Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Long-term dupilumab treatment reduced the severity of hand eczema (HE) and enhanced the quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, 87.1% patients achieved ≥75% improvement in Hand Eczema Severity Index score, 90.3% patients achieved “clear” or “almost clear” endpoint based on the photographic guide, and mean HE-specific Health-related QoL improved by 63.5% (95% CI −71.1% to −55.9%).

Study details: This was a prospective, observational study including 72 adults with moderate-to-severe AD and concomitant HE, of whom 62 patients completed the 52-week dupilumab treatment.

Disclosures: This study was supported by Sanofi and Regeneron Pharmaceuticals. MLA Schuttelaar and MS de Bruin-Welle declared serving as advisors, consultants, speakers, investigators, and advisory board members or receiving grants from several sources, including Regeneron and Sanofi Genzyme.

Source: Voorberg AN et al. The long-term effect of dupilumab on chronic hand eczema in patients with moderate to severe atopic dermatitis – 52 week results from the Dutch BioDay registry. Contact Dermatitis. 2022 (Mar 13). Doi: 10.1111/cod.14104

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: Under maximum use conditions, ruxolitinib cream was well-tolerated and reduced the severity of atopic dermatitis (AD) in patients with ≥25% body surface area (BSA) involvement.

Major finding: Treatment-emergent adverse events (AE) of mostly mild and moderate intensity and treatment-related AE were reported by 31.7% and 9.8% of patients, respectively. At day 56, 94.6% of patients reported ≥75% improvement in the Eczema Area and Severity Index.

Study details: Findings are from the phase 1 maximum-use trial including 41 patients with AD who had ≥25% BSA involvement and were administered 1.5% ruxolitinib cream twice daily for 28 days. Of these, 37 patients did not experience any safety concerns and continued treatment for an additional 28 days.

Disclosures: This study was funded by Incyte Corporation. Three authors declared being employees and shareholders of Incyte Corporation and other authors reported ties with several sources.

Source: Bissonnette R et al. A maximum-use trial of ruxolitinib cream in adolescents and adults with atopic dermatitis. Am J Clin Dermatol. 2022 (Apr 4). Doi: 10.1007/s40257-022-00690-3

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), baricitinib therapy resulted in rapid and sustained improvement in skin pain leading to an enhanced quality of life (QoL).

Major finding: Skin pain improved as early as by day 1 with 2 mg baricitinib (least square mean % change from baseline [Δ] −4.4%; P = .048) and by day 2 with 1 mg baricitinib (Δ −6.7%; P = .011) vs. placebo, with improvements maintained through week 16 for both baricitinib doses (P ≤ .05) and 70.9% vs. 10.4% of skin pain responders vs. nonresponders experiencing clinically meaningful improvement in QoL (P < .0001).

Study details: Findings are from a post hoc analysis of the phase 3 BREEZE-AD5 study including 440 adults with moderate-to-severe AD and inadequate response to topical therapy who were randomly assigned to receive once-daily 1 mg baricitinib, 2 mg baricitinib, or placebo for 16 weeks.

Disclosures: This study was sponsored by Eli Lilly and Company. Three authors declared being employees and shareholders of Eli Lilly and other authors reported ties with several sources, including Eli Lilly.

Source: Rosmarin D et al. Rapid improvement in skin pain severity and its impact on quality of life in adult patients with moderate-to-severe atopic dermatitis from a double-blind, placebo-controlled baricitinib phase 3 study. J Cutan Med Surg. 2022 (Mar 31). Doi: 10.1177/12034754221088542

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Children born to mothers who had a cumulative exposure to psychological distress in the prenatal and postnatal periods were at an increased risk of developing atopic dermatitis (AD) at 1-2 years of age.

Major finding: Maternal psychological distress vs. no psychological distress in both prenatal and postnatal periods (adjusted relative risk [RR] 1.34; 95% CI 1.20-1.47) and only in the postnatal period (adjusted RR 1.23; 95% CI 1.07-1.39) was significantly associated with an increased risk of developing AD in children at 1-2 years of age.

