore, the risk for overweight or obesity was almost 20 times higher in patients with moderate to severe AD  (OR 20.4; P < .001) vs those with mild AD.

Study details: This retrospective case-control study included 130 children with AD and 130 age- and sex-matched control participants who were categorized according to their BMI and nutritional status as underweight (percentile < 5), normal weight (percentile 5-84), overweight (percentile 85-94), or obese (percentile ≥ 95).

Disclosures: The authors did not disclose any source of funding. The authors declared no conflicts of interest.

Source: Sendrea AM, Cristea S, Salavastru CM. Association between increased body mass index (BMI) and atopic dermatitis in children attending a tertiary referral center: A case-control study. Cureus. 2024;16:e60770. doi: 10.7759/cureus.60770 Source

Key clinical point: Children with atopic dermatitis (AD) have a significantly higher likelihood of increased body mass index (BMI) corresponding to overweight or obesity, with a positive correlation observed between increased BMI and AD severity.

Major finding: Patients with AD had a three times higher risk for overweight (odds ratio [OR] 3.61; P < .01) and a six times higher risk for obesity (OR 6.61; P < .05) than control participants. Furthermore, the risk for overweight or obesity was almost 20 times higher in patients with moderate to severe AD  (OR 20.4; P < .001) vs those with mild AD.

Study details: This retrospective case-control study included 130 children with AD and 130 age- and sex-matched control participants who were categorized according to their BMI and nutritional status as underweight (percentile < 5), normal weight (percentile 5-84), overweight (percentile 85-94), or obese (percentile ≥ 95).

Disclosures: The authors did not disclose any source of funding. The authors declared no conflicts of interest.

Source: Sendrea AM, Cristea S, Salavastru CM. Association between increased body mass index (BMI) and atopic dermatitis in children attending a tertiary referral center: A case-control study. Cureus. 2024;16:e60770. doi: 10.7759/cureus.60770 Source

Key clinical point: Children with atopic dermatitis (AD) have a significantly higher likelihood of increased body mass index (BMI) corresponding to overweight or obesity, with a positive correlation observed between increased BMI and AD severity.

Major finding: Patients with AD had a three times higher risk for overweight (odds ratio [OR] 3.61; P < .01) and a six times higher risk for obesity (OR 6.61; P < .05) than control participants. Furthermore, the risk for overweight or obesity was almost 20 times higher in patients with moderate to severe AD  (OR 20.4; P < .001) vs those with mild AD.

Study details: This retrospective case-control study included 130 children with AD and 130 age- and sex-matched control participants who were categorized according to their BMI and nutritional status as underweight (percentile < 5), normal weight (percentile 5-84), overweight (percentile 85-94), or obese (percentile ≥ 95).

Disclosures: The authors did not disclose any source of funding. The authors declared no conflicts of interest.

Source: Sendrea AM, Cristea S, Salavastru CM. Association between increased body mass index (BMI) and atopic dermatitis in children attending a tertiary referral center: A case-control study. Cureus. 2024;16:e60770. doi: 10.7759/cureus.60770 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: Topical 1% tapinarof showed significant clinical efficacy and favorable safety and tolerability in adults and children age 2 years or older with moderate to severe atopic dermatitis (AD).

Major finding: At 8 weeks, a significantly higher proportion of patients treated with tapinarof vs vehicle achieved a Validated Investigator Global Assessment for Atopic Dermatitis™ score of 0 or 1 and ≥2-grade improvement from baseline in ADORING 1 (45.4% vs 13.9%) and ADORING 2 (46.4% vs 18.0%) trials (both P < .0001). Few serious treatment-emergent adverse events were reported; rates of discontinuation due to adverse events were lower with tapinarof compared to vehicle.

Study details: The phase 3 ADORING 1 (n = 407) and 2 (n = 406) trials included adults and children age 2 years or older with moderate to severe AD who were randomly assigned to receive 1% tapinarof cream or vehicle once daily for 8 weeks.

Disclosures: This study was supported by Dermavant Sciences, Inc. Five authors declared being employees of or holding stock options in Dermavant Sciences. Several authors declared having other ties with various sources, including Dermavant Sciences.

Source: Silverberg JI, Eichenfield LF, Hebert AA, et al. Tapinarof cream 1% once daily: Significant efficacy in the treatment of moderate to severe atopic dermatitis in adults and children down to 2 years of age in the pivotal phase 3 ADORING trials. J Am Acad Dermatol. 2024 (May 20). doi:  10.1016/j.jaad.2024.05.023 Source

Key clinical point: A higher body mass index (BMI) was associated with short-term reduction in the efficacy of dupilumab in patients with moderate to severe atopic dermatitis (AD), with no effect on long-term efficacy.

