Key clinical point: Maternal exposure to nickel was associated with increased serum interleukin (IL)-2 levels but decreased serum eotaxin-1 levels and was negatively associated with the development of atopic dermatitis (AD) in children aged 3 years.

Major finding: Maternal nickel exposure was associated with increased serum levels of IL-2 (β 16.820; P < .001) but decreased serum levels of eotaxin-1 (β −5.065; P < .01) and was negatively associated with the development of AD (P  =  .024) in children aged 3 years.

Study details: Findings are from the analysis of an ongoing birth cohort study including 140 mother-child pairs.

Disclosures: This work was supported by grants from the Ministry of Science and Technology, Taiwan, and National Health Research Institutes. The authors declared no conflicts of interest.

Source: Ho JC et al. Prenatal exposure to nickel and atopic dermatitis at age 3 years: A birth cohort study with cytokine profiles. J Eur Acad Dermatol Venereol. 2022 (Jul 16). Doi: 10.1111/jdv.18425

Key clinical point: Maternal exposure to nickel was associated with increased serum interleukin (IL)-2 levels but decreased serum eotaxin-1 levels and was negatively associated with the development of atopic dermatitis (AD) in children aged 3 years.

Major finding: Maternal nickel exposure was associated with increased serum levels of IL-2 (β 16.820; P < .001) but decreased serum levels of eotaxin-1 (β −5.065; P < .01) and was negatively associated with the development of AD (P  =  .024) in children aged 3 years.

Study details: Findings are from the analysis of an ongoing birth cohort study including 140 mother-child pairs.

Disclosures: This work was supported by grants from the Ministry of Science and Technology, Taiwan, and National Health Research Institutes. The authors declared no conflicts of interest.

Source: Ho JC et al. Prenatal exposure to nickel and atopic dermatitis at age 3 years: A birth cohort study with cytokine profiles. J Eur Acad Dermatol Venereol. 2022 (Jul 16). Doi: 10.1111/jdv.18425

Key clinical point: Maternal exposure to nickel was associated with increased serum interleukin (IL)-2 levels but decreased serum eotaxin-1 levels and was negatively associated with the development of atopic dermatitis (AD) in children aged 3 years.

Major finding: Maternal nickel exposure was associated with increased serum levels of IL-2 (β 16.820; P < .001) but decreased serum levels of eotaxin-1 (β −5.065; P < .01) and was negatively associated with the development of AD (P  =  .024) in children aged 3 years.

Study details: Findings are from the analysis of an ongoing birth cohort study including 140 mother-child pairs.

Disclosures: This work was supported by grants from the Ministry of Science and Technology, Taiwan, and National Health Research Institutes. The authors declared no conflicts of interest.

Source: Ho JC et al. Prenatal exposure to nickel and atopic dermatitis at age 3 years: A birth cohort study with cytokine profiles. J Eur Acad Dermatol Venereol. 2022 (Jul 16). Doi: 10.1111/jdv.18425

Key clinical point: Interleukin (IL)-13 inhibitors, such as lebrikizumab and tralokinumab, rapidly reduced disease severity and were well tolerated in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A significantly higher proportion of patients receiving lebrikizumab or tralokinumab vs placebo achieved ≥75% improvement in the Eczema Area and Severity Index as early as week 4 (risk ratio [RR] 2.09; P  =  .006) and ≥4-point improvement in the Pruritus Numerical Rating Scale score (RR 1.59; 95% CI 1.23-2.05). Lebrikizumab/tralokinumab was associated with a higher risk for conjunctivitis than placebo (RR 2.318; P < .001).

Study details: Findings are from a meta-analysis of 7 randomized controlled trials including 2946 adults with moderate-to-severe AD who were randomly assigned to receive lebrikizumab, tralokinumab, or placebo for 12-16 weeks.

Disclosures: This study was supported by the Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Zhang Y et al. The efficacy and safety of IL-13 inhibitors in atopic dermatitis: A systematic review and meta-analysis. Front Immunol. 2022;13:923362 (Jul 27). Doi: 10.3389/fimmu.2022.923362

Key clinical point: Interleukin (IL)-13 inhibitors, such as lebrikizumab and tralokinumab, rapidly reduced disease severity and were well tolerated in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A significantly higher proportion of patients receiving lebrikizumab or tralokinumab vs placebo achieved ≥75% improvement in the Eczema Area and Severity Index as early as week 4 (risk ratio [RR] 2.09; P  =  .006) and ≥4-point improvement in the Pruritus Numerical Rating Scale score (RR 1.59; 95% CI 1.23-2.05). Lebrikizumab/tralokinumab was associated with a higher risk for conjunctivitis than placebo (RR 2.318; P < .001).

Study details: Findings are from a meta-analysis of 7 randomized controlled trials including 2946 adults with moderate-to-severe AD who were randomly assigned to receive lebrikizumab, tralokinumab, or placebo for 12-16 weeks.

