Looking Back to Look Forward: Key Dermatology Updates in 2024

Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, Dr. Raj Chovatiya will share his insights on recent significant updates in the dermatology field. Dr. Chovatiya is a Clinical Associate Professor at the Rosalind Franklin University Chicago Medical School and Founder and Director of the Center for Medical Dermatology and Immunology Research in Chicago. Let’s hear from him now.

Dr. Chovatiya:
Every time we have this conversation, it feels like I’m saying that this was the best and biggest year yet, and 2024 is no exception. Across many of our chronic inflammatory disease states—the area of which I know, love, and really live—there’s been a lot happening, and I would say that therapeutic innovation and therapeutic approval were probably the two biggest trends we saw across multiple different diseases. So we can start where we’ve kind of started the last few years in terms of atopic dermatitis and eczema, and we had multiple new therapy approvals here. So topicals are something that we’ve really been lacking, particularly nonsteroidal topicals, and 2024 saw the approval of two nonsteroidals: roflumilast, a next-generation topical phosphodiesterase 4 inhibitor, and tapinarof 1% cream, an aryl hydrocarbon receptor modulator, both of which have really intriguing short-term and in particular long-term data for disease control, which is really the place that nonsteroidals hopefully are going to make a big dent into steroid use. 

We saw some systemic approvals here too. So we saw the approval of lebrikizumab, an anti-IL-13 monoclonal antibody that had some really exciting longer-term data, particularly in terms of individuals that were put on less-frequent dosing of medication or even removed from medication itself, suggesting maybe some longer-lived effects. Nemolizumab, an anti-IL-31 myologic therapy—really sort of our master target when we think about itch—saw not only approval for atopic dermatitis but also prurigo nodularis, a related but distinct condition. And this particular therapy seems like it’s really going to carve a hole in a lot of pruritic diseases, even beyond atopic dermatitis and prurigo nodularis. 

Finally, not necessarily a new approval, but we did see some really cool JAK inhibitor data, particularly head-to-head data come out in terms of the LEVEL UP study with upadacitinib versus dupilumab, and what we saw in the first two periods of the study was that in terms of on-label dosing of upadacitinib and in terms of achieving the highest-level endpoints and composite endpoints—really getting to the point of nearly clear or almost clear skin and nearly no or no itch whatsoever—upadacitinib outperformed dupilumab. And even patients who were flipped from dupilumab to upadacitinib were able to achieve high levels of response.

Other disease states that I really want to touch on where there’s cool stuff happening: HS.    HS is really set to be perhaps the most exciting disease for the next decade. Hidradenitis has sort of been a big mystery for us, but at least last year, we saw another therapeutic approval in the case of bimekizumab, a monoclonal antibody that targets IL-17A and F.  Psoriatic arthritis was another approval that ended up coming for bimekizumab, and so now it has multiple beyond psoriasis, but it’s really some of the highest-level data we’ve seen for bimekizumab when it comes to HS. That makes it really exciting to go beyond perhaps some of the baseline scores that we have been used to with older therapies. 

I’ll finally mention psoriasis. And while there weren’t necessarily any brand-new targets that got approval, we’re starting to see more data from targets that we know a little bit about in a different format. So we managed to see some more data for oral therapies, particularly in the case of TIK2 to as well as IL-23, that really looked like this might be an important story for 2025 and beyond.

Announcer:
That was Dr. Raj Chovatiya talking about key updates in the dermatology field. To access this and other episodes in our series, visit Clinician’s Roundable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!