Major finding: At week 16, patients with BMI ≥ 25 kg/m² vs those with BMI < 25 kg/m² showed a significantly reduced improvement in Eczema Area Severity Index (P < .001), Pruritus Numerical Rating Scale (P < .05), and Dermatology Life Quality Index (P < .05) scores, but improvements were comparable at weeks 24 and 52. However, all patients showed significant improvement in all scores from baseline to week 16, which was sustained till week 52.

Study details: This single-center, retrospective study included 839 adult patients with moderate to severe AD and a BMI < 25 kg/m² or ≥ 25 kg/m² who received dupilumab.

Disclosures: This study did not receive any funding. Two authors declared serving as investigators, speakers, consultants, or advisory board members for various sources.

Source: Patruno C, Potestio L, Cecere D, et al. The impact of body mass index on dupilumab treatment outcomes in adult atopic dermatitis patients. J Eur Acad Dermatol Venereol. 2024 (May 19). doi: 10.1111/jdv.20111 Source

Key clinical point: A higher body mass index (BMI) was associated with short-term reduction in the efficacy of dupilumab in patients with moderate to severe atopic dermatitis (AD), with no effect on long-term efficacy.

Major finding: At week 16, patients with BMI ≥ 25 kg/m² vs those with BMI < 25 kg/m² showed a significantly reduced improvement in Eczema Area Severity Index (P < .001), Pruritus Numerical Rating Scale (P < .05), and Dermatology Life Quality Index (P < .05) scores, but improvements were comparable at weeks 24 and 52. However, all patients showed significant improvement in all scores from baseline to week 16, which was sustained till week 52.

Study details: This single-center, retrospective study included 839 adult patients with moderate to severe AD and a BMI < 25 kg/m² or ≥ 25 kg/m² who received dupilumab.

Disclosures: This study did not receive any funding. Two authors declared serving as investigators, speakers, consultants, or advisory board members for various sources.

Source: Patruno C, Potestio L, Cecere D, et al. The impact of body mass index on dupilumab treatment outcomes in adult atopic dermatitis patients. J Eur Acad Dermatol Venereol. 2024 (May 19). doi: 10.1111/jdv.20111 Source

Key clinical point: A higher body mass index (BMI) was associated with short-term reduction in the efficacy of dupilumab in patients with moderate to severe atopic dermatitis (AD), with no effect on long-term efficacy.

Major finding: At week 16, patients with BMI ≥ 25 kg/m² vs those with BMI < 25 kg/m² showed a significantly reduced improvement in Eczema Area Severity Index (P < .001), Pruritus Numerical Rating Scale (P < .05), and Dermatology Life Quality Index (P < .05) scores, but improvements were comparable at weeks 24 and 52. However, all patients showed significant improvement in all scores from baseline to week 16, which was sustained till week 52.

Study details: This single-center, retrospective study included 839 adult patients with moderate to severe AD and a BMI < 25 kg/m² or ≥ 25 kg/m² who received dupilumab.

Disclosures: This study did not receive any funding. Two authors declared serving as investigators, speakers, consultants, or advisory board members for various sources.

Source: Patruno C, Potestio L, Cecere D, et al. The impact of body mass index on dupilumab treatment outcomes in adult atopic dermatitis patients. J Eur Acad Dermatol Venereol. 2024 (May 19). doi: 10.1111/jdv.20111 Source

Key clinical point: Lebrikizumab monotherapy significantly improved skin symptoms and itch in adolescents with moderate to severe atopic dermatitis (AD).

Major finding: At week 16, a higher proportion of patients treated with lebrikizumab vs placebo in ADvocate 1 and 2 achieved an Investigator’s Global Assessment score of 0 or 1 with at least a two-point improvement from baseline (46.6% vs 14.3%) and at least a 75% improvement in the Eczema Area and Severity Index score (62.0% vs 17.3%), with improvements observed as early as week 4 (all P < .05). Consistent corresponding results were observed for ADhere.

Study details: This post hoc analysis of the ADvocate 1 and 2 trials and ADhere trial included 148 adolescents with moderate to severe AD who were randomly assigned to receive subcutaneous lebrikizumab or placebo alone in ADvocate 1 and 2 or combined with topical corticosteroids in ADhere.