Study details: This study analyzed maternal psychological distress during early pregnancy and 1 year after delivery in 8377 mother-child pairs, wherein the child had not developed AD by the age of 1 year.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. K Murakami declared being an editorial board member of BMC Public Health.

Source: Kawaguchi C et al. Cumulative exposure to maternal psychological distress in the prenatal and postnatal periods and atopic dermatitis in children: Findings from the TMM BirThree Cohort Study. BMC Pregnancy Childbirth. 2022;22:242 (Mar 24). Doi: 10.1186/s12884-022-04556-8

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: Patients with chronic rhinosinusitis (CRS) were more likely to develop atopic dermatitis (AD), particularly young (<45 years) and middle-aged (45-64 years) patients.

Major finding: The risk of developing AD was significantly higher in patients with vs. without CRS (adjusted hazard ratio [aHR] 1.1952; 95% CI 1.1009-1.2976), especially among young (aHR 1.1491; 95% CI 1.0386-1.2713) and middle-aged (aHR 1.2944; 95% CI 1.1044-1.5171) patients.

Study details: This was a longitudinal cohort study that included 16,668 patients with CRS and 33,336 sociodemographically matched control individuals without CRS who were followed-up for 11 years.

Disclosures: This research was supported by Hallym University Research Fund and the National Research Foundation funded by the Korean government. The authors declared no conflicts of interest.

Source: Son D-S et al. Chronic rhinosinusitis and the increased incidence of atopic dermatitis. Am J Rhinol Allergy. 2022 (Mar 29). Doi: 10.1177/19458924221090050

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: BNT162b2 SARS-CoV-2 mRNA (BioNTech Pfizer) vaccine is highly effective in patients with atopic dermatitis (AD), with no indication for alternate vaccination strategies among patients receiving immunosuppressants.

Major finding: Patients with AD who received both doses of BNT162b2 vaccine vs. those who were not vaccinated had a significantly reduced risk for SARS-CoV-2 infection (adjusted hazard ratio [aHR] 0.20), COVID-19-associated hospitalization (aHR 0.08), and COVID-19-associated mortality (aHR 0.04; all P < .001), with no impact of immunosuppressive drugs on vaccine efficacy against SARS-CoV-2 infection (P = .958).

Study details: This population-based cohort study evaluated 77,682 adults with AD, of which 58,582 patients had completed two doses of BNT162b2 vaccine.

Disclosures: This study did not receive any funding. AD Cohen declared serving as an advisor, investigator, or speaker for several pharmaceutical companies.

Source: Kridin K et al. Determinants and effectiveness of BNT162b2 mRNA vaccination among patients with atopic dermatitis: A population-based study. Am J Clin Dermatol. 2022 (Mar 16). Doi: 10.1007/s40257-022-00672-5

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Both oral and topical Janus kinase inhibitors (JAKi) led to clinically meaningful improvement in the severity of atopic dermatitis (AD), with topical JAKi demonstrating an excellent safety profile and oral JAKi demonstrating an adverse effect (AE) profile that warrants monitoring.

Major finding: Patients receiving JAKi vs. placebo showed a significant improvement in the Eczema Area and Severity Index score (standardized mean difference [SMD] −0.79) and the pruritus numerical rating scale score (SMD −0.49; both P < .00001). Although patients in topical JAKi groups experienced no significant AE; however, those in oral JAKi groups were at an increased risk for ≥1 AE (odds ratio 1.23; P < .0001) with the most frequent AE being gastrointestinal disorders (P < .00001) and headache (P = .0003).

Study details: Findings are from a meta-analysis of 25 studies including 9931 patients with AD, of which 2383 and 7548 participants were involved in topical and oral JAKi studies, respectively.

Disclosures: This study did not receive any funding. No conflicts of interest were reported.