Disclosures: This study was supported by the Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Zhang Y et al. The efficacy and safety of IL-13 inhibitors in atopic dermatitis: A systematic review and meta-analysis. Front Immunol. 2022;13:923362 (Jul 27). Doi: 10.3389/fimmu.2022.923362

Key clinical point: Interleukin (IL)-13 inhibitors, such as lebrikizumab and tralokinumab, rapidly reduced disease severity and were well tolerated in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: A significantly higher proportion of patients receiving lebrikizumab or tralokinumab vs placebo achieved ≥75% improvement in the Eczema Area and Severity Index as early as week 4 (risk ratio [RR] 2.09; P  =  .006) and ≥4-point improvement in the Pruritus Numerical Rating Scale score (RR 1.59; 95% CI 1.23-2.05). Lebrikizumab/tralokinumab was associated with a higher risk for conjunctivitis than placebo (RR 2.318; P < .001).

Study details: Findings are from a meta-analysis of 7 randomized controlled trials including 2946 adults with moderate-to-severe AD who were randomly assigned to receive lebrikizumab, tralokinumab, or placebo for 12-16 weeks.

Disclosures: This study was supported by the Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Zhang Y et al. The efficacy and safety of IL-13 inhibitors in atopic dermatitis: A systematic review and meta-analysis. Front Immunol. 2022;13:923362 (Jul 27). Doi: 10.3389/fimmu.2022.923362

Key clinical point: A 2-week treatment with a test cream (TC) containing a steroid and pseudoceramide rapidly improved skin barrier function compared with a control cream (CC) containing only steroids in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: In the TC group, the mean skin hydration value (48.0; P < .01) and transepidermal water loss (−2.1; P < .05) improved significantly as early as at 1 week after application, with similar improvements observed at 2 weeks; however, no significant improvements were observed in the CC group.

Study details: Findings are from a parallel, double-blind study including 36 patients with mild-to-moderate AD skin symptoms on the inner forearm who were randomly assigned to receive a TC containing 0.15% prednisolone valerate acetate (PVA)+3% synthetic pseudoceramide or a CC containing 0.15% PVA for 2 weeks.

Disclosures: This study was fully funded by Kao Corporation, Japan. The authors declared no conflicts of interest.

Source: Okoshi K et al. Efficacy of pseudo-ceramide-containing steroid lamellar cream in patients with mild to moderate atopic dermatitis: A randomized, double-blind study. Dermatol Ther (Heidelb). 2022;12:1823–1834 (Jul 19). Doi: 10.1007/s13555-022-00766-2

Key clinical point: A 2-week treatment with a test cream (TC) containing a steroid and pseudoceramide rapidly improved skin barrier function compared with a control cream (CC) containing only steroids in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: In the TC group, the mean skin hydration value (48.0; P < .01) and transepidermal water loss (−2.1; P < .05) improved significantly as early as at 1 week after application, with similar improvements observed at 2 weeks; however, no significant improvements were observed in the CC group.

Study details: Findings are from a parallel, double-blind study including 36 patients with mild-to-moderate AD skin symptoms on the inner forearm who were randomly assigned to receive a TC containing 0.15% prednisolone valerate acetate (PVA)+3% synthetic pseudoceramide or a CC containing 0.15% PVA for 2 weeks.

Disclosures: This study was fully funded by Kao Corporation, Japan. The authors declared no conflicts of interest.

Source: Okoshi K et al. Efficacy of pseudo-ceramide-containing steroid lamellar cream in patients with mild to moderate atopic dermatitis: A randomized, double-blind study. Dermatol Ther (Heidelb). 2022;12:1823–1834 (Jul 19). Doi: 10.1007/s13555-022-00766-2

Key clinical point: A 2-week treatment with a test cream (TC) containing a steroid and pseudoceramide rapidly improved skin barrier function compared with a control cream (CC) containing only steroids in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: In the TC group, the mean skin hydration value (48.0; P < .01) and transepidermal water loss (−2.1; P < .05) improved significantly as early as at 1 week after application, with similar improvements observed at 2 weeks; however, no significant improvements were observed in the CC group.

Study details: Findings are from a parallel, double-blind study including 36 patients with mild-to-moderate AD skin symptoms on the inner forearm who were randomly assigned to receive a TC containing 0.15% prednisolone valerate acetate (PVA)+3% synthetic pseudoceramide or a CC containing 0.15% PVA for 2 weeks.

Disclosures: This study was fully funded by Kao Corporation, Japan. The authors declared no conflicts of interest.

Source: Okoshi K et al. Efficacy of pseudo-ceramide-containing steroid lamellar cream in patients with mild to moderate atopic dermatitis: A randomized, double-blind study. Dermatol Ther (Heidelb). 2022;12:1823–1834 (Jul 19). Doi: 10.1007/s13555-022-00766-2

Key clinical point: Dupilumab demonstrated comparable long-term efficacy and safety in patients with moderate-to-severe atopic dermatitis (AD) and other major comorbidities (special population) as well as patients with only AD.

Major finding: Patients with AD and concomitant comorbidities achieved significant improvements in the Eczema Area and Severity Index at weeks 4, 16, and 52 (all P < .0001), with comparable outcomes observed in patients with only AD. Patients with vs without concomitant comorbidities reported injection site reactions (12.0% vs 17.22%) and conjunctivitis (8.0% vs 11.34%) as the main adverse events.

Study details: Findings are from a 52-week retrospective study including 263 adults with moderate-to-severe AD who received dupilumab for 16 weeks, including 25 patients with severe kidney failure, hepatitis B/C, neurological diseases, AIDS, or a history of cancer or organ transplantation who were classified as the special population.

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

Source: Patruno C et al. Dupilumab for the treatment of adult atopic dermatitis in special populations. J Dermatolog Treat. 2022 (Jul 19). Doi: 10.1080/09546634.2022.2102121

Key clinical point: Dupilumab demonstrated comparable long-term efficacy and safety in patients with moderate-to-severe atopic dermatitis (AD) and other major comorbidities (special population) as well as patients with only AD.

Major finding: Patients with AD and concomitant comorbidities achieved significant improvements in the Eczema Area and Severity Index at weeks 4, 16, and 52 (all P < .0001), with comparable outcomes observed in patients with only AD. Patients with vs without concomitant comorbidities reported injection site reactions (12.0% vs 17.22%) and conjunctivitis (8.0% vs 11.34%) as the main adverse events.

Study details: Findings are from a 52-week retrospective study including 263 adults with moderate-to-severe AD who received dupilumab for 16 weeks, including 25 patients with severe kidney failure, hepatitis B/C, neurological diseases, AIDS, or a history of cancer or organ transplantation who were classified as the special population.

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

Source: Patruno C et al. Dupilumab for the treatment of adult atopic dermatitis in special populations. J Dermatolog Treat. 2022 (Jul 19). Doi: 10.1080/09546634.2022.2102121

Key clinical point: Dupilumab demonstrated comparable long-term efficacy and safety in patients with moderate-to-severe atopic dermatitis (AD) and other major comorbidities (special population) as well as patients with only AD.

Major finding: Patients with AD and concomitant comorbidities achieved significant improvements in the Eczema Area and Severity Index at weeks 4, 16, and 52 (all P < .0001), with comparable outcomes observed in patients with only AD. Patients with vs without concomitant comorbidities reported injection site reactions (12.0% vs 17.22%) and conjunctivitis (8.0% vs 11.34%) as the main adverse events.

Study details: Findings are from a 52-week retrospective study including 263 adults with moderate-to-severe AD who received dupilumab for 16 weeks, including 25 patients with severe kidney failure, hepatitis B/C, neurological diseases, AIDS, or a history of cancer or organ transplantation who were classified as the special population.

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

Source: Patruno C et al. Dupilumab for the treatment of adult atopic dermatitis in special populations. J Dermatolog Treat. 2022 (Jul 19). Doi: 10.1080/09546634.2022.2102121

Key clinical point: Dupilumab was effective against pruritus and improved itch and sleep scores in patients with atopic dermatitis (AD).

Major finding: By 36 months, the mean numerical rating scale peak of pruritus (NRSpp) score dropped from 8.6 to 1.7 and the mean NRS sleep disturbance (NRSsd) score dropped from 7 to 0. The Eczema Area and Severity Index and Dermatology Life Quality Index scores were significantly correlated with both NRSpp and NRSsd scores (P < .001).

Study details: Findings are from a retrospective, observational study including 356 patients with AD who received dupilumab.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Mastorino L et al. Chronic pruritus in atopic patients treated with dupilumab: Real life response and related parameters in 354 patients. Pharmaceuticals (Basel). 2022;15(7):883 (Jul 17). Doi: 10.3390/ph15070883

Key clinical point: Dupilumab was effective against pruritus and improved itch and sleep scores in patients with atopic dermatitis (AD).

Major finding: By 36 months, the mean numerical rating scale peak of pruritus (NRSpp) score dropped from 8.6 to 1.7 and the mean NRS sleep disturbance (NRSsd) score dropped from 7 to 0. The Eczema Area and Severity Index and Dermatology Life Quality Index scores were significantly correlated with both NRSpp and NRSsd scores (P < .001).

Study details: Findings are from a retrospective, observational study including 356 patients with AD who received dupilumab.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Mastorino L et al. Chronic pruritus in atopic patients treated with dupilumab: Real life response and related parameters in 354 patients. Pharmaceuticals (Basel). 2022;15(7):883 (Jul 17). Doi: 10.3390/ph15070883

Key clinical point: Dupilumab was effective against pruritus and improved itch and sleep scores in patients with atopic dermatitis (AD).

Major finding: By 36 months, the mean numerical rating scale peak of pruritus (NRSpp) score dropped from 8.6 to 1.7 and the mean NRS sleep disturbance (NRSsd) score dropped from 7 to 0. The Eczema Area and Severity Index and Dermatology Life Quality Index scores were significantly correlated with both NRSpp and NRSsd scores (P < .001).

Study details: Findings are from a retrospective, observational study including 356 patients with AD who received dupilumab.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Mastorino L et al. Chronic pruritus in atopic patients treated with dupilumab: Real life response and related parameters in 354 patients. Pharmaceuticals (Basel). 2022;15(7):883 (Jul 17). Doi: 10.3390/ph15070883

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) who continued tralokinumab and topical corticosteroids (TCS) as needed showed progressive and sustained improvement in disease extent and severity and quality-of-life over 32 weeks.