Disclosures: The three trials were funded by Dermira, Inc., a subsidiary wholly owned by Eli Lilly and Company. Four authors declared being employees of Eli Lilly and Company. Several authors declared being consultants or speakers for or having other ties with various sources, including Eli Lilly and Company.

Source: Hebert AA, Flohr C, Hong HC, et al. Efficacy of lebrikizumab in adolescent patients with moderate-to-severe atopic dermatitis: 16-week results from three randomized phase 3 clinical trials. J Dermatolog Treat. 2024;35:2324833. doi: 10.1080/09546634.2024.2324833 Source

Key clinical point: Lebrikizumab monotherapy significantly improved skin symptoms and itch in adolescents with moderate to severe atopic dermatitis (AD).

Major finding: At week 16, a higher proportion of patients treated with lebrikizumab vs placebo in ADvocate 1 and 2 achieved an Investigator’s Global Assessment score of 0 or 1 with at least a two-point improvement from baseline (46.6% vs 14.3%) and at least a 75% improvement in the Eczema Area and Severity Index score (62.0% vs 17.3%), with improvements observed as early as week 4 (all P < .05). Consistent corresponding results were observed for ADhere.

Study details: This post hoc analysis of the ADvocate 1 and 2 trials and ADhere trial included 148 adolescents with moderate to severe AD who were randomly assigned to receive subcutaneous lebrikizumab or placebo alone in ADvocate 1 and 2 or combined with topical corticosteroids in ADhere.

Disclosures: The three trials were funded by Dermira, Inc., a subsidiary wholly owned by Eli Lilly and Company. Four authors declared being employees of Eli Lilly and Company. Several authors declared being consultants or speakers for or having other ties with various sources, including Eli Lilly and Company.

Source: Hebert AA, Flohr C, Hong HC, et al. Efficacy of lebrikizumab in adolescent patients with moderate-to-severe atopic dermatitis: 16-week results from three randomized phase 3 clinical trials. J Dermatolog Treat. 2024;35:2324833. doi: 10.1080/09546634.2024.2324833 Source

Key clinical point: Lebrikizumab monotherapy significantly improved skin symptoms and itch in adolescents with moderate to severe atopic dermatitis (AD).

Major finding: At week 16, a higher proportion of patients treated with lebrikizumab vs placebo in ADvocate 1 and 2 achieved an Investigator’s Global Assessment score of 0 or 1 with at least a two-point improvement from baseline (46.6% vs 14.3%) and at least a 75% improvement in the Eczema Area and Severity Index score (62.0% vs 17.3%), with improvements observed as early as week 4 (all P < .05). Consistent corresponding results were observed for ADhere.

Study details: This post hoc analysis of the ADvocate 1 and 2 trials and ADhere trial included 148 adolescents with moderate to severe AD who were randomly assigned to receive subcutaneous lebrikizumab or placebo alone in ADvocate 1 and 2 or combined with topical corticosteroids in ADhere.

Disclosures: The three trials were funded by Dermira, Inc., a subsidiary wholly owned by Eli Lilly and Company. Four authors declared being employees of Eli Lilly and Company. Several authors declared being consultants or speakers for or having other ties with various sources, including Eli Lilly and Company.

Source: Hebert AA, Flohr C, Hong HC, et al. Efficacy of lebrikizumab in adolescent patients with moderate-to-severe atopic dermatitis: 16-week results from three randomized phase 3 clinical trials. J Dermatolog Treat. 2024;35:2324833. doi: 10.1080/09546634.2024.2324833 Source

Key clinical point: Dupilumab demonstrated sustained clinical benefits and an acceptable long-term safety profile in children age 6 months to 5 years with uncontrolled moderate to severe atopic dermatitis (AD).

Major finding: At week 52, 36.2% of patients achieved an Investigator’s Global Assessment score of 0 or 1, and 96.6%, 79.3%, and 58.6% of patients achieved at least a 50%, 75%, and 90% improvement in the Eczema Area and Severity Index score, respectively. Overall, 78.2% of patients reported one or more treatment-emergent adverse events, most of mild or moderate severity.

Study details: Findings are from the phase 3 LIBERTY AD PED-OLE study that included 142 children with moderate to severe AD who had previously participated in the LIBERTY AD PRESCHOOL part B study and received a weight-tiered dose of 200 mg or 300 mg of subcutaneous dupilumab every 4 weeks.