Source: Chen J et al. the efficacy and safety of Janus kinase inhibitors in patients with atopic dermatitis: A systematic review and meta-analysis. J Am Acad Dermatol. 2022 (Mar 28). Doi: 10.1016/j.jaad.2022.03.039

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: Dupilumab lowered SARS-CoV-2 immunoglobulin G (IgG) antibody levels in unvaccinated patients with atopic dermatitis (AD) and COVID-19 infection; however, it did not impair antibody response in mRNA vaccinated patients with AD.

Major finding: SARS-CoV-2 IgG antibody levels were significantly lower in unvaccinated patients with COVID-19 infection receiving dupilumab vs. systemic medications (P = .01) for AD, whereas they were similar in all vaccinated patients across the dupilumab, systemic medication, and topical therapy treatment groups (P > .18).

Study details: This study included patients with moderate-to-severe AD who were either infected with COVID-19 and were unvaccinated (n = 54) or had received a second mRNA vaccine dose ≥14 days before serum samples were collected (n = 180).

Disclosures: This work was supported by the Department of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City, Regeneron, Sanofi, and the US National Institute of Allergy and Infectious Diseases. E Guttman-Yassky declared being an employee of Mount Sinai, receiving research funds, and serving as a consultant for several sources. AB Pavel declared having a research contract with Mount Sinai.

Source: Ungar B et al. The impact of dupilumab treatment on severe acute respiratory syndrome coronavirus 2-coronavirus disease 2019 antibody responses in patients with atopic dermatitis. Ann Allergy Asthma Immunol. 2022 (Mar 25). Doi: 10.1016/j.anai.2022.03.019

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455

Key clinical point: In patients with atopic dermatitis (AD), once-daily 200 mg abrocitinib or 30 mg upadacitinib more effectively improved Eczema Area and Severity Index (EASI) scores than dupilumab, whereas improvement with baricitinib and tralokinumab were comparable to dupilumab.

Major finding: Compared with dupilumab, up to 16 weeks of treatment with 200 mg abrocitinib (mean difference [MD] 2.2; 95% credible interval [CrI] 0.2-4.0) or 30 mg upadacitinib (MD 2.7; 95% CrI 0.6-4.7) led to greater reduction in EASI scores, whereas 600 mg tralokinumab followed by 300 mg every 2 weeks (MD −3.5; 95% CrI −5.8 to −1.3) and 2 mg baricitinib daily (MD −5.2; 95% CrI −7.5 to −2.9) and 4 mg baricitinib daily (MD −3.2; 95% CrI −5.7 to −0.8) were associated with a lesser reduction.

Study details: Findings are from a meta-analysis of 60 trials including 16,579 children and adults with moderate-to-severe AD.

Disclosures: This work was supported by the UK National Institute for Health Research Career Development Fellowship. The authors declared serving as consultants, co-principal/chief investigators, or employees or receiving compensation, research grants, fees, and funding from several sources.

Source: Drucker AM et al. Systemic immunomodulatory treatments for atopic dermatitis: Update of a living systematic review and network meta-analysis. JAMA Dermatol. 2022 (Mar 16). Doi: 10.1001/jamadermatol.2022.0455

Most people believe that, if you want to conduct clinical research, the best path is going into academic medicine. However, for physicians who want both the benefits of practicing in the community setting and a career in research, there are many ways to both treat patients and have a rewarding experience making a difference in facilitating treatment options that can become available to patients.

Our practices, Capital Digestive Care in Silver Spring, Md., and the PACT-Gastroenterology Center in Hamden, Conn, have been conducting clinical trials for many years on serious diseases such as inflammatory bowel disease, gastroparesis, and most recently, recurrent infection of Clostridioides difficile. We both also worked on the National Institutes of Health–sponsored Anal Cancer/HSIL Outcomes Research (ANCHOR) study.
 

Academic setting vs. private practice

Research in our practices is similar to the academic setting with regards to how studies are conducted and structured since everyone involved in the study follows the same protocol. The benefit of being in a community setting is that you have a wide range of patients that you are seeing every day.

Getting involved in research is not for everyone, but for those who do get involved, the decision is a rewarding one that can make a significant difference in patients’ lives. Offering new therapeutics for disease states is a powerful tool for a provider, and it is exciting and rewarding to engage in the research considering new mechanisms of action and new approaches to treating diseases.
 

Finding a better treatment for C. difficile

For example, C. difficile is common in older people who’ve received antibiotics for other infections, especially residents of long-term care facilities. These residents have frequent antibiotic exposure and are already vulnerable to infection because of advanced age, multiple comorbid conditions, and communal living conditions. Once a case of C. difficile is diagnosed in a nursing home, it can spread through contaminated equipment, environments, or hands.

The treatment for C. difficile is to control the bacteria with antibiotics, but spores remain, so after a few days in certain people the spores germinate, and the C. difficile returns: a recurrence. It used to be that, after a second reoccurrence, you would send the patient for a fecal transplant, which was a scarce resource and a challenging process.

To perform a fecal transplant, you would need a spouse or a family member to provide a stool sample. After their stool was tested, the family member would need to process their stool in a blender with saline and draw it up in syringes. Once you had the material, the patient would need to go through a full colonoscopy to infuse the material into the colon. Of course, increased restrictions and safety precautions from the COVID-19 pandemic have made fecal transplants even more complex.

Given all these challenges, conducting research considering microbiota-based live biotherapeutics, the term the Food and Drug Administration uses for pharmaceutically produced forms of fecal microbiota transplantation, is very appealing. There are several different formulations that have come through clinical trials recently including RBX-2660, SER-109, and CP101.

SER-109 is an orally taken treatment produced by Seres Therapeutics. Once patients with acute recurrence of C. difficile are treated with standard antibiotics, they are given a course of four SER-109 capsules for 3 days. The results of the SER-109 study were published recently in the New England Journal of Medicine. This is the first phase 3 clinical trial published on a microbiota-based live biotherapeutic treatment, and the results were exciting, showing a clear efficacy benefit for SER-109.

In the case of C. difficile, we understand the deficiency that SER-109 replaces. SER-109 changes the microbiome within the colon so that the environment becomes less hospitable to C. difficile, which helps to better resist recurrence. With this therapy, we are replenishing the good bacteria, which helps to keep C. difficile from regerminating.

The therapy showed excellent results through the significant difference in rates of recurrence seen in patients with recurrent C. difficile infection following 8 weeks of follow-up. This is exciting because we believe the future of therapeutics for many diseases might involve this type of manipulation of the microbiota, and this is the first to show such an impact with this class of therapeutic.


 

Joining a practice that conducts clinical research

Within private practice settings, the opportunity to participate in clinical trials usually involves somewhat less bureaucracy and a more patient-centric approach. Private practitioners can also be selective in their research, and we only participate in a handful of selected trials that fit with the expertise of the providers in our practice.

We find the people best suited for involvement in pharmaceutical trials are those providers who want to participate in the scientific process and who see specialized patient populations with the diseases treated by the therapies being studied. In our experience, the young practitioner who enjoyed conducting research in fellowship, who attends national conferences, who keeps track of cutting-edge therapeutics within gastroenterology, and who is highly motivated will be successful in providing this service to their patients.

If you’re an early-career physician who would like to explore clinical research in private practice, there are a several things to look for when considering joining a practice.

Make sure the group has a support infrastructure and a clear compensation model for physicians who want to conduct research. Another important consideration is the kind of support staff the practice provides to manage clinical trials. Does the practice have physician and physician assistant subinvestigators and certified clinical research coordinators? It would be smart to research what kind of capabilities the practice has and inquire about what kind of commitment they have in terms of supporting research efforts.

If the practice you’re thinking of joining has a well-supported research program, you’ll soon be on the way to studying innovative treatments for a wide range of diseases affecting our communities, such as Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, celiac disease, and many others. Many practices also participate in trials assessing new technologies in endoscopy, such as capsule endoscopy of the colon.

It’s incredibly important for community practices to engage in studies and actively recruit younger physicians to participate in their research programs. It changes the character of the practice by bringing a certain level of scholarly activity that benefits the patients we serve, the field of gastroenterology, and medicine as a whole.

Dr. Feuerstadt is a practicing gastroenterologist at the PACT-Gastroenterology Center and is affiliated with Yale New Haven Hospital. Dr. Korman is codirector of Chevy Chase Clinical Research at Capital Digestive Care and a principal investigator in the Seres Therapeutics phase 3 ECOSPOR III study evaluating SER-109. Dr. Feuerstadt disclosed relationships with SERES Therapeutics, Ferring Rebiotix, Finch Therapeutics, and Merck. Dr. Korman disclosed a relationship with SERES Therapeutics.

Most people believe that, if you want to conduct clinical research, the best path is going into academic medicine. However, for physicians who want both the benefits of practicing in the community setting and a career in research, there are many ways to both treat patients and have a rewarding experience making a difference in facilitating treatment options that can become available to patients.

Our practices, Capital Digestive Care in Silver Spring, Md., and the PACT-Gastroenterology Center in Hamden, Conn, have been conducting clinical trials for many years on serious diseases such as inflammatory bowel disease, gastroparesis, and most recently, recurrent infection of Clostridioides difficile. We both also worked on the National Institutes of Health–sponsored Anal Cancer/HSIL Outcomes Research (ANCHOR) study.
 

Academic setting vs. private practice

Research in our practices is similar to the academic setting with regards to how studies are conducted and structured since everyone involved in the study follows the same protocol. The benefit of being in a community setting is that you have a wide range of patients that you are seeing every day.

Getting involved in research is not for everyone, but for those who do get involved, the decision is a rewarding one that can make a significant difference in patients’ lives. Offering new therapeutics for disease states is a powerful tool for a provider, and it is exciting and rewarding to engage in the research considering new mechanisms of action and new approaches to treating diseases.
 

Finding a better treatment for C. difficile

For example, C. difficile is common in older people who’ve received antibiotics for other infections, especially residents of long-term care facilities. These residents have frequent antibiotic exposure and are already vulnerable to infection because of advanced age, multiple comorbid conditions, and communal living conditions. Once a case of C. difficile is diagnosed in a nursing home, it can spread through contaminated equipment, environments, or hands.

The treatment for C. difficile is to control the bacteria with antibiotics, but spores remain, so after a few days in certain people the spores germinate, and the C. difficile returns: a recurrence. It used to be that, after a second reoccurrence, you would send the patient for a fecal transplant, which was a scarce resource and a challenging process.

To perform a fecal transplant, you would need a spouse or a family member to provide a stool sample. After their stool was tested, the family member would need to process their stool in a blender with saline and draw it up in syringes. Once you had the material, the patient would need to go through a full colonoscopy to infuse the material into the colon. Of course, increased restrictions and safety precautions from the COVID-19 pandemic have made fecal transplants even more complex.

Given all these challenges, conducting research considering microbiota-based live biotherapeutics, the term the Food and Drug Administration uses for pharmaceutically produced forms of fecal microbiota transplantation, is very appealing. There are several different formulations that have come through clinical trials recently including RBX-2660, SER-109, and CP101.

SER-109 is an orally taken treatment produced by Seres Therapeutics. Once patients with acute recurrence of C. difficile are treated with standard antibiotics, they are given a course of four SER-109 capsules for 3 days. The results of the SER-109 study were published recently in the New England Journal of Medicine. This is the first phase 3 clinical trial published on a microbiota-based live biotherapeutic treatment, and the results were exciting, showing a clear efficacy benefit for SER-109.

In the case of C. difficile, we understand the deficiency that SER-109 replaces. SER-109 changes the microbiome within the colon so that the environment becomes less hospitable to C. difficile, which helps to better resist recurrence. With this therapy, we are replenishing the good bacteria, which helps to keep C. difficile from regerminating.

The therapy showed excellent results through the significant difference in rates of recurrence seen in patients with recurrent C. difficile infection following 8 weeks of follow-up. This is exciting because we believe the future of therapeutics for many diseases might involve this type of manipulation of the microbiota, and this is the first to show such an impact with this class of therapeutic.


 

Joining a practice that conducts clinical research

Within private practice settings, the opportunity to participate in clinical trials usually involves somewhat less bureaucracy and a more patient-centric approach. Private practitioners can also be selective in their research, and we only participate in a handful of selected trials that fit with the expertise of the providers in our practice.

We find the people best suited for involvement in pharmaceutical trials are those providers who want to participate in the scientific process and who see specialized patient populations with the diseases treated by the therapies being studied. In our experience, the young practitioner who enjoyed conducting research in fellowship, who attends national conferences, who keeps track of cutting-edge therapeutics within gastroenterology, and who is highly motivated will be successful in providing this service to their patients.

If you’re an early-career physician who would like to explore clinical research in private practice, there are a several things to look for when considering joining a practice.

Make sure the group has a support infrastructure and a clear compensation model for physicians who want to conduct research. Another important consideration is the kind of support staff the practice provides to manage clinical trials. Does the practice have physician and physician assistant subinvestigators and certified clinical research coordinators? It would be smart to research what kind of capabilities the practice has and inquire about what kind of commitment they have in terms of supporting research efforts.

If the practice you’re thinking of joining has a well-supported research program, you’ll soon be on the way to studying innovative treatments for a wide range of diseases affecting our communities, such as Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, celiac disease, and many others. Many practices also participate in trials assessing new technologies in endoscopy, such as capsule endoscopy of the colon.

It’s incredibly important for community practices to engage in studies and actively recruit younger physicians to participate in their research programs. It changes the character of the practice by bringing a certain level of scholarly activity that benefits the patients we serve, the field of gastroenterology, and medicine as a whole.

Dr. Feuerstadt is a practicing gastroenterologist at the PACT-Gastroenterology Center and is affiliated with Yale New Haven Hospital. Dr. Korman is codirector of Chevy Chase Clinical Research at Capital Digestive Care and a principal investigator in the Seres Therapeutics phase 3 ECOSPOR III study evaluating SER-109. Dr. Feuerstadt disclosed relationships with SERES Therapeutics, Ferring Rebiotix, Finch Therapeutics, and Merck. Dr. Korman disclosed a relationship with SERES Therapeutics.

Most people believe that, if you want to conduct clinical research, the best path is going into academic medicine. However, for physicians who want both the benefits of practicing in the community setting and a career in research, there are many ways to both treat patients and have a rewarding experience making a difference in facilitating treatment options that can become available to patients.

Our practices, Capital Digestive Care in Silver Spring, Md., and the PACT-Gastroenterology Center in Hamden, Conn, have been conducting clinical trials for many years on serious diseases such as inflammatory bowel disease, gastroparesis, and most recently, recurrent infection of Clostridioides difficile. We both also worked on the National Institutes of Health–sponsored Anal Cancer/HSIL Outcomes Research (ANCHOR) study.
 

Academic setting vs. private practice

Research in our practices is similar to the academic setting with regards to how studies are conducted and structured since everyone involved in the study follows the same protocol. The benefit of being in a community setting is that you have a wide range of patients that you are seeing every day.

Getting involved in research is not for everyone, but for those who do get involved, the decision is a rewarding one that can make a significant difference in patients’ lives. Offering new therapeutics for disease states is a powerful tool for a provider, and it is exciting and rewarding to engage in the research considering new mechanisms of action and new approaches to treating diseases.
 

Finding a better treatment for C. difficile

For example, C. difficile is common in older people who’ve received antibiotics for other infections, especially residents of long-term care facilities. These residents have frequent antibiotic exposure and are already vulnerable to infection because of advanced age, multiple comorbid conditions, and communal living conditions. Once a case of C. difficile is diagnosed in a nursing home, it can spread through contaminated equipment, environments, or hands.

The treatment for C. difficile is to control the bacteria with antibiotics, but spores remain, so after a few days in certain people the spores germinate, and the C. difficile returns: a recurrence. It used to be that, after a second reoccurrence, you would send the patient for a fecal transplant, which was a scarce resource and a challenging process.

To perform a fecal transplant, you would need a spouse or a family member to provide a stool sample. After their stool was tested, the family member would need to process their stool in a blender with saline and draw it up in syringes. Once you had the material, the patient would need to go through a full colonoscopy to infuse the material into the colon. Of course, increased restrictions and safety precautions from the COVID-19 pandemic have made fecal transplants even more complex.

Given all these challenges, conducting research considering microbiota-based live biotherapeutics, the term the Food and Drug Administration uses for pharmaceutically produced forms of fecal microbiota transplantation, is very appealing. There are several different formulations that have come through clinical trials recently including RBX-2660, SER-109, and CP101.

SER-109 is an orally taken treatment produced by Seres Therapeutics. Once patients with acute recurrence of C. difficile are treated with standard antibiotics, they are given a course of four SER-109 capsules for 3 days. The results of the SER-109 study were published recently in the New England Journal of Medicine. This is the first phase 3 clinical trial published on a microbiota-based live biotherapeutic treatment, and the results were exciting, showing a clear efficacy benefit for SER-109.

In the case of C. difficile, we understand the deficiency that SER-109 replaces. SER-109 changes the microbiome within the colon so that the environment becomes less hospitable to C. difficile, which helps to better resist recurrence. With this therapy, we are replenishing the good bacteria, which helps to keep C. difficile from regerminating.

The therapy showed excellent results through the significant difference in rates of recurrence seen in patients with recurrent C. difficile infection following 8 weeks of follow-up. This is exciting because we believe the future of therapeutics for many diseases might involve this type of manipulation of the microbiota, and this is the first to show such an impact with this class of therapeutic.


 

Joining a practice that conducts clinical research

Within private practice settings, the opportunity to participate in clinical trials usually involves somewhat less bureaucracy and a more patient-centric approach. Private practitioners can also be selective in their research, and we only participate in a handful of selected trials that fit with the expertise of the providers in our practice.

We find the people best suited for involvement in pharmaceutical trials are those providers who want to participate in the scientific process and who see specialized patient populations with the diseases treated by the therapies being studied. In our experience, the young practitioner who enjoyed conducting research in fellowship, who attends national conferences, who keeps track of cutting-edge therapeutics within gastroenterology, and who is highly motivated will be successful in providing this service to their patients.

If you’re an early-career physician who would like to explore clinical research in private practice, there are a several things to look for when considering joining a practice.

Make sure the group has a support infrastructure and a clear compensation model for physicians who want to conduct research. Another important consideration is the kind of support staff the practice provides to manage clinical trials. Does the practice have physician and physician assistant subinvestigators and certified clinical research coordinators? It would be smart to research what kind of capabilities the practice has and inquire about what kind of commitment they have in terms of supporting research efforts.

If the practice you’re thinking of joining has a well-supported research program, you’ll soon be on the way to studying innovative treatments for a wide range of diseases affecting our communities, such as Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, celiac disease, and many others. Many practices also participate in trials assessing new technologies in endoscopy, such as capsule endoscopy of the colon.

It’s incredibly important for community practices to engage in studies and actively recruit younger physicians to participate in their research programs. It changes the character of the practice by bringing a certain level of scholarly activity that benefits the patients we serve, the field of gastroenterology, and medicine as a whole.

Dr. Feuerstadt is a practicing gastroenterologist at the PACT-Gastroenterology Center and is affiliated with Yale New Haven Hospital. Dr. Korman is codirector of Chevy Chase Clinical Research at Capital Digestive Care and a principal investigator in the Seres Therapeutics phase 3 ECOSPOR III study evaluating SER-109. Dr. Feuerstadt disclosed relationships with SERES Therapeutics, Ferring Rebiotix, Finch Therapeutics, and Merck. Dr. Korman disclosed a relationship with SERES Therapeutics.