Major finding: Longer use of tralokinumab was associated with a higher proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (week 16: 56%; week 32: 70.2%) and sustained improvement in the Dermatology Life Quality Index scores (week 16: 65.4%; week 32: 66.8%).

Study details: This post hoc analysis of the phase 3 ECZTRA 3 trial included 380 patients with moderate-to-severe AD who were randomized to receive tralokinumab or placebo every 2 weeks, both with TCS as needed, for 16 weeks followed by tralokinumab every 2-4 weeks with TCS until week 32 after re-randomization.

Disclosures: The ECZTRA 3 trial was sponsored by LEO Pharma A/S. Two authors declared being employees and owning stocks in LEO Pharma. The other authors reported ties with several sources, including LEO Pharma.

Source: Silverberg JI et al. Tralokinumab plus topical corticosteroids as needed provides progressive and sustained efficacy in adults with moderate-to-severe atopic dermatitis over a 32-week period: An ECZTRA 3 post hoc analysis. Am J Clin Dermatol. 2022;23:547–559 (Jul 20). Doi: 10.1007/s40257-022-00702-2

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) who continued tralokinumab and topical corticosteroids (TCS) as needed showed progressive and sustained improvement in disease extent and severity and quality-of-life over 32 weeks.

Major finding: Longer use of tralokinumab was associated with a higher proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (week 16: 56%; week 32: 70.2%) and sustained improvement in the Dermatology Life Quality Index scores (week 16: 65.4%; week 32: 66.8%).

Study details: This post hoc analysis of the phase 3 ECZTRA 3 trial included 380 patients with moderate-to-severe AD who were randomized to receive tralokinumab or placebo every 2 weeks, both with TCS as needed, for 16 weeks followed by tralokinumab every 2-4 weeks with TCS until week 32 after re-randomization.

Disclosures: The ECZTRA 3 trial was sponsored by LEO Pharma A/S. Two authors declared being employees and owning stocks in LEO Pharma. The other authors reported ties with several sources, including LEO Pharma.

Source: Silverberg JI et al. Tralokinumab plus topical corticosteroids as needed provides progressive and sustained efficacy in adults with moderate-to-severe atopic dermatitis over a 32-week period: An ECZTRA 3 post hoc analysis. Am J Clin Dermatol. 2022;23:547–559 (Jul 20). Doi: 10.1007/s40257-022-00702-2

Key clinical point: Adults with moderate-to-severe atopic dermatitis (AD) who continued tralokinumab and topical corticosteroids (TCS) as needed showed progressive and sustained improvement in disease extent and severity and quality-of-life over 32 weeks.

Major finding: Longer use of tralokinumab was associated with a higher proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (week 16: 56%; week 32: 70.2%) and sustained improvement in the Dermatology Life Quality Index scores (week 16: 65.4%; week 32: 66.8%).

Study details: This post hoc analysis of the phase 3 ECZTRA 3 trial included 380 patients with moderate-to-severe AD who were randomized to receive tralokinumab or placebo every 2 weeks, both with TCS as needed, for 16 weeks followed by tralokinumab every 2-4 weeks with TCS until week 32 after re-randomization.

Disclosures: The ECZTRA 3 trial was sponsored by LEO Pharma A/S. Two authors declared being employees and owning stocks in LEO Pharma. The other authors reported ties with several sources, including LEO Pharma.

Source: Silverberg JI et al. Tralokinumab plus topical corticosteroids as needed provides progressive and sustained efficacy in adults with moderate-to-severe atopic dermatitis over a 32-week period: An ECZTRA 3 post hoc analysis. Am J Clin Dermatol. 2022;23:547–559 (Jul 20). Doi: 10.1007/s40257-022-00702-2

Key clinical point: A patient-centered dose reduction after 52 weeks of dupilumab therapy helped maintain low disease activity in a subgroup of patients with persistently controlled atopic dermatitis (AD).

Major finding: After ≥3 months of dupilumab dose reduction, >80% and 93.3% of patients receiving dupilumab every 4 weeks (Q4W) and every 6-8 weeks (Q6W/Q8W) maintained an Eczema Area and Severity Index score of ≤7, respectively.

Study details: Findings are from an observational cohort study including 90 adult patients with AD from the BioDay registry who were treated with dupilumab every 2 weeks (Q2W) for 52 weeks, after which the dosing interval was prolonged to Q4W (n = 60) and subsequently to Q6W/Q8W (n = 30) in patients with controlled disease.

Disclosures: The BioDay registry was sponsored by Sanofi Genzyme. Some authors declared receiving research funding or grants from or serving as advisors, consultants, speakers, investigators, or advisory board members for several sources, including Sanofi Genzyme.

Source: Spekhorst LS et al. Patient-centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitis. Allergy. 2022 (Jul 15). Doi: 10.1111/all.15439 

Key clinical point: A patient-centered dose reduction after 52 weeks of dupilumab therapy helped maintain low disease activity in a subgroup of patients with persistently controlled atopic dermatitis (AD).

Major finding: After ≥3 months of dupilumab dose reduction, >80% and 93.3% of patients receiving dupilumab every 4 weeks (Q4W) and every 6-8 weeks (Q6W/Q8W) maintained an Eczema Area and Severity Index score of ≤7, respectively.