Disclosures: The study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Five authors declared being employees of or holding stocks or stock options in Sanofi or Regeneron. The other authors declared having ties with various sources, including Sanofi and Regeneron.

Source: Paller AS, Siegfried EC, Simpson EL, et al. Dupilumab safety and efficacy up to 1 year in children aged 6 months to 5 years with atopic dermatitis: Results from a phase 3 open-label extension study. Am J Clin Dermatol. 2024 (May 14). doi: 10.1007/s40257-024-00859-y Source

Key clinical point: Dupilumab demonstrated sustained clinical benefits and an acceptable long-term safety profile in children age 6 months to 5 years with uncontrolled moderate to severe atopic dermatitis (AD).

Major finding: At week 52, 36.2% of patients achieved an Investigator’s Global Assessment score of 0 or 1, and 96.6%, 79.3%, and 58.6% of patients achieved at least a 50%, 75%, and 90% improvement in the Eczema Area and Severity Index score, respectively. Overall, 78.2% of patients reported one or more treatment-emergent adverse events, most of mild or moderate severity.

Study details: Findings are from the phase 3 LIBERTY AD PED-OLE study that included 142 children with moderate to severe AD who had previously participated in the LIBERTY AD PRESCHOOL part B study and received a weight-tiered dose of 200 mg or 300 mg of subcutaneous dupilumab every 4 weeks.

Disclosures: The study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Five authors declared being employees of or holding stocks or stock options in Sanofi or Regeneron. The other authors declared having ties with various sources, including Sanofi and Regeneron.

Source: Paller AS, Siegfried EC, Simpson EL, et al. Dupilumab safety and efficacy up to 1 year in children aged 6 months to 5 years with atopic dermatitis: Results from a phase 3 open-label extension study. Am J Clin Dermatol. 2024 (May 14). doi: 10.1007/s40257-024-00859-y Source

Key clinical point: Dupilumab demonstrated sustained clinical benefits and an acceptable long-term safety profile in children age 6 months to 5 years with uncontrolled moderate to severe atopic dermatitis (AD).

Major finding: At week 52, 36.2% of patients achieved an Investigator’s Global Assessment score of 0 or 1, and 96.6%, 79.3%, and 58.6% of patients achieved at least a 50%, 75%, and 90% improvement in the Eczema Area and Severity Index score, respectively. Overall, 78.2% of patients reported one or more treatment-emergent adverse events, most of mild or moderate severity.

Study details: Findings are from the phase 3 LIBERTY AD PED-OLE study that included 142 children with moderate to severe AD who had previously participated in the LIBERTY AD PRESCHOOL part B study and received a weight-tiered dose of 200 mg or 300 mg of subcutaneous dupilumab every 4 weeks.

Disclosures: The study was funded by Sanofi and Regeneron Pharmaceuticals Inc. Five authors declared being employees of or holding stocks or stock options in Sanofi or Regeneron. The other authors declared having ties with various sources, including Sanofi and Regeneron.

Source: Paller AS, Siegfried EC, Simpson EL, et al. Dupilumab safety and efficacy up to 1 year in children aged 6 months to 5 years with atopic dermatitis: Results from a phase 3 open-label extension study. Am J Clin Dermatol. 2024 (May 14). doi: 10.1007/s40257-024-00859-y Source

Key clinical point: Use of e-cigarettes by parents is associated with an increased risk for atopic dermatitis (AD) in children.

Major finding: The prevalence of parental e-cigarette use was 18.0% (95% CI 16.5%-19.0%) among children with AD and 14.4% (95% CI 13.9%-15.0%) among those without AD. The risk for AD was significantly higher in children whose parents used e-cigarettes (adjusted odds ratio 1.24; P = .002).

Study details: This retrospective, cross-sectional analysis of data from the US National Health Interview Survey (2014-2018) included 48,637,111 children (age < 18 years), of whom 6,354,515 had a history of AD.

Disclosures: This study did not receive specific funding from any sources. Albert S. Chiou declared receiving consultation fees from Corvus Therapeutics outside the submitted work.

Source: Youn GM, Sarin KY, Chiou AS, et al. Parental e-cigarette use and pediatric atopic dermatitis. JAMA Dermatol. 2024 (May 22). doi: 10.1001/jamadermatol.2024.1283 Source

Key clinical point: Use of e-cigarettes by parents is associated with an increased risk for atopic dermatitis (AD) in children.

