Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) are most likely to benefit from long-term 2 mg baricitinib therapy if affected body surface area (BSA) at baseline was 10%-50% and early clinical improvement in itch/skin inflammation was seen after 4-8 weeks of treatment initiation.

Major finding: At week 16, at least 75% improvement in Eczema Area and Severity Index (EASI75) was achieved by a higher proportion of patients treated with 2 mg baricitinib with baseline BSA 10%-50% vs. >50% (37.5% vs. 9.5%) and those with vs. without an early response to 2 mg baricitinib at week 4 (55.4% vs. 16.7%) and week 8 (66.7% vs. 2.1%).

Study details: Findings are post hoc analysis of the ongoing phase 3 BREEZE-AD5 trial including 440 adults with moderate-to-severe AD who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo.

Disclosures: This work was funded by Eli Lilly and Company. The authors declared having ties with several sources including Eli Lilly. Four authors declared being current or former employees and shareholders of Eli Lilly.

Source: Silverberg JI et al. Dermatol Ther (Heidelb). 2021 (Nov 30). Doi: 10.1007/s13555-021-00640-7.

Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) are most likely to benefit from long-term 2 mg baricitinib therapy if affected body surface area (BSA) at baseline was 10%-50% and early clinical improvement in itch/skin inflammation was seen after 4-8 weeks of treatment initiation.

Major finding: At week 16, at least 75% improvement in Eczema Area and Severity Index (EASI75) was achieved by a higher proportion of patients treated with 2 mg baricitinib with baseline BSA 10%-50% vs. >50% (37.5% vs. 9.5%) and those with vs. without an early response to 2 mg baricitinib at week 4 (55.4% vs. 16.7%) and week 8 (66.7% vs. 2.1%).

Study details: Findings are post hoc analysis of the ongoing phase 3 BREEZE-AD5 trial including 440 adults with moderate-to-severe AD who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo.

Disclosures: This work was funded by Eli Lilly and Company. The authors declared having ties with several sources including Eli Lilly. Four authors declared being current or former employees and shareholders of Eli Lilly.

Source: Silverberg JI et al. Dermatol Ther (Heidelb). 2021 (Nov 30). Doi: 10.1007/s13555-021-00640-7.

Key clinical point: Patients with moderate-to-severe atopic dermatitis (AD) are most likely to benefit from long-term 2 mg baricitinib therapy if affected body surface area (BSA) at baseline was 10%-50% and early clinical improvement in itch/skin inflammation was seen after 4-8 weeks of treatment initiation.

Major finding: At week 16, at least 75% improvement in Eczema Area and Severity Index (EASI75) was achieved by a higher proportion of patients treated with 2 mg baricitinib with baseline BSA 10%-50% vs. >50% (37.5% vs. 9.5%) and those with vs. without an early response to 2 mg baricitinib at week 4 (55.4% vs. 16.7%) and week 8 (66.7% vs. 2.1%).

Study details: Findings are post hoc analysis of the ongoing phase 3 BREEZE-AD5 trial including 440 adults with moderate-to-severe AD who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo.

Disclosures: This work was funded by Eli Lilly and Company. The authors declared having ties with several sources including Eli Lilly. Four authors declared being current or former employees and shareholders of Eli Lilly.

Source: Silverberg JI et al. Dermatol Ther (Heidelb). 2021 (Nov 30). Doi: 10.1007/s13555-021-00640-7.

Key clinical point: Topical tacrolimus (TAC; 0.3% and 0.1%) and topical corticosteroids (TCS) of mild and moderate potency were safe and showed a comparable safety profile in young children with moderate-to-severe atopic dermatitis (AD).

Major finding: Skin-related infections (P = .198), other infections (P = .498), height (P = .601), weight (P = .812), vaccination responses (P = .620), and serum cortisone levels (P = .228) were not significantly different between TAC and TCS groups. In both groups, Eczema Area and Severity Index decreased significantly (P < .0001) and was similar after 36 months (P = .187).

Study details: Findings are from a 36-month follow-up study including 152 children (age 1-3 years) with moderate-to-severe AD who were randomly assigned to receive TCS creams or TAC ointments (0.03% and 0.1%).

Disclosures: The work was supported by the Pediatric Research Foundation, Helsinki University Hospital, Sigrid Juselius Foundation, and others. The authors declared no conflict of interests.

Source: Salava A et al. Clin Exp Dermatol. 2021 (Nov 19). Doi: 10.1111/ced.15024.

Key clinical point: Topical tacrolimus (TAC; 0.3% and 0.1%) and topical corticosteroids (TCS) of mild and moderate potency were safe and showed a comparable safety profile in young children with moderate-to-severe atopic dermatitis (AD).

Major finding: Skin-related infections (P = .198), other infections (P = .498), height (P = .601), weight (P = .812), vaccination responses (P = .620), and serum cortisone levels (P = .228) were not significantly different between TAC and TCS groups. In both groups, Eczema Area and Severity Index decreased significantly (P < .0001) and was similar after 36 months (P = .187).

Study details: Findings are from a 36-month follow-up study including 152 children (age 1-3 years) with moderate-to-severe AD who were randomly assigned to receive TCS creams or TAC ointments (0.03% and 0.1%).

Disclosures: The work was supported by the Pediatric Research Foundation, Helsinki University Hospital, Sigrid Juselius Foundation, and others. The authors declared no conflict of interests.

Source: Salava A et al. Clin Exp Dermatol. 2021 (Nov 19). Doi: 10.1111/ced.15024.