Study details: Findings are from an observational cohort study including 90 adult patients with AD from the BioDay registry who were treated with dupilumab every 2 weeks (Q2W) for 52 weeks, after which the dosing interval was prolonged to Q4W (n = 60) and subsequently to Q6W/Q8W (n = 30) in patients with controlled disease.

Disclosures: The BioDay registry was sponsored by Sanofi Genzyme. Some authors declared receiving research funding or grants from or serving as advisors, consultants, speakers, investigators, or advisory board members for several sources, including Sanofi Genzyme.

Source: Spekhorst LS et al. Patient-centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitis. Allergy. 2022 (Jul 15). Doi: 10.1111/all.15439 

Key clinical point: A patient-centered dose reduction after 52 weeks of dupilumab therapy helped maintain low disease activity in a subgroup of patients with persistently controlled atopic dermatitis (AD).

Major finding: After ≥3 months of dupilumab dose reduction, >80% and 93.3% of patients receiving dupilumab every 4 weeks (Q4W) and every 6-8 weeks (Q6W/Q8W) maintained an Eczema Area and Severity Index score of ≤7, respectively.

Study details: Findings are from an observational cohort study including 90 adult patients with AD from the BioDay registry who were treated with dupilumab every 2 weeks (Q2W) for 52 weeks, after which the dosing interval was prolonged to Q4W (n = 60) and subsequently to Q6W/Q8W (n = 30) in patients with controlled disease.

Disclosures: The BioDay registry was sponsored by Sanofi Genzyme. Some authors declared receiving research funding or grants from or serving as advisors, consultants, speakers, investigators, or advisory board members for several sources, including Sanofi Genzyme.

Source: Spekhorst LS et al. Patient-centered dupilumab dosing regimen leads to successful dose reduction in persistently controlled atopic dermatitis. Allergy. 2022 (Jul 15). Doi: 10.1111/all.15439 

Key clinical point: Tralokinumab was well tolerated and maintained long-term disease control for up to 2 years in patients with moderate-to-severe atopic dermatitis (AD).

 Major finding: In the safety analysis set (n = 1174), the exposure-adjusted incidence rate of adverse events (AE) was 237.8 events/100 patient-years of exposure and 71.9% of participants reported ≥1 AE of mostly mild or moderate severity. In the efficacy analysis set (n = 345), 82.5% of patients treated with tralokinumab for 2 years maintained ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the 2-year post hoc interim analysis of the ongoing, 5-year open-label extension trial, ECZTEND, including adult participants with moderate-to-severe AD from previous parent trials who received 300 mg tralokinumab every 2 weeks with or without topical corticosteroids.

Disclosures: The ECZTEND trial was sponsored by LEO Pharma A/S. Three authors declared being employees of LEO Pharma, and other authors reported ties with several sources, including LEO Pharma.

Source: Blauvelt A et al. Long-term 2-year safety and efficacy of tralokinumab in adults with moderate-to-severe atopic dermatitis: Interim analysis of the ECZTEND open-label extension trial. J Am Acad Dermatol. 2022 (Jul 18). Doi: 10.1016/j.jaad.2022.07.019

Key clinical point: Tralokinumab was well tolerated and maintained long-term disease control for up to 2 years in patients with moderate-to-severe atopic dermatitis (AD).

 Major finding: In the safety analysis set (n = 1174), the exposure-adjusted incidence rate of adverse events (AE) was 237.8 events/100 patient-years of exposure and 71.9% of participants reported ≥1 AE of mostly mild or moderate severity. In the efficacy analysis set (n = 345), 82.5% of patients treated with tralokinumab for 2 years maintained ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the 2-year post hoc interim analysis of the ongoing, 5-year open-label extension trial, ECZTEND, including adult participants with moderate-to-severe AD from previous parent trials who received 300 mg tralokinumab every 2 weeks with or without topical corticosteroids.

Disclosures: The ECZTEND trial was sponsored by LEO Pharma A/S. Three authors declared being employees of LEO Pharma, and other authors reported ties with several sources, including LEO Pharma.

Source: Blauvelt A et al. Long-term 2-year safety and efficacy of tralokinumab in adults with moderate-to-severe atopic dermatitis: Interim analysis of the ECZTEND open-label extension trial. J Am Acad Dermatol. 2022 (Jul 18). Doi: 10.1016/j.jaad.2022.07.019

Key clinical point: Tralokinumab was well tolerated and maintained long-term disease control for up to 2 years in patients with moderate-to-severe atopic dermatitis (AD).

 Major finding: In the safety analysis set (n = 1174), the exposure-adjusted incidence rate of adverse events (AE) was 237.8 events/100 patient-years of exposure and 71.9% of participants reported ≥1 AE of mostly mild or moderate severity. In the efficacy analysis set (n = 345), 82.5% of patients treated with tralokinumab for 2 years maintained ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the 2-year post hoc interim analysis of the ongoing, 5-year open-label extension trial, ECZTEND, including adult participants with moderate-to-severe AD from previous parent trials who received 300 mg tralokinumab every 2 weeks with or without topical corticosteroids.

Disclosures: The ECZTEND trial was sponsored by LEO Pharma A/S. Three authors declared being employees of LEO Pharma, and other authors reported ties with several sources, including LEO Pharma.