Major finding: The prevalence of parental e-cigarette use was 18.0% (95% CI 16.5%-19.0%) among children with AD and 14.4% (95% CI 13.9%-15.0%) among those without AD. The risk for AD was significantly higher in children whose parents used e-cigarettes (adjusted odds ratio 1.24; P = .002).

Study details: This retrospective, cross-sectional analysis of data from the US National Health Interview Survey (2014-2018) included 48,637,111 children (age < 18 years), of whom 6,354,515 had a history of AD.

Disclosures: This study did not receive specific funding from any sources. Albert S. Chiou declared receiving consultation fees from Corvus Therapeutics outside the submitted work.

Source: Youn GM, Sarin KY, Chiou AS, et al. Parental e-cigarette use and pediatric atopic dermatitis. JAMA Dermatol. 2024 (May 22). doi: 10.1001/jamadermatol.2024.1283 Source

Key clinical point: Use of e-cigarettes by parents is associated with an increased risk for atopic dermatitis (AD) in children.

Major finding: The prevalence of parental e-cigarette use was 18.0% (95% CI 16.5%-19.0%) among children with AD and 14.4% (95% CI 13.9%-15.0%) among those without AD. The risk for AD was significantly higher in children whose parents used e-cigarettes (adjusted odds ratio 1.24; P = .002).

Study details: This retrospective, cross-sectional analysis of data from the US National Health Interview Survey (2014-2018) included 48,637,111 children (age < 18 years), of whom 6,354,515 had a history of AD.

Disclosures: This study did not receive specific funding from any sources. Albert S. Chiou declared receiving consultation fees from Corvus Therapeutics outside the submitted work.

Source: Youn GM, Sarin KY, Chiou AS, et al. Parental e-cigarette use and pediatric atopic dermatitis. JAMA Dermatol. 2024 (May 22). doi: 10.1001/jamadermatol.2024.1283 Source

Key clinical point: High dietary intake of sodium, estimated according to 24-hour urinary sodium excretion, was associated with a greater likelihood of atopic dermatitis (AD) diagnosis, having active AD, and increasing severity of AD.

Major finding: A 1-g increase in estimated 24-hour urine sodium excretion was associated with an increased likelihood of AD (adjusted odds ratio [aOR] 1.11; 95% CI 1.07-1.14), active AD (aOR 1.16; 95% CI 1.05-1.28), and increasing AD severity (aOR 1.11; 95% CI 1.07-1.15).

Study details: This cross-sectional study evaluated the association between high levels of dietary sodium intake and AD prevalence, activity, and severity in 215,832 adults from the UK Biobank cohort, of whom 10,839 had AD.

Disclosures: This study was supported by grants from the Medical Student in Aging Research Program and US National Institute on Aging and by the National Eczema Association. One author declared receiving research funding to her institution and consulting fees from various sources.

Source: Chiang BM, Ye M, Chattopadhyay A, et al. Sodium intake and atopic dermatitis. JAMA Dermatol. 2024 (Jun 5). doi: 10.1001/jamadermatol.2024.1544 Source

Key clinical point: High dietary intake of sodium, estimated according to 24-hour urinary sodium excretion, was associated with a greater likelihood of atopic dermatitis (AD) diagnosis, having active AD, and increasing severity of AD.

Major finding: A 1-g increase in estimated 24-hour urine sodium excretion was associated with an increased likelihood of AD (adjusted odds ratio [aOR] 1.11; 95% CI 1.07-1.14), active AD (aOR 1.16; 95% CI 1.05-1.28), and increasing AD severity (aOR 1.11; 95% CI 1.07-1.15).

Study details: This cross-sectional study evaluated the association between high levels of dietary sodium intake and AD prevalence, activity, and severity in 215,832 adults from the UK Biobank cohort, of whom 10,839 had AD.

Disclosures: This study was supported by grants from the Medical Student in Aging Research Program and US National Institute on Aging and by the National Eczema Association. One author declared receiving research funding to her institution and consulting fees from various sources.

Source: Chiang BM, Ye M, Chattopadhyay A, et al. Sodium intake and atopic dermatitis. JAMA Dermatol. 2024 (Jun 5). doi: 10.1001/jamadermatol.2024.1544 Source

Key clinical point: High dietary intake of sodium, estimated according to 24-hour urinary sodium excretion, was associated with a greater likelihood of atopic dermatitis (AD) diagnosis, having active AD, and increasing severity of AD.