Key clinical point: Topical tacrolimus (TAC; 0.3% and 0.1%) and topical corticosteroids (TCS) of mild and moderate potency were safe and showed a comparable safety profile in young children with moderate-to-severe atopic dermatitis (AD).

Major finding: Skin-related infections (P = .198), other infections (P = .498), height (P = .601), weight (P = .812), vaccination responses (P = .620), and serum cortisone levels (P = .228) were not significantly different between TAC and TCS groups. In both groups, Eczema Area and Severity Index decreased significantly (P < .0001) and was similar after 36 months (P = .187).

Study details: Findings are from a 36-month follow-up study including 152 children (age 1-3 years) with moderate-to-severe AD who were randomly assigned to receive TCS creams or TAC ointments (0.03% and 0.1%).

Disclosures: The work was supported by the Pediatric Research Foundation, Helsinki University Hospital, Sigrid Juselius Foundation, and others. The authors declared no conflict of interests.

Source: Salava A et al. Clin Exp Dermatol. 2021 (Nov 19). Doi: 10.1111/ced.15024.

Key clinical point: Patients aged 2 years or older with mild-to-moderate atopic dermatitis (AD) showed a better response to 2% crisaborole ointment than other topical calcineurin inhibitors, such as 1% pimecrolimus and 0.03% tacrolimus.

Major finding: By week 6, the odds of achieving Investigator’s Static Global Assessment score of 0/1 was higher for 2% crisaborole vs. 1% pimecrolimus (odds ratio [OR] 2.03; P < .001) and 0.03% tacrolimus (OR, 1.50; P = .012).

Study details: Findings are from an unanchored matching-adjusted indirect comparison of crisaborole 2% with pimecrolimus 1% and tacrolimus (0.03% and 0.1%) in patients aged 2 years or older who had mild-to-moderate AD using individual patient data from 2 phase 3 randomized controlled trials (RCTs) and comparators used in published RCTs.

Disclosures: This study was funded by Pfizer. The authors declared serving as advisor and speaker and/or receiving consulting fees and funding from several sources. Five employees declared being employees and/or shareholders of Pfizer.

Source: Thom H et al. Dermatol Ther (Heidelb). 2021 (Dec 8). Doi: 10.1007/s13555-021-00646-1.

Key clinical point: Patients aged 2 years or older with mild-to-moderate atopic dermatitis (AD) showed a better response to 2% crisaborole ointment than other topical calcineurin inhibitors, such as 1% pimecrolimus and 0.03% tacrolimus.

Major finding: By week 6, the odds of achieving Investigator’s Static Global Assessment score of 0/1 was higher for 2% crisaborole vs. 1% pimecrolimus (odds ratio [OR] 2.03; P < .001) and 0.03% tacrolimus (OR, 1.50; P = .012).

Study details: Findings are from an unanchored matching-adjusted indirect comparison of crisaborole 2% with pimecrolimus 1% and tacrolimus (0.03% and 0.1%) in patients aged 2 years or older who had mild-to-moderate AD using individual patient data from 2 phase 3 randomized controlled trials (RCTs) and comparators used in published RCTs.

Disclosures: This study was funded by Pfizer. The authors declared serving as advisor and speaker and/or receiving consulting fees and funding from several sources. Five employees declared being employees and/or shareholders of Pfizer.

Source: Thom H et al. Dermatol Ther (Heidelb). 2021 (Dec 8). Doi: 10.1007/s13555-021-00646-1.

Key clinical point: Patients aged 2 years or older with mild-to-moderate atopic dermatitis (AD) showed a better response to 2% crisaborole ointment than other topical calcineurin inhibitors, such as 1% pimecrolimus and 0.03% tacrolimus.

Major finding: By week 6, the odds of achieving Investigator’s Static Global Assessment score of 0/1 was higher for 2% crisaborole vs. 1% pimecrolimus (odds ratio [OR] 2.03; P < .001) and 0.03% tacrolimus (OR, 1.50; P = .012).

Study details: Findings are from an unanchored matching-adjusted indirect comparison of crisaborole 2% with pimecrolimus 1% and tacrolimus (0.03% and 0.1%) in patients aged 2 years or older who had mild-to-moderate AD using individual patient data from 2 phase 3 randomized controlled trials (RCTs) and comparators used in published RCTs.

Disclosures: This study was funded by Pfizer. The authors declared serving as advisor and speaker and/or receiving consulting fees and funding from several sources. Five employees declared being employees and/or shareholders of Pfizer.

Source: Thom H et al. Dermatol Ther (Heidelb). 2021 (Dec 8). Doi: 10.1007/s13555-021-00646-1.

Key clinical point: Add-on sublingual immunotherapy (SLIT) with house dust mite (HDM) extract may effectively improve signs and symptoms of atopic dermatitis in patients sensitized to HDM.

Major finding: After 18 months, the SCORing Atopic Dermatitis score decrease in HDM SLIT vs. placebo groups was 55.6% vs. 34.5%, with a significant mean difference of 20.4 (95% credible interval [CI] 3.89-37.3). A significantly higher proportion of patients in the HDM SLIT vs. placebo groups achieved the Investigator’s Global Assessment score of 0/1 (relative risk 2.63; 95% CI, 1.09-6.39). Headache and abdominal pain were the most common adverse events reported by both groups.

Study details: Findings are from a phase 4 study including 91 patients, mostly with moderate-to-severe AD, who were randomly assigned to receive HDM SLIT or placebo for 18 months along with background AD therapy.

Disclosures: This study was funded by the São Paulo Research Foundation, Brazilian National Council for Scientific and Technological Development, and others. Two authors declared receiving doctoral scholarship and research grants from various sources.

Source: Langer SS et al. J Allergy Clin Immunol Pract. 2021 (Nov 9). Doi: 10.1016/j.jaip.2021.10.060.

Key clinical point: Add-on sublingual immunotherapy (SLIT) with house dust mite (HDM) extract may effectively improve signs and symptoms of atopic dermatitis in patients sensitized to HDM.

Major finding: After 18 months, the SCORing Atopic Dermatitis score decrease in HDM SLIT vs. placebo groups was 55.6% vs. 34.5%, with a significant mean difference of 20.4 (95% credible interval [CI] 3.89-37.3). A significantly higher proportion of patients in the HDM SLIT vs. placebo groups achieved the Investigator’s Global Assessment score of 0/1 (relative risk 2.63; 95% CI, 1.09-6.39). Headache and abdominal pain were the most common adverse events reported by both groups.

Study details: Findings are from a phase 4 study including 91 patients, mostly with moderate-to-severe AD, who were randomly assigned to receive HDM SLIT or placebo for 18 months along with background AD therapy.

Disclosures: This study was funded by the São Paulo Research Foundation, Brazilian National Council for Scientific and Technological Development, and others. Two authors declared receiving doctoral scholarship and research grants from various sources.

Source: Langer SS et al. J Allergy Clin Immunol Pract. 2021 (Nov 9). Doi: 10.1016/j.jaip.2021.10.060.

Key clinical point: Add-on sublingual immunotherapy (SLIT) with house dust mite (HDM) extract may effectively improve signs and symptoms of atopic dermatitis in patients sensitized to HDM.

Major finding: After 18 months, the SCORing Atopic Dermatitis score decrease in HDM SLIT vs. placebo groups was 55.6% vs. 34.5%, with a significant mean difference of 20.4 (95% credible interval [CI] 3.89-37.3). A significantly higher proportion of patients in the HDM SLIT vs. placebo groups achieved the Investigator’s Global Assessment score of 0/1 (relative risk 2.63; 95% CI, 1.09-6.39). Headache and abdominal pain were the most common adverse events reported by both groups.

Study details: Findings are from a phase 4 study including 91 patients, mostly with moderate-to-severe AD, who were randomly assigned to receive HDM SLIT or placebo for 18 months along with background AD therapy.

Disclosures: This study was funded by the São Paulo Research Foundation, Brazilian National Council for Scientific and Technological Development, and others. Two authors declared receiving doctoral scholarship and research grants from various sources.

Source: Langer SS et al. J Allergy Clin Immunol Pract. 2021 (Nov 9). Doi: 10.1016/j.jaip.2021.10.060.

Key clinical point: Atopic dermatitis (AD) was associated with an increased burden of a wide range of psychiatric, dermatologic, and extracutaneous comorbidities, increased awareness of which could help better patient management.

Major finding: Compared with control participants, adults with AD were at an increased risk for psychiatric disorders, such as anxiety (odds ratio [OR] 1.44) and obsessive-compulsive disorder (OR 2.01); autoimmune diseases, such as alopecia areata (OR 6.01) and vitiligo (OR 4.44); dermatologic problems, such as cellulitis (OR 2.52); and systemic conditions, such as lymphoid malignancy (OR 1.91), atherosclerosis (OR 1.69), and metabolic syndrome (OR 1.47; all P < .001).

Study details: Findings are a retrospective analysis of 39,779 patients with AD, who were matched with 353,743 control participants from the general population.

Disclosures: The corresponding author Dr. Kwatra received funding from Pfizer and declared serving as an advisory board member, consultant, and investigator for several sources.

Source: Roh YS et al. J Am Acad Dermatol. 2021 (Nov 17). Doi: 10.1016/j.jaad.2021.11.014.

Key clinical point: Atopic dermatitis (AD) was associated with an increased burden of a wide range of psychiatric, dermatologic, and extracutaneous comorbidities, increased awareness of which could help better patient management.

Major finding: Compared with control participants, adults with AD were at an increased risk for psychiatric disorders, such as anxiety (odds ratio [OR] 1.44) and obsessive-compulsive disorder (OR 2.01); autoimmune diseases, such as alopecia areata (OR 6.01) and vitiligo (OR 4.44); dermatologic problems, such as cellulitis (OR 2.52); and systemic conditions, such as lymphoid malignancy (OR 1.91), atherosclerosis (OR 1.69), and metabolic syndrome (OR 1.47; all P < .001).

Study details: Findings are a retrospective analysis of 39,779 patients with AD, who were matched with 353,743 control participants from the general population.

Disclosures: The corresponding author Dr. Kwatra received funding from Pfizer and declared serving as an advisory board member, consultant, and investigator for several sources.

Source: Roh YS et al. J Am Acad Dermatol. 2021 (Nov 17). Doi: 10.1016/j.jaad.2021.11.014.

Key clinical point: Atopic dermatitis (AD) was associated with an increased burden of a wide range of psychiatric, dermatologic, and extracutaneous comorbidities, increased awareness of which could help better patient management.

Major finding: Compared with control participants, adults with AD were at an increased risk for psychiatric disorders, such as anxiety (odds ratio [OR] 1.44) and obsessive-compulsive disorder (OR 2.01); autoimmune diseases, such as alopecia areata (OR 6.01) and vitiligo (OR 4.44); dermatologic problems, such as cellulitis (OR 2.52); and systemic conditions, such as lymphoid malignancy (OR 1.91), atherosclerosis (OR 1.69), and metabolic syndrome (OR 1.47; all P < .001).

Study details: Findings are a retrospective analysis of 39,779 patients with AD, who were matched with 353,743 control participants from the general population.

Disclosures: The corresponding author Dr. Kwatra received funding from Pfizer and declared serving as an advisory board member, consultant, and investigator for several sources.

Source: Roh YS et al. J Am Acad Dermatol. 2021 (Nov 17). Doi: 10.1016/j.jaad.2021.11.014.

Key clinical point: Phototherapy with narrowband (NB) ultraviolet type B (UV-B) light showed high and long-lasting efficacy in atopic dermatitis (AD) with patients with facial involvement and adverse events (AE) responding poorly to the treatment.

Major finding: Overall, 55.4% patients achieved Investigator’s Global Assessment score of 0 and 1 with an overall median response duration of 12 months. Facial involvement (odds ratio [OR] 2.743; P < .001), adverse events (OR 2.366; P = .015), and lower number of treatments (OR 1.017; P = .089) were related with poor response.

Study details: Findings are from a retrospective cohort study of 390 patients with moderate-to-severe AD who were treated with NB-UV-B therapy and followed up for at least 3 years after completing therapy.

Disclosures: This study did not report any funding. The authors declared no conflict of interests.

Source: Ben Mordehai Y et al. Dermatitis. 2021 (Nov 27). Doi: 10.1097/DER.0000000000000810.

Key clinical point: Phototherapy with narrowband (NB) ultraviolet type B (UV-B) light showed high and long-lasting efficacy in atopic dermatitis (AD) with patients with facial involvement and adverse events (AE) responding poorly to the treatment.

Major finding: Overall, 55.4% patients achieved Investigator’s Global Assessment score of 0 and 1 with an overall median response duration of 12 months. Facial involvement (odds ratio [OR] 2.743; P < .001), adverse events (OR 2.366; P = .015), and lower number of treatments (OR 1.017; P = .089) were related with poor response.

Study details: Findings are from a retrospective cohort study of 390 patients with moderate-to-severe AD who were treated with NB-UV-B therapy and followed up for at least 3 years after completing therapy.

Disclosures: This study did not report any funding. The authors declared no conflict of interests.

Source: Ben Mordehai Y et al. Dermatitis. 2021 (Nov 27). Doi: 10.1097/DER.0000000000000810.

Key clinical point: Phototherapy with narrowband (NB) ultraviolet type B (UV-B) light showed high and long-lasting efficacy in atopic dermatitis (AD) with patients with facial involvement and adverse events (AE) responding poorly to the treatment.

Major finding: Overall, 55.4% patients achieved Investigator’s Global Assessment score of 0 and 1 with an overall median response duration of 12 months. Facial involvement (odds ratio [OR] 2.743; P < .001), adverse events (OR 2.366; P = .015), and lower number of treatments (OR 1.017; P = .089) were related with poor response.

Study details: Findings are from a retrospective cohort study of 390 patients with moderate-to-severe AD who were treated with NB-UV-B therapy and followed up for at least 3 years after completing therapy.

Disclosures: This study did not report any funding. The authors declared no conflict of interests.

Source: Ben Mordehai Y et al. Dermatitis. 2021 (Nov 27). Doi: 10.1097/DER.0000000000000810.

Key clinical point: Ocular surface diseases (OSD), particularly conjunctivitis, are prevalent among patients with atopic dermatitis (AD), with the prevalence increasing with AD severity and childhood onset of AD.

Major finding: Of all OSDs, lifetime prevalence was highest for conjunctivitis (66.6%), followed by other OSDs, such as hordeolum (63.5%), blepharitis (11%), and keratitis (9.7%). The lifetime occurrence of conjunctivitis was higher for mild (adjusted odds ratio [aOR] 1.48; 95% CI 1.02-2.14), moderate (aOR 1.73; 95% CI 1.19-2.53), and severe (aOR 2.17; 95% CI 1.42-3.21) AD vs. inactive AD and for childhood-onset vs. adult-onset AD (aOR 1.34; 95% CI 1.16-1.56).

Study details: Findings are from a nationwide, cross-sectional questionnaire-based survey sent to 16,718 patients with AD, of which 7,044 patients responded.

Disclosures: This study was funded by the Kgl. Hofbundtmager Aage Bang Foundation. The authors declared serving as advisory board members, investigators, and consultants or receiving honoraria, grants, and funding from several sources.

Source: Rønnstad ATM et al. J Eur Acad Dermatol Venereol. 2021 (Nov 23). Doi: 10.1111/jdv.17832.

Key clinical point: Ocular surface diseases (OSD), particularly conjunctivitis, are prevalent among patients with atopic dermatitis (AD), with the prevalence increasing with AD severity and childhood onset of AD.

Major finding: Of all OSDs, lifetime prevalence was highest for conjunctivitis (66.6%), followed by other OSDs, such as hordeolum (63.5%), blepharitis (11%), and keratitis (9.7%). The lifetime occurrence of conjunctivitis was higher for mild (adjusted odds ratio [aOR] 1.48; 95% CI 1.02-2.14), moderate (aOR 1.73; 95% CI 1.19-2.53), and severe (aOR 2.17; 95% CI 1.42-3.21) AD vs. inactive AD and for childhood-onset vs. adult-onset AD (aOR 1.34; 95% CI 1.16-1.56).

Study details: Findings are from a nationwide, cross-sectional questionnaire-based survey sent to 16,718 patients with AD, of which 7,044 patients responded.

Disclosures: This study was funded by the Kgl. Hofbundtmager Aage Bang Foundation. The authors declared serving as advisory board members, investigators, and consultants or receiving honoraria, grants, and funding from several sources.

