Defining a good indication of nemoluzimab based on clinical criteria ➜ DOI: 10.1111/1346-8138.17626 Nemolizumab is an effective treatment for pruritus in atopic dermatitis, but it has a relatively high incidence of cutaneous adverse events (cAEs). To optimize the use of nemolizumab, Japanese researchers investigated the relationship between baseline severity in specific body areas and the frequency of cAEs. They found that cases who discontinued treatment with nemolizumab had more severe erythema and edema/papulation on the trunk than those who continued nemolizumab and that the score of excoriation on the trunk tended to be higher. They suggest that in Japanese patients with mild severity of trunk involvement at initial assessment could be suitable for nemolizumab therapy, with the potential for long-term continuation with the control of cAEs. Studies in other populations are needed for confirmation.
Which appropriate injection intervals of Dupilumab in controlled adult AD? ➜ DOI: 10.5021/ad.24.084 There is a growing demand for extending dosing intervals of dupilumab injections in patients with AD due to treatment burden, costs and side effects. In this Korean study, interval prolongation was considered in controlled patients assessed by EASI score and serum inflammatory markers after at least 40 weeks of treatment with a standard regimen. A total of 52 patients were included with 11 patients extending intervals to 3–4 weeks without flare-ups. The mean dupilumab treatment before tapering was around a year. The tapering group had a significantly lower body mass index. All patients of the tapering group had EASI scores under 4 and immunoglobulin E (IgE) levels under 1,000 IU/mL at week 40. EASI scores and IgE levels remained consistently low after dose reduction, with a mean follow-up time of 14.36 months. Such tapering markers at week 40 need to be confirmed in other populations.
Overall good news for male adolescents with AD ➜ DOI: 10.2340/actadv.v105.42127 Using a national registry data, the investigators included a total of 205,394 men born between 1952 and 1956 in Sweden who underwent military conscription examination including assessment of AD and AD severity. They examined the association between AD and AD severity in late adolescence and labor-market participation, income from work, marital status, and medication for anxiety and depression later in adult life. AD was not found to be associated with a disadvantage in terms of occupational socioeconomic group, income from work, and unemployment benefits. However, individuals with severe AD, more often had a prescription for antidepressants or anxiolytics at the age of 50–57 years.
Dupilumab-Related Payments to Physicians in the US ➜ DOI: 10.1177/19458924251316686 This US study characterizes the change in payments by pharma to physicians for dupilumab-related promotional activities from 2017 to 2023 using the Open Payments website filtered to determine the number of dupilumab-related payments to physicians, the amounts of these payments, the number of unique physicians that were paid, and the amount of money going towards different payment purposes. In 2017, pharmaceutical companies paid a total of $6.1 million to US allergists/immunologists, dermatologists, gastroenterologists, otolaryngologists, and pulmonologists for dupilumab-related activities. This amount grew to a total of $22.6 million in 2023. Most money went for non-consulting, non-continuing education speaker fees. Those data need to be benchmarked to the global drug sales of Dupixent, $ 11.5 billion in 2023, and to the unknown money which goes to patients’ advocacies to influence health care providers.
Updated consensus Korean diagnostic criteria for AD ➜ DOI: 10.5021/ad.24.049 The Korean Atopic Dermatitis Association working group released simplified and practical AD diagnostic criteria using a modified Delphi method composed of 3 rounds of email questionnaires. Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids (which replace minor criteria for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation (micropapular eczema), and personal or family history of atopy.
Dupilumab unmasking of allergic contact dermatitis ➜ DOI: 10.1111/cod.14758 This case report highlights that dupilumab is not the cause of all cases of facial dermatitis under treatment. Patch tests remain useful, here to diagnose methylisothiazolinone contact allergy, due to a preservative present in the patient’s shampoo that he had been using for more than 2 years, before starting dupilumab. The authors suggest that dupilumab immunologically exacerbated the TH1 predominant contact allergy.