Major finding: A 1-g increase in estimated 24-hour urine sodium excretion was associated with an increased likelihood of AD (adjusted odds ratio [aOR] 1.11; 95% CI 1.07-1.14), active AD (aOR 1.16; 95% CI 1.05-1.28), and increasing AD severity (aOR 1.11; 95% CI 1.07-1.15).

Study details: This cross-sectional study evaluated the association between high levels of dietary sodium intake and AD prevalence, activity, and severity in 215,832 adults from the UK Biobank cohort, of whom 10,839 had AD.

Disclosures: This study was supported by grants from the Medical Student in Aging Research Program and US National Institute on Aging and by the National Eczema Association. One author declared receiving research funding to her institution and consulting fees from various sources.

Source: Chiang BM, Ye M, Chattopadhyay A, et al. Sodium intake and atopic dermatitis. JAMA Dermatol. 2024 (Jun 5). doi: 10.1001/jamadermatol.2024.1544 Source

Halifax, Nova Scotia; American Samoa; Queens, New York; Lansing, Michigan; Gurugram, India. I often ask patients where they’re from. Practicing in San Diego, the answers are a geography lesson. People from around the world come here. I sometimes add the more interesting question: How’d you end up here? Many took the three highways to San Diego: the Navy, the defense industry (like General Dynamics), or followed a partner. My Queens patient had a better answer: Super Bowl XXII. On Sunday, Jan. 31st, 1988, the Redskins played the Broncos in San Diego. John Elway and the Broncos lost, but it didn’t matter. “I was scrapin’ the ice off my windshield that Monday morning when I thought, that’s it. I’m done! I drove to the garage where I worked and quit on the spot. Then I drove home and packed my bags.”

In a paper on how to make life decisions, this guy would be Exhibit A: “Don’t overthink it.” That approach might not be suitable for everyone, or for every decision. It might actually be an example of how not to make life decisions (more on that later). But, is there a best way to go about making big life decisions?

The first treatise on this subject was a paper by one Franklin, Ben in 1772. Providing advice to a friend on how to make a career decision, Franklin argued: “My way is to divide half a sheet of paper by a line into two columns; writing over the one Pro and over the other Con.” This “moral algebra” as he called it was a framework to put rigor to a messy, organic problem.

Jeffrey Benabio, MD, MBA

The flaw in this method is that in the end you have two lists. Then what? Do the length of the lists decide? What if some factors are more important? Well, let’s add tools to help. You could use a spreadsheet and assign weights to each variable. Then sum the values and choose based on that. So if “not scraping ice off your windshield” is twice as important as “doubling your rent,” then you’ve got your answer. But what if you aren’t good at estimating how important things are? Actually, most of us are pretty awful at assigning weights to life variables – having bags of money is the consummate example. Seems important, but because of habituation, it turns out to not be sustainable. Note Exhibit B, our wealthy neighbor who owns a Lambo and G-Wagen (AMG squared, of course), who just parked a Cybertruck in his driveway. Realizing the risk of depending on peoples’ flawed judgment, companies instead use statistical modeling called bootstrap aggregating to “vote” on the weights for variables in a prediction. If you aren’t sure how important a new Rivian or walking to the beach would be, a model can answer that for you! It’s a bit disconcerting, I know. I mean, how can a model know what we’d like? Wait, isn’t that how Netflix picks stuff for you? Exactly.

Ok, so why don’t we just ask our friendly personal AI? “OK, ChatGPT, given what you know about me, where can I have it all?” Alas, here we slam into a glass wall. It seems the answer is out there but even our life-changing magical AI tools fail us. Mathematically, it is impossible to have it all. An illustrative example of this is called the economic “impossible trinity problem.” Even the most sophisticated algorithm cannot find an optional solution to some trinities such as fixed foreign exchange rate, free capital movement, and an independent monetary policy. Economists have concluded you must trade off one to have the other two. Impossible trinities are common in economics and in life. Armistead Maupin in his “Tales of the City” codifies it as Mona’s Law, the essence of which is: You cannot have the perfect job, the perfect partner, and the perfect house at the same time. (See Exhibit C, one Tom Brady).

This brings me to my final point, hard decisions are matters of the heart and experiencing life is the best way to understand its beautiful chaos. If making rash judgments is ill-advised and using technology cannot solve all problems (try asking your AI buddy for the square root of 2 as a fraction) what tools can we use? Maybe try reading more novels. They allow us to experience multiple lifetimes in a short time, which is what we need to learn what matters. Reading Dorothea’s choice at the end of “Middlemarch” is a nice example. Should she give up Lowick Manor and marry the penniless Ladislaw or keep it and use her wealth to help others? Seeing her struggle helps us understand how to answer questions like: Should I give up my academic practice or marry that guy or move to Texas? These cannot be reduced to arithmetic. The only way to know is to know as much of life as possible.