Source: Rønnstad ATM et al. J Eur Acad Dermatol Venereol. 2021 (Nov 23). Doi: 10.1111/jdv.17832.

Key clinical point: Ocular surface diseases (OSD), particularly conjunctivitis, are prevalent among patients with atopic dermatitis (AD), with the prevalence increasing with AD severity and childhood onset of AD.

Major finding: Of all OSDs, lifetime prevalence was highest for conjunctivitis (66.6%), followed by other OSDs, such as hordeolum (63.5%), blepharitis (11%), and keratitis (9.7%). The lifetime occurrence of conjunctivitis was higher for mild (adjusted odds ratio [aOR] 1.48; 95% CI 1.02-2.14), moderate (aOR 1.73; 95% CI 1.19-2.53), and severe (aOR 2.17; 95% CI 1.42-3.21) AD vs. inactive AD and for childhood-onset vs. adult-onset AD (aOR 1.34; 95% CI 1.16-1.56).

Study details: Findings are from a nationwide, cross-sectional questionnaire-based survey sent to 16,718 patients with AD, of which 7,044 patients responded.

Disclosures: This study was funded by the Kgl. Hofbundtmager Aage Bang Foundation. The authors declared serving as advisory board members, investigators, and consultants or receiving honoraria, grants, and funding from several sources.

Source: Rønnstad ATM et al. J Eur Acad Dermatol Venereol. 2021 (Nov 23). Doi: 10.1111/jdv.17832.

Key clinical point: Treatment with once-daily oral abrocitinib led to significantly greater improvements in patient-reported outcomes than placebo in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 16, the patient-oriented eczema measure score improved significantly for 100 mg abrocitinib (least square mean change from baseline [LSM] −9.2) and 200 mg abrocitinib (LSM −12.5) vs. placebo (−5.0; P for both < .0001). A significantly higher proportion of patients receiving abrocitinib, both 200 mg and 100 mg, than placebo reported clinically meaningful improvement in pruritus and symptoms assessment for AD and patient global assessment response (all P < .05).

Study details: Findings are from a phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, with background topical therapy.

Disclosures: This study was funded by Pfizer. The authors declared serving as a consultants, speakers, advisors, and investigators or receiving grants from Pfizer and other sources. Six authors declared being employees and shareholders of Pfizer.

Source: Thyssen JP et al. J Eur Acad Dermatol Venereol. 2021 (Nov 15). Doi: 10.1111/jdv.17813.

Key clinical point: Treatment with once-daily oral abrocitinib led to significantly greater improvements in patient-reported outcomes than placebo in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 16, the patient-oriented eczema measure score improved significantly for 100 mg abrocitinib (least square mean change from baseline [LSM] −9.2) and 200 mg abrocitinib (LSM −12.5) vs. placebo (−5.0; P for both < .0001). A significantly higher proportion of patients receiving abrocitinib, both 200 mg and 100 mg, than placebo reported clinically meaningful improvement in pruritus and symptoms assessment for AD and patient global assessment response (all P < .05).

Study details: Findings are from a phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, with background topical therapy.

Disclosures: This study was funded by Pfizer. The authors declared serving as a consultants, speakers, advisors, and investigators or receiving grants from Pfizer and other sources. Six authors declared being employees and shareholders of Pfizer.

Source: Thyssen JP et al. J Eur Acad Dermatol Venereol. 2021 (Nov 15). Doi: 10.1111/jdv.17813.

Key clinical point: Treatment with once-daily oral abrocitinib led to significantly greater improvements in patient-reported outcomes than placebo in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 16, the patient-oriented eczema measure score improved significantly for 100 mg abrocitinib (least square mean change from baseline [LSM] −9.2) and 200 mg abrocitinib (LSM −12.5) vs. placebo (−5.0; P for both < .0001). A significantly higher proportion of patients receiving abrocitinib, both 200 mg and 100 mg, than placebo reported clinically meaningful improvement in pruritus and symptoms assessment for AD and patient global assessment response (all P < .05).

Study details: Findings are from a phase 3 JADE COMPARE study including 837 patients with moderate-to-severe AD who were randomly assigned to receive 200 mg abrocitinib, 100 mg abrocitinib, dupilumab, or placebo, with background topical therapy.

Disclosures: This study was funded by Pfizer. The authors declared serving as a consultants, speakers, advisors, and investigators or receiving grants from Pfizer and other sources. Six authors declared being employees and shareholders of Pfizer.

Source: Thyssen JP et al. J Eur Acad Dermatol Venereol. 2021 (Nov 15). Doi: 10.1111/jdv.17813.

Key clinical point: Atopic dermatitis (AD) was associated with shorter height and higher body mass index (BMI) in early childhood, but these associations attenuated as children approached adolescence.

Major finding: AD was associated with a lower mean z-height score (−0.13; P < .001) and higher mean z-BMI score (0.05; P = .008); however, this association attenuated by age 14 and 5.5 years, respectively. Based on World Health Organization growth tables, children with vs. without AD were 0.5 cm shorter and had 0.2 more BMI units at 2 years of age and 0.6 cm shorter with no difference in BMI at 5 years of age.

Study details: Findings are from TARGet Kids!, a prospective, longitudinal cohort study including 10,611 children, of which 1,834 had AD during follow-up.

Disclosures: This study was funded by Women’s College Hospital and the Canadian Institutes of Health Research. Dr. Drucker reported receiving compensation and serving as a paid consultant for several sources.

Source: Nicholas MN et al. JAMA Dermatol. 2021 (Nov 17). Doi: 10.1001/jamadermatol.2021.4529.

Key clinical point: Atopic dermatitis (AD) was associated with shorter height and higher body mass index (BMI) in early childhood, but these associations attenuated as children approached adolescence.

Major finding: AD was associated with a lower mean z-height score (−0.13; P < .001) and higher mean z-BMI score (0.05; P = .008); however, this association attenuated by age 14 and 5.5 years, respectively. Based on World Health Organization growth tables, children with vs. without AD were 0.5 cm shorter and had 0.2 more BMI units at 2 years of age and 0.6 cm shorter with no difference in BMI at 5 years of age.

Study details: Findings are from TARGet Kids!, a prospective, longitudinal cohort study including 10,611 children, of which 1,834 had AD during follow-up.

Disclosures: This study was funded by Women’s College Hospital and the Canadian Institutes of Health Research. Dr. Drucker reported receiving compensation and serving as a paid consultant for several sources.

Source: Nicholas MN et al. JAMA Dermatol. 2021 (Nov 17). Doi: 10.1001/jamadermatol.2021.4529.

Key clinical point: Atopic dermatitis (AD) was associated with shorter height and higher body mass index (BMI) in early childhood, but these associations attenuated as children approached adolescence.

Major finding: AD was associated with a lower mean z-height score (−0.13; P < .001) and higher mean z-BMI score (0.05; P = .008); however, this association attenuated by age 14 and 5.5 years, respectively. Based on World Health Organization growth tables, children with vs. without AD were 0.5 cm shorter and had 0.2 more BMI units at 2 years of age and 0.6 cm shorter with no difference in BMI at 5 years of age.

Study details: Findings are from TARGet Kids!, a prospective, longitudinal cohort study including 10,611 children, of which 1,834 had AD during follow-up.

Disclosures: This study was funded by Women’s College Hospital and the Canadian Institutes of Health Research. Dr. Drucker reported receiving compensation and serving as a paid consultant for several sources.

Source: Nicholas MN et al. JAMA Dermatol. 2021 (Nov 17). Doi: 10.1001/jamadermatol.2021.4529.

The American Diabetes Association’s updated clinical recommendations for 2022 call for wider population screening, along with furthering the trends toward individualization of care use of diabetes technology.

Courtesy Joslin Diabetes Center

The summary of changes from 2021 spans four pages. “Diabetes is a really dynamic field so there is a lot to update which is good. It means progress,” ADA chief science and medical officer Robert A. Gabbay, MD, PhD, told this news organization.

The ADA Standards of Medical Care in Diabetes – 2022 was published Dec. 20, 2021, online as a supplement to Diabetes Care.
 

Screening widened by age, in pregnancy, and for type 1 diabetes

One dramatic change is a drop in age to begin screening all people for prediabetes and diabetes from 45 years to 35 years, regardless of risk factors such as obesity.

“Sadly, there are increasing numbers of people with diabetes and developing diabetes younger,” Dr. Gabbay said.

In August 2021, the U.S. Preventive Services Task Force dropped its recommended age of diabetes screening from 40 to 35 years for people with overweight or obesity, but not universally, as ADA now has.

The ADA made its recommendation independently, Dr. Gabbay noted.

The recommendation for testing pregnant women early in gestation (<15 weeks) for preexisting diabetes was also expanded, from just those with risk factors to consideration of testing all women for undiagnosed diabetes at the time they’re planning pregnancy, and if not then, at the first prenatal visit. Screening for gestational diabetes is then performed at 24-28 weeks.

Again, this is caused by increasing diabetes onset at younger ages, Dr. Gabbay said. “We’re well aware that the number of women who have diabetes and don’t know it and become pregnant is significant and therefore screening early on is important.”

New guidance regarding autoantibody screening in adults suspected of having type 1 diabetes and genetic testing for those who don’t fit typical criteria for either of the two main types are based on the ADA/European Association for the Study of Diabetes joint consensus statement on type 1 diabetes in adults.
 

Individualization of care based on comorbidities, other factors

The concept of individualization of care in diabetes has been emphasized for several years now, but continues to be enhanced with new data and newly available management tools.

Regarding management of type 2 diabetes, several charts have been included to help guide decision-making.

One lists drug-specific and patient factors, including comorbidities, to consider when selecting glucose-lowering medications. A new table depicts a building with four “pillars,” for complication risk reduction, including management of blood pressure, lipids, and glucose, as well as use of agents with cardiovascular and kidney benefit.

“On the type 2 side, the choice of therapy is really guided by several factors. We lay them out in a nice diagram. ... A lot of useful information there compares classes of drugs in order to help clinicians make decisions on what would be the appropriate therapy for a given individual,” Dr. Gabbay said.

An algorithm for pharmacologic treatment includes considerations of weight, hypoglycemia, and cost. Tables are also provided listing average wholesale prices of insulins and noninsulin medications.

A section now entitled “Obesity and weight management for the prevention and treatment of type 2 diabetes” has added content regarding the importance of addressing obesity in diabetes, particularly in the context of the COVID-19 pandemic, and the addition of semaglutide as an approved obesity treatment.

“What we hope is that this engenders a shared decision-making process with the patient to identify what the goals are and then choose the appropriate therapy for those goals,” Dr. Gabbay said.

New information has also been added about management of nonalcoholic fatty liver disease. “I think that’s one of the unrecognized and unaddressed complications of diabetes that we’ll see in the future, particularly as new therapies come out,” Dr. Gabbay predicted.

The section on cardiovascular disease and risk management, endorsed for the fourth year in a row by the American College of Cardiology, includes several new recommendations, including diagnosis of hypertension at a single visit if blood pressure is 180/110 mm Hg or greater, and individualization of blood pressure targets.