Source: Blauvelt A et al. Long-term 2-year safety and efficacy of tralokinumab in adults with moderate-to-severe atopic dermatitis: Interim analysis of the ECZTEND open-label extension trial. J Am Acad Dermatol. 2022 (Jul 18). Doi: 10.1016/j.jaad.2022.07.019

Key clinical point: Abrocitinib was more effective than dupilumab in inducing early itch reduction and controlling disease severity in adults with moderate-to-severe atopic dermatitis (AD) on background topical therapy.

Major finding: A significantly higher proportion of patients in the abrocitinib vs dupilumab group achieved ≥4-point improvement in the Peak Pruritus Numerical Rating Scale score at week 2 (48% vs 26%; P < .0001) and ≥90% improvement in the Eczema Area and Severity Index at week 4 (29% vs 15%; P < .0001). Treatment-emergent adverse events were more frequent in the abrocitinib vs dupilumab group (74% vs 65%).

Study details: Findings are from a phase 3 trial including 727 adults with moderate-to-severe AD who showed inadequate response to medicated topical therapy and were randomly assigned to receive oral abrocitinib or subcutaneous dupilumab for 26 weeks.

Disclosures: This study was funded by Pfizer. Seven authors declared being current or former employees or shareholders of Pfizer or Pfizer Pharma. The other authors reported ties with several sources.

Source: Reich K et al. Efficacy and safety of abrocitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A randomised, double-blind, multicentre phase 3 trial. Lancet. 2022;400(10348):273-282 (Jul 23). Doi: 10.1016/S0140-6736(22)01199-0

Key clinical point: Abrocitinib was more effective than dupilumab in inducing early itch reduction and controlling disease severity in adults with moderate-to-severe atopic dermatitis (AD) on background topical therapy.

Major finding: A significantly higher proportion of patients in the abrocitinib vs dupilumab group achieved ≥4-point improvement in the Peak Pruritus Numerical Rating Scale score at week 2 (48% vs 26%; P < .0001) and ≥90% improvement in the Eczema Area and Severity Index at week 4 (29% vs 15%; P < .0001). Treatment-emergent adverse events were more frequent in the abrocitinib vs dupilumab group (74% vs 65%).

Study details: Findings are from a phase 3 trial including 727 adults with moderate-to-severe AD who showed inadequate response to medicated topical therapy and were randomly assigned to receive oral abrocitinib or subcutaneous dupilumab for 26 weeks.

Disclosures: This study was funded by Pfizer. Seven authors declared being current or former employees or shareholders of Pfizer or Pfizer Pharma. The other authors reported ties with several sources.

Source: Reich K et al. Efficacy and safety of abrocitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A randomised, double-blind, multicentre phase 3 trial. Lancet. 2022;400(10348):273-282 (Jul 23). Doi: 10.1016/S0140-6736(22)01199-0

Key clinical point: Abrocitinib was more effective than dupilumab in inducing early itch reduction and controlling disease severity in adults with moderate-to-severe atopic dermatitis (AD) on background topical therapy.

Major finding: A significantly higher proportion of patients in the abrocitinib vs dupilumab group achieved ≥4-point improvement in the Peak Pruritus Numerical Rating Scale score at week 2 (48% vs 26%; P < .0001) and ≥90% improvement in the Eczema Area and Severity Index at week 4 (29% vs 15%; P < .0001). Treatment-emergent adverse events were more frequent in the abrocitinib vs dupilumab group (74% vs 65%).

Study details: Findings are from a phase 3 trial including 727 adults with moderate-to-severe AD who showed inadequate response to medicated topical therapy and were randomly assigned to receive oral abrocitinib or subcutaneous dupilumab for 26 weeks.

Disclosures: This study was funded by Pfizer. Seven authors declared being current or former employees or shareholders of Pfizer or Pfizer Pharma. The other authors reported ties with several sources.

Source: Reich K et al. Efficacy and safety of abrocitinib versus dupilumab in adults with moderate-to-severe atopic dermatitis: A randomised, double-blind, multicentre phase 3 trial. Lancet. 2022;400(10348):273-282 (Jul 23). Doi: 10.1016/S0140-6736(22)01199-0

A study aimed at determining whether behind some of the sex differences in chronic obstructive airway disease (COPD) prevalence and clinical outcomes lie structural differences in airways found that airway lumen sizes quantified through chest CT were smaller in women than in men.

The findings, published in Radiology, took into account height and lung size. The lower baseline airway lumen sizes in women conferred lower reserves against respiratory morbidity and mortality for equivalent changes, compared with men.

Alfred Pasieka/Science Source

Among key findings in a secondary analysis of consecutive participants (9,363 ever-smokers and 420 never-smokers) enrolled in the Genetic Epidemiology of COPD (COPDGene) study, airway lumen dimensions were lower in never-smoker women than in men (segmental lumen diameter, 8.1 mm vs. 9.1 mm; P < .001). Also, ever-smoker women had narrower segmental lumen diameter (7.8 mm ± 0.05 vs. 8.7 mm ± 0.04; P < .001). The investigators found also that a unit change in wall thickness or lumen area resulted in more severe airflow obstruction, more dyspnea, worse respiratory quality of life, lower 6-minute walk distance, and worse survival in women, compared with men.