My last visit with my Queens patient was our last together. He’s divorced and moving from San Diego to Gallatin, Tennessee. “I’ve paid my last taxes to California, Doc. I decided that’s it, I’m done!” Perhaps he should have read “The Grapes of Wrath” before he set out for California in the first place.

Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].

Halifax, Nova Scotia; American Samoa; Queens, New York; Lansing, Michigan; Gurugram, India. I often ask patients where they’re from. Practicing in San Diego, the answers are a geography lesson. People from around the world come here. I sometimes add the more interesting question: How’d you end up here? Many took the three highways to San Diego: the Navy, the defense industry (like General Dynamics), or followed a partner. My Queens patient had a better answer: Super Bowl XXII. On Sunday, Jan. 31st, 1988, the Redskins played the Broncos in San Diego. John Elway and the Broncos lost, but it didn’t matter. “I was scrapin’ the ice off my windshield that Monday morning when I thought, that’s it. I’m done! I drove to the garage where I worked and quit on the spot. Then I drove home and packed my bags.”

In a paper on how to make life decisions, this guy would be Exhibit A: “Don’t overthink it.” That approach might not be suitable for everyone, or for every decision. It might actually be an example of how not to make life decisions (more on that later). But, is there a best way to go about making big life decisions?

The first treatise on this subject was a paper by one Franklin, Ben in 1772. Providing advice to a friend on how to make a career decision, Franklin argued: “My way is to divide half a sheet of paper by a line into two columns; writing over the one Pro and over the other Con.” This “moral algebra” as he called it was a framework to put rigor to a messy, organic problem.

Jeffrey Benabio, MD, MBA

The flaw in this method is that in the end you have two lists. Then what? Do the length of the lists decide? What if some factors are more important? Well, let’s add tools to help. You could use a spreadsheet and assign weights to each variable. Then sum the values and choose based on that. So if “not scraping ice off your windshield” is twice as important as “doubling your rent,” then you’ve got your answer. But what if you aren’t good at estimating how important things are? Actually, most of us are pretty awful at assigning weights to life variables – having bags of money is the consummate example. Seems important, but because of habituation, it turns out to not be sustainable. Note Exhibit B, our wealthy neighbor who owns a Lambo and G-Wagen (AMG squared, of course), who just parked a Cybertruck in his driveway. Realizing the risk of depending on peoples’ flawed judgment, companies instead use statistical modeling called bootstrap aggregating to “vote” on the weights for variables in a prediction. If you aren’t sure how important a new Rivian or walking to the beach would be, a model can answer that for you! It’s a bit disconcerting, I know. I mean, how can a model know what we’d like? Wait, isn’t that how Netflix picks stuff for you? Exactly.

Ok, so why don’t we just ask our friendly personal AI? “OK, ChatGPT, given what you know about me, where can I have it all?” Alas, here we slam into a glass wall. It seems the answer is out there but even our life-changing magical AI tools fail us. Mathematically, it is impossible to have it all. An illustrative example of this is called the economic “impossible trinity problem.” Even the most sophisticated algorithm cannot find an optional solution to some trinities such as fixed foreign exchange rate, free capital movement, and an independent monetary policy. Economists have concluded you must trade off one to have the other two. Impossible trinities are common in economics and in life. Armistead Maupin in his “Tales of the City” codifies it as Mona’s Law, the essence of which is: You cannot have the perfect job, the perfect partner, and the perfect house at the same time. (See Exhibit C, one Tom Brady).

This brings me to my final point, hard decisions are matters of the heart and experiencing life is the best way to understand its beautiful chaos. If making rash judgments is ill-advised and using technology cannot solve all problems (try asking your AI buddy for the square root of 2 as a fraction) what tools can we use? Maybe try reading more novels. They allow us to experience multiple lifetimes in a short time, which is what we need to learn what matters. Reading Dorothea’s choice at the end of “Middlemarch” is a nice example. Should she give up Lowick Manor and marry the penniless Ladislaw or keep it and use her wealth to help others? Seeing her struggle helps us understand how to answer questions like: Should I give up my academic practice or marry that guy or move to Texas? These cannot be reduced to arithmetic. The only way to know is to know as much of life as possible.

