Biologics in the Treatment Landscape for Atopic Dermatitis Patients

Neal Bhatia, MD (00:07):

Hi, I'm Dr. Neal Bhatia. I'm Chief Medical Editor of Practical Dermatology and Director of Clinical Dermatology at Therapeutics Clinical Research in San Diego, California.

(00:16):

So there has not been a better revolution for atopic dermatitis patients than the initiation of biologics by dermatologists, for dermatologists, especially for patients who have been really struggling with atopic dermatitis. We have been using immunosuppressants, we've been using steroids, and a lot of things that just chase the atopic dermatitis patient's profile and their symptoms. And now we have targeted therapy that's not only very safe, but offered long-term solutions where we didn't have them. The analogy I like to use is turning off the faucet instead of mopping up the mess. And that's what biologic therapies tend to offer us, by targeting those cytokines and their receptors that are part of the equation.

(00:53):

We think back to dupilumab when it first came out. We now have tralokinumab, lebrikizumab, and nemolizumab. These are all very effective, safe therapies that really should be part of the toolbox for all atopic dermatitis patients.

(01:05):

So there's often a choice which biologic therapies we turn to. And taking access aside, we look at their efficacy, we look at their safety data, what form do they come in, whether it's a subcutaneous pen, a syringe, or some other delivery system. Many times we'll think about how often is the itching out of proportion to the amount of rash, for example. Nemolizumab tends to do a really good job with taking care of some of that itching. We think of dupilumab, lebrikizumab, and tralokinumab as having different dosing schedules. Obviously, they come in different delivery systems. Of course, dupilumab has an indication down to six months of age. And even more so, we get a lot of opportunities to treat patients early and change often their childhood, especially if the atopic dermatitis is that severe.

(01:46):

So again, looking for biologics really comes back to not only the choice, the preference and, of course, again, access, but also, again, looking at the delivery system and the amount of impact it has on the itch-scratch cycle.