In her session, “What’s New and Hot in Atopic Dermatitis,” Emma Guttman-Yassky, MD, PhD, reviewed recent targeted therapies for the treatment of atopic dermatitis (AD).

Dr Guttman-Yassky begin with a brief overview of AD, the most common inflammatory skin disease. Twenty percent to 30% of patients have moderate to severe disease, and there is a large unmet need for long-term disease control. AD is highly heterogeneous and involves multiple immune cytokines, such as IL-4, IL-13, IL-22, and IFN-γ. A better understanding of disease pathogenesis has enabled the development of targeted therapies.

New IL-13 inhibitors in the pipeline for AD include:

• Tralokinumab
• Lebrikizumab
• Cendakimab
•  ASLAN004 (IL-13RA1)

Other targeted therapies in the pipeline include:

• CBP201 (IL-4RA)
• Nemolizumab (IL-31)
• KHK4083/ AMG 4051 (OX40)
• Amlitelimab/KY100 (OX40L)
• RPT193 5 (CCR4)
• Etrasimod (S1PR)

Dr Guttman-Yassky also discussed dupilumab (IL-4 and IL-13), as well as the JAK inhibitors topical ruxolitinib, upadacitinib, and abrocitinib. “Ruxolitinib is approved now. An 8-week study showed high Eczema Area and Severity Index 75. We know that it’s also approved for vitiligo, with high efficacy in AD. Please pay attention that it’s approved for up to 20% body surface area,” she stressed.

OX40 is a new target for AD. “It’s primarily expressed by activated T-cells, including activated Th2 cells,” Dr Guttman-Yassky explained. She shared results from a study of an OX40 antagonist, noting, “This is the first study that shows the idea that we can not only treat our patients successfully, but maybe maintain responses.”

Dr Guttman Yassky concluded that this is an exciting time for new and emerging treatments for AD. Because AD is a complex and heterogenous disease, we may need broader treatments to successfully treat all patients. Some treatments in the pipeline may hold promise for sustained responses and even disease modification. Long-term safety data across indications are needed to understand risks over prolonged exposure periods and the patient characteristics to consider during treatment selection.

Reference

Guttman-Yassky E. What’s new and hot in atopic dermatitis. Presented at: Fall Clinical Dermatology Conference 2022; October 20–23, 2022; Las Vegas, NV.