Chronic kidney disease management has now been separated from other microvascular complications into a standalone section, with several new updates. Retinopathy, neuropathy, and foot care remain combined in one section.
 

Diabetes technology: Rapidly evolving, access an issue

The new technology section “doubles down on the time in [normal glucose] range (TIR) concept,” but also emphasizes the importance of time below range.

“When we see that, we need to make a therapeutic change. We were concerned that as there’s more and more information and numbers, users might not pick up on what’s important,” Dr. Gabbay noted.

The new standards also provides greater affirmation of the value of continuous glucose monitoring (CGM) for people with both type 1 and type 2 diabetes at any age, with individualized choice of devices.

Access to technology is a “big issue, and something the ADA has really been fighting for, particularly in terms of health disparities,” Dr. Gabbay said, noting that ADA has a new Health Equity Now platform, which includes a “bill of rights” calling for all patients with diabetes to have access to state-of-the-art technologies, including CGM.

Overall, he said, “I think the big picture is diabetes continues to evolve and advance. After careful review of the literature, the standards of care identifies at least four big areas where there are some changes that clinicians need to know about: screening, how to individualize treatment, considerations of comorbidities, and the important role that technology plays.”

Dr. Gabbay is an employee of the ADA.

A version of this article first appeared on Medscape.com.

The American Diabetes Association’s updated clinical recommendations for 2022 call for wider population screening, along with furthering the trends toward individualization of care use of diabetes technology.

Courtesy Joslin Diabetes Center

The summary of changes from 2021 spans four pages. “Diabetes is a really dynamic field so there is a lot to update which is good. It means progress,” ADA chief science and medical officer Robert A. Gabbay, MD, PhD, told this news organization.

The ADA Standards of Medical Care in Diabetes – 2022 was published Dec. 20, 2021, online as a supplement to Diabetes Care.
 

Screening widened by age, in pregnancy, and for type 1 diabetes

One dramatic change is a drop in age to begin screening all people for prediabetes and diabetes from 45 years to 35 years, regardless of risk factors such as obesity.

“Sadly, there are increasing numbers of people with diabetes and developing diabetes younger,” Dr. Gabbay said.

In August 2021, the U.S. Preventive Services Task Force dropped its recommended age of diabetes screening from 40 to 35 years for people with overweight or obesity, but not universally, as ADA now has.

The ADA made its recommendation independently, Dr. Gabbay noted.

The recommendation for testing pregnant women early in gestation (<15 weeks) for preexisting diabetes was also expanded, from just those with risk factors to consideration of testing all women for undiagnosed diabetes at the time they’re planning pregnancy, and if not then, at the first prenatal visit. Screening for gestational diabetes is then performed at 24-28 weeks.

Again, this is caused by increasing diabetes onset at younger ages, Dr. Gabbay said. “We’re well aware that the number of women who have diabetes and don’t know it and become pregnant is significant and therefore screening early on is important.”

New guidance regarding autoantibody screening in adults suspected of having type 1 diabetes and genetic testing for those who don’t fit typical criteria for either of the two main types are based on the ADA/European Association for the Study of Diabetes joint consensus statement on type 1 diabetes in adults.
 

Individualization of care based on comorbidities, other factors

The concept of individualization of care in diabetes has been emphasized for several years now, but continues to be enhanced with new data and newly available management tools.

Regarding management of type 2 diabetes, several charts have been included to help guide decision-making.

One lists drug-specific and patient factors, including comorbidities, to consider when selecting glucose-lowering medications. A new table depicts a building with four “pillars,” for complication risk reduction, including management of blood pressure, lipids, and glucose, as well as use of agents with cardiovascular and kidney benefit.

“On the type 2 side, the choice of therapy is really guided by several factors. We lay them out in a nice diagram. ... A lot of useful information there compares classes of drugs in order to help clinicians make decisions on what would be the appropriate therapy for a given individual,” Dr. Gabbay said.

An algorithm for pharmacologic treatment includes considerations of weight, hypoglycemia, and cost. Tables are also provided listing average wholesale prices of insulins and noninsulin medications.

A section now entitled “Obesity and weight management for the prevention and treatment of type 2 diabetes” has added content regarding the importance of addressing obesity in diabetes, particularly in the context of the COVID-19 pandemic, and the addition of semaglutide as an approved obesity treatment.

“What we hope is that this engenders a shared decision-making process with the patient to identify what the goals are and then choose the appropriate therapy for those goals,” Dr. Gabbay said.

New information has also been added about management of nonalcoholic fatty liver disease. “I think that’s one of the unrecognized and unaddressed complications of diabetes that we’ll see in the future, particularly as new therapies come out,” Dr. Gabbay predicted.

The section on cardiovascular disease and risk management, endorsed for the fourth year in a row by the American College of Cardiology, includes several new recommendations, including diagnosis of hypertension at a single visit if blood pressure is 180/110 mm Hg or greater, and individualization of blood pressure targets.

Chronic kidney disease management has now been separated from other microvascular complications into a standalone section, with several new updates. Retinopathy, neuropathy, and foot care remain combined in one section.
 

Diabetes technology: Rapidly evolving, access an issue

The new technology section “doubles down on the time in [normal glucose] range (TIR) concept,” but also emphasizes the importance of time below range.

“When we see that, we need to make a therapeutic change. We were concerned that as there’s more and more information and numbers, users might not pick up on what’s important,” Dr. Gabbay noted.

The new standards also provides greater affirmation of the value of continuous glucose monitoring (CGM) for people with both type 1 and type 2 diabetes at any age, with individualized choice of devices.