While COPD is diagnosed more often in men than women, changes in smoking behavior and increasing urbanization have led to COPD prevalence in women fast approaching the rate in men. Although age-adjusted rates for COPD-related deaths have continued to decline in men, in women they have not. Indeed, never-smoking women accounted for two-thirds of COPD in a population-based study.

COPDGene, a prospective, multicenter, observational cohort study, enrolled current and former smokers, as well as never-smokers, aged 45-80 years at 21 clinical centers across the United States from January 2008 to June 2011 with longitudinal follow-up until November 2020. The investigators quantified airway disease through CT imaging using the following metrics: airway wall thickness of segmental airways, wall area percent of segmental airways, the square root of the wall area of a hypothetical airway with 10-mm internal perimeter, total airway count, lumen diameter of segmental airways, airway volume, and airway fractal dimension.

“Not all sex differences in prevalence of COPD have been explained, and structural differences may explain some of these differences. Our findings may have implications for patient selection for clinical trials,” corresponding author Surya P. Bhatt, MD, associate professor of medicine and director of the University of Alabama Imaging Core at Birmingham, said in an interview.

The investigators wrote: “Our findings have implications for airflow limitation and the consequent clinical outcomes. ... We confirmed that men have more emphysema than women with equivalent smoking burden, and our results suggest that the lower reserve conferred by smaller airways predisposes women to develop airflow limitation predominantly through the airway phenotype. All airway remodeling changes were associated with more dyspnea, worse respiratory quality of life, and lower functional capacity in women than in men. The smaller airways in women can result in higher airway resistance and more turbulent airflow, and thus place a higher ventilatory constraint during exertion. Alteration in each airway measure was also associated with worse survival in women than in men, partially explaining the comparable mortality between the sexes for COPD despite the differing degrees of emphysema.”

“I think these findings highlight underappreciated sex differences in the natural history of COPD,” Mohsen Sadatsafavi, MD, PhD, associate professor, faculty of pharmaceutical sciences, at the University of British Columbia, Vancouver, said in an interview. “To me, first and foremost, the Bhatt et al. findings highlight how the ‘one size fits all’ approach to COPD management of using exacerbation history alone to guide preventive therapies is incorrect. These findings have the potential to change the management paradigm of COPD in the long term, but before getting there, I think we need to relate these findings to clinically relevant and patient-reported outcomes.”

Noting study limitations, the authors stated that a higher proportion of men were active smokers, compared with women, and despite adjustments for smoking status, some of the airway wall differences may be from the impact of active cigarette smoking on airway wall thickness.

Five study authors reported receiving support from various government and industry sources and disclosed conflicts of interest based on relationships with industry. The rest reported no conflicts of interest.

A study aimed at determining whether behind some of the sex differences in chronic obstructive airway disease (COPD) prevalence and clinical outcomes lie structural differences in airways found that airway lumen sizes quantified through chest CT were smaller in women than in men.

The findings, published in Radiology, took into account height and lung size. The lower baseline airway lumen sizes in women conferred lower reserves against respiratory morbidity and mortality for equivalent changes, compared with men.

Alfred Pasieka/Science Source

Among key findings in a secondary analysis of consecutive participants (9,363 ever-smokers and 420 never-smokers) enrolled in the Genetic Epidemiology of COPD (COPDGene) study, airway lumen dimensions were lower in never-smoker women than in men (segmental lumen diameter, 8.1 mm vs. 9.1 mm; P < .001). Also, ever-smoker women had narrower segmental lumen diameter (7.8 mm ± 0.05 vs. 8.7 mm ± 0.04; P < .001). The investigators found also that a unit change in wall thickness or lumen area resulted in more severe airflow obstruction, more dyspnea, worse respiratory quality of life, lower 6-minute walk distance, and worse survival in women, compared with men.

While COPD is diagnosed more often in men than women, changes in smoking behavior and increasing urbanization have led to COPD prevalence in women fast approaching the rate in men. Although age-adjusted rates for COPD-related deaths have continued to decline in men, in women they have not. Indeed, never-smoking women accounted for two-thirds of COPD in a population-based study.

COPDGene, a prospective, multicenter, observational cohort study, enrolled current and former smokers, as well as never-smokers, aged 45-80 years at 21 clinical centers across the United States from January 2008 to June 2011 with longitudinal follow-up until November 2020. The investigators quantified airway disease through CT imaging using the following metrics: airway wall thickness of segmental airways, wall area percent of segmental airways, the square root of the wall area of a hypothetical airway with 10-mm internal perimeter, total airway count, lumen diameter of segmental airways, airway volume, and airway fractal dimension.

“Not all sex differences in prevalence of COPD have been explained, and structural differences may explain some of these differences. Our findings may have implications for patient selection for clinical trials,” corresponding author Surya P. Bhatt, MD, associate professor of medicine and director of the University of Alabama Imaging Core at Birmingham, said in an interview.

The investigators wrote: “Our findings have implications for airflow limitation and the consequent clinical outcomes. ... We confirmed that men have more emphysema than women with equivalent smoking burden, and our results suggest that the lower reserve conferred by smaller airways predisposes women to develop airflow limitation predominantly through the airway phenotype. All airway remodeling changes were associated with more dyspnea, worse respiratory quality of life, and lower functional capacity in women than in men. The smaller airways in women can result in higher airway resistance and more turbulent airflow, and thus place a higher ventilatory constraint during exertion. Alteration in each airway measure was also associated with worse survival in women than in men, partially explaining the comparable mortality between the sexes for COPD despite the differing degrees of emphysema.”

“I think these findings highlight underappreciated sex differences in the natural history of COPD,” Mohsen Sadatsafavi, MD, PhD, associate professor, faculty of pharmaceutical sciences, at the University of British Columbia, Vancouver, said in an interview. “To me, first and foremost, the Bhatt et al. findings highlight how the ‘one size fits all’ approach to COPD management of using exacerbation history alone to guide preventive therapies is incorrect. These findings have the potential to change the management paradigm of COPD in the long term, but before getting there, I think we need to relate these findings to clinically relevant and patient-reported outcomes.”

Noting study limitations, the authors stated that a higher proportion of men were active smokers, compared with women, and despite adjustments for smoking status, some of the airway wall differences may be from the impact of active cigarette smoking on airway wall thickness.

Five study authors reported receiving support from various government and industry sources and disclosed conflicts of interest based on relationships with industry. The rest reported no conflicts of interest.

A study aimed at determining whether behind some of the sex differences in chronic obstructive airway disease (COPD) prevalence and clinical outcomes lie structural differences in airways found that airway lumen sizes quantified through chest CT were smaller in women than in men.

The findings, published in Radiology, took into account height and lung size. The lower baseline airway lumen sizes in women conferred lower reserves against respiratory morbidity and mortality for equivalent changes, compared with men.

Alfred Pasieka/Science Source

Among key findings in a secondary analysis of consecutive participants (9,363 ever-smokers and 420 never-smokers) enrolled in the Genetic Epidemiology of COPD (COPDGene) study, airway lumen dimensions were lower in never-smoker women than in men (segmental lumen diameter, 8.1 mm vs. 9.1 mm; P < .001). Also, ever-smoker women had narrower segmental lumen diameter (7.8 mm ± 0.05 vs. 8.7 mm ± 0.04; P < .001). The investigators found also that a unit change in wall thickness or lumen area resulted in more severe airflow obstruction, more dyspnea, worse respiratory quality of life, lower 6-minute walk distance, and worse survival in women, compared with men.

While COPD is diagnosed more often in men than women, changes in smoking behavior and increasing urbanization have led to COPD prevalence in women fast approaching the rate in men. Although age-adjusted rates for COPD-related deaths have continued to decline in men, in women they have not. Indeed, never-smoking women accounted for two-thirds of COPD in a population-based study.

COPDGene, a prospective, multicenter, observational cohort study, enrolled current and former smokers, as well as never-smokers, aged 45-80 years at 21 clinical centers across the United States from January 2008 to June 2011 with longitudinal follow-up until November 2020. The investigators quantified airway disease through CT imaging using the following metrics: airway wall thickness of segmental airways, wall area percent of segmental airways, the square root of the wall area of a hypothetical airway with 10-mm internal perimeter, total airway count, lumen diameter of segmental airways, airway volume, and airway fractal dimension.

“Not all sex differences in prevalence of COPD have been explained, and structural differences may explain some of these differences. Our findings may have implications for patient selection for clinical trials,” corresponding author Surya P. Bhatt, MD, associate professor of medicine and director of the University of Alabama Imaging Core at Birmingham, said in an interview.

The investigators wrote: “Our findings have implications for airflow limitation and the consequent clinical outcomes. ... We confirmed that men have more emphysema than women with equivalent smoking burden, and our results suggest that the lower reserve conferred by smaller airways predisposes women to develop airflow limitation predominantly through the airway phenotype. All airway remodeling changes were associated with more dyspnea, worse respiratory quality of life, and lower functional capacity in women than in men. The smaller airways in women can result in higher airway resistance and more turbulent airflow, and thus place a higher ventilatory constraint during exertion. Alteration in each airway measure was also associated with worse survival in women than in men, partially explaining the comparable mortality between the sexes for COPD despite the differing degrees of emphysema.”

“I think these findings highlight underappreciated sex differences in the natural history of COPD,” Mohsen Sadatsafavi, MD, PhD, associate professor, faculty of pharmaceutical sciences, at the University of British Columbia, Vancouver, said in an interview. “To me, first and foremost, the Bhatt et al. findings highlight how the ‘one size fits all’ approach to COPD management of using exacerbation history alone to guide preventive therapies is incorrect. These findings have the potential to change the management paradigm of COPD in the long term, but before getting there, I think we need to relate these findings to clinically relevant and patient-reported outcomes.”

Noting study limitations, the authors stated that a higher proportion of men were active smokers, compared with women, and despite adjustments for smoking status, some of the airway wall differences may be from the impact of active cigarette smoking on airway wall thickness.

Five study authors reported receiving support from various government and industry sources and disclosed conflicts of interest based on relationships with industry. The rest reported no conflicts of interest.