My last visit with my Queens patient was our last together. He’s divorced and moving from San Diego to Gallatin, Tennessee. “I’ve paid my last taxes to California, Doc. I decided that’s it, I’m done!” Perhaps he should have read “The Grapes of Wrath” before he set out for California in the first place.

Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].

Halifax, Nova Scotia; American Samoa; Queens, New York; Lansing, Michigan; Gurugram, India. I often ask patients where they’re from. Practicing in San Diego, the answers are a geography lesson. People from around the world come here. I sometimes add the more interesting question: How’d you end up here? Many took the three highways to San Diego: the Navy, the defense industry (like General Dynamics), or followed a partner. My Queens patient had a better answer: Super Bowl XXII. On Sunday, Jan. 31st, 1988, the Redskins played the Broncos in San Diego. John Elway and the Broncos lost, but it didn’t matter. “I was scrapin’ the ice off my windshield that Monday morning when I thought, that’s it. I’m done! I drove to the garage where I worked and quit on the spot. Then I drove home and packed my bags.”

In a paper on how to make life decisions, this guy would be Exhibit A: “Don’t overthink it.” That approach might not be suitable for everyone, or for every decision. It might actually be an example of how not to make life decisions (more on that later). But, is there a best way to go about making big life decisions?

The first treatise on this subject was a paper by one Franklin, Ben in 1772. Providing advice to a friend on how to make a career decision, Franklin argued: “My way is to divide half a sheet of paper by a line into two columns; writing over the one Pro and over the other Con.” This “moral algebra” as he called it was a framework to put rigor to a messy, organic problem.

Jeffrey Benabio, MD, MBA

The flaw in this method is that in the end you have two lists. Then what? Do the length of the lists decide? What if some factors are more important? Well, let’s add tools to help. You could use a spreadsheet and assign weights to each variable. Then sum the values and choose based on that. So if “not scraping ice off your windshield” is twice as important as “doubling your rent,” then you’ve got your answer. But what if you aren’t good at estimating how important things are? Actually, most of us are pretty awful at assigning weights to life variables – having bags of money is the consummate example. Seems important, but because of habituation, it turns out to not be sustainable. Note Exhibit B, our wealthy neighbor who owns a Lambo and G-Wagen (AMG squared, of course), who just parked a Cybertruck in his driveway. Realizing the risk of depending on peoples’ flawed judgment, companies instead use statistical modeling called bootstrap aggregating to “vote” on the weights for variables in a prediction. If you aren’t sure how important a new Rivian or walking to the beach would be, a model can answer that for you! It’s a bit disconcerting, I know. I mean, how can a model know what we’d like? Wait, isn’t that how Netflix picks stuff for you? Exactly.

Ok, so why don’t we just ask our friendly personal AI? “OK, ChatGPT, given what you know about me, where can I have it all?” Alas, here we slam into a glass wall. It seems the answer is out there but even our life-changing magical AI tools fail us. Mathematically, it is impossible to have it all. An illustrative example of this is called the economic “impossible trinity problem.” Even the most sophisticated algorithm cannot find an optional solution to some trinities such as fixed foreign exchange rate, free capital movement, and an independent monetary policy. Economists have concluded you must trade off one to have the other two. Impossible trinities are common in economics and in life. Armistead Maupin in his “Tales of the City” codifies it as Mona’s Law, the essence of which is: You cannot have the perfect job, the perfect partner, and the perfect house at the same time. (See Exhibit C, one Tom Brady).

This brings me to my final point, hard decisions are matters of the heart and experiencing life is the best way to understand its beautiful chaos. If making rash judgments is ill-advised and using technology cannot solve all problems (try asking your AI buddy for the square root of 2 as a fraction) what tools can we use? Maybe try reading more novels. They allow us to experience multiple lifetimes in a short time, which is what we need to learn what matters. Reading Dorothea’s choice at the end of “Middlemarch” is a nice example. Should she give up Lowick Manor and marry the penniless Ladislaw or keep it and use her wealth to help others? Seeing her struggle helps us understand how to answer questions like: Should I give up my academic practice or marry that guy or move to Texas? These cannot be reduced to arithmetic. The only way to know is to know as much of life as possible.

My last visit with my Queens patient was our last together. He’s divorced and moving from San Diego to Gallatin, Tennessee. “I’ve paid my last taxes to California, Doc. I decided that’s it, I’m done!” Perhaps he should have read “The Grapes of Wrath” before he set out for California in the first place.

Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].