Access to technology is a “big issue, and something the ADA has really been fighting for, particularly in terms of health disparities,” Dr. Gabbay said, noting that ADA has a new Health Equity Now platform, which includes a “bill of rights” calling for all patients with diabetes to have access to state-of-the-art technologies, including CGM.

Overall, he said, “I think the big picture is diabetes continues to evolve and advance. After careful review of the literature, the standards of care identifies at least four big areas where there are some changes that clinicians need to know about: screening, how to individualize treatment, considerations of comorbidities, and the important role that technology plays.”

Dr. Gabbay is an employee of the ADA.

A version of this article first appeared on Medscape.com.

The American Diabetes Association’s updated clinical recommendations for 2022 call for wider population screening, along with furthering the trends toward individualization of care use of diabetes technology.

Courtesy Joslin Diabetes Center

The summary of changes from 2021 spans four pages. “Diabetes is a really dynamic field so there is a lot to update which is good. It means progress,” ADA chief science and medical officer Robert A. Gabbay, MD, PhD, told this news organization.

The ADA Standards of Medical Care in Diabetes – 2022 was published Dec. 20, 2021, online as a supplement to Diabetes Care.
 

Screening widened by age, in pregnancy, and for type 1 diabetes

One dramatic change is a drop in age to begin screening all people for prediabetes and diabetes from 45 years to 35 years, regardless of risk factors such as obesity.

“Sadly, there are increasing numbers of people with diabetes and developing diabetes younger,” Dr. Gabbay said.

In August 2021, the U.S. Preventive Services Task Force dropped its recommended age of diabetes screening from 40 to 35 years for people with overweight or obesity, but not universally, as ADA now has.

The ADA made its recommendation independently, Dr. Gabbay noted.

The recommendation for testing pregnant women early in gestation (<15 weeks) for preexisting diabetes was also expanded, from just those with risk factors to consideration of testing all women for undiagnosed diabetes at the time they’re planning pregnancy, and if not then, at the first prenatal visit. Screening for gestational diabetes is then performed at 24-28 weeks.

Again, this is caused by increasing diabetes onset at younger ages, Dr. Gabbay said. “We’re well aware that the number of women who have diabetes and don’t know it and become pregnant is significant and therefore screening early on is important.”

New guidance regarding autoantibody screening in adults suspected of having type 1 diabetes and genetic testing for those who don’t fit typical criteria for either of the two main types are based on the ADA/European Association for the Study of Diabetes joint consensus statement on type 1 diabetes in adults.
 

Individualization of care based on comorbidities, other factors

The concept of individualization of care in diabetes has been emphasized for several years now, but continues to be enhanced with new data and newly available management tools.

Regarding management of type 2 diabetes, several charts have been included to help guide decision-making.

One lists drug-specific and patient factors, including comorbidities, to consider when selecting glucose-lowering medications. A new table depicts a building with four “pillars,” for complication risk reduction, including management of blood pressure, lipids, and glucose, as well as use of agents with cardiovascular and kidney benefit.

“On the type 2 side, the choice of therapy is really guided by several factors. We lay them out in a nice diagram. ... A lot of useful information there compares classes of drugs in order to help clinicians make decisions on what would be the appropriate therapy for a given individual,” Dr. Gabbay said.

An algorithm for pharmacologic treatment includes considerations of weight, hypoglycemia, and cost. Tables are also provided listing average wholesale prices of insulins and noninsulin medications.

A section now entitled “Obesity and weight management for the prevention and treatment of type 2 diabetes” has added content regarding the importance of addressing obesity in diabetes, particularly in the context of the COVID-19 pandemic, and the addition of semaglutide as an approved obesity treatment.

“What we hope is that this engenders a shared decision-making process with the patient to identify what the goals are and then choose the appropriate therapy for those goals,” Dr. Gabbay said.

New information has also been added about management of nonalcoholic fatty liver disease. “I think that’s one of the unrecognized and unaddressed complications of diabetes that we’ll see in the future, particularly as new therapies come out,” Dr. Gabbay predicted.

The section on cardiovascular disease and risk management, endorsed for the fourth year in a row by the American College of Cardiology, includes several new recommendations, including diagnosis of hypertension at a single visit if blood pressure is 180/110 mm Hg or greater, and individualization of blood pressure targets.

Chronic kidney disease management has now been separated from other microvascular complications into a standalone section, with several new updates. Retinopathy, neuropathy, and foot care remain combined in one section.
 

Diabetes technology: Rapidly evolving, access an issue

The new technology section “doubles down on the time in [normal glucose] range (TIR) concept,” but also emphasizes the importance of time below range.

“When we see that, we need to make a therapeutic change. We were concerned that as there’s more and more information and numbers, users might not pick up on what’s important,” Dr. Gabbay noted.

The new standards also provides greater affirmation of the value of continuous glucose monitoring (CGM) for people with both type 1 and type 2 diabetes at any age, with individualized choice of devices.

Access to technology is a “big issue, and something the ADA has really been fighting for, particularly in terms of health disparities,” Dr. Gabbay said, noting that ADA has a new Health Equity Now platform, which includes a “bill of rights” calling for all patients with diabetes to have access to state-of-the-art technologies, including CGM.

Overall, he said, “I think the big picture is diabetes continues to evolve and advance. After careful review of the literature, the standards of care identifies at least four big areas where there are some changes that clinicians need to know about: screening, how to individualize treatment, considerations of comorbidities, and the important role that technology plays.”

Dr. Gabbay is an employee of the ADA.

A version of this article first appeared on Medscape.com.