ReachMD

From enhancing the diagnosis and treatment of skin diseases to identifying unmet clinical needs, artificial intelligence (AI) and big data are upending the practice of dermatology.

Stefan Weiss, MD, MHSc, MBA, a dermatologist, and the Managing Director of Dermatology at OM1, is helping to lead this charge. OM1 works with DataDerm, the American Academy of Dermatology’s (AAD) clinical data registry, and the OM1 Dermatology Data Network to capture pertinent information and trends regarding disease activity, lab results, comorbidities, patient outcomes, medication use, side effects, adverse events, and more for 13 million and counting dermatology patients including those with psoriasis, atopic dermatitis (AD), hidradenitis suppurativa (HS), and alopecia areata.

Dr. Weiss shared insights from this data with Practical Dermatology® magazine.

How does data from OM1 help identify trends and unmet needs in dermatology?

Stefan Weiss, MD, MHSc, MBA: We use large datasets to begin to understand where dermatology patients are on their journey. We can see if they are coming to the doctor more frequently and switching medications more often, for example. This helps us to see opportunities for new therapies and where and when patients are most at risk for undertreatment.

Based on these insights, 2023 was the year of…

Dr. Weiss: Alopecia areata. One year after baracitinib (Olumiant, Eli Lilly), the first Janus kinase (JAK) inhibitor for alopecia areata, was approved by the US Food and Drug Administration (FDA) in 2022, a second JAK inhibitor, ritlecitinib (Litfulo, Pfizer), was approved for alopecia areata in both adolescents and adults. These drugs have been transformative and brought hope to millions of alopecia patients who previously had few to no options.

Based on these insights, 2024 will be the year of…

Dr. Weiss: Hidradenitis suppurativa (HS) will be the skin disease of the year as secukinumab (Cosentyx, Novartis) was just approved for HS, joining an already approved TNF inhibitor adalimumab (Humira, AbbVie) and a full pipeline of therapies in various stages of clinical investigation. The introduction of Cosentyx should spark a wave of new HS drugs. Humira works well, but something more effective was needed for patients, and IL-17 inhibition seems to be very promising.

Why is this so important in HS, in particular?

Dr. Weiss: With HS, we have been able to see a trail of misdiagnoses where patients present with a cyst in their groin, and it is lanced in urgent care, for example. It is a vicious cycle and takes up to seven years for HS patients to get a correct diagnosis. Intervening early with effective drugs gives us a greater chance to improve HS patients’ quality of life. It will take about six months of regular use of secukinumab in HS to see the true impact. Over the course of data analysis in 2024, we will be able to see who is using it, how many people with HS will switch from adalimumab, and the subsequent change in disease severity.

What can this OM1 data tell us about AD?

Dr. Weiss: We have seen an explosion of AD treatments. Five years ago, pre-dupilumab (Dupixent, Sanofi/Regeneron), we would see patients with AD on topicals, seeking multiple refills or floating between broader, non-specific, non-indicated immunosuppressants. We don’t see that once they start on one of the newer advanced systemic agents for atopic dermatitis.

What’s next?

Dr. Weiss: The next area where we anticipate seeing changes will be in vitiligo. Now, we have ruxolitinib (Opzelura, Incyte), which is the first and only FDA-approved product for repigmentation in nonsegmental vitiligo, and researchers are exploring topical and oral JAK inhibitors. It will be great for a dermatologist to have multiple new treatments for patient care.

Is anything popping up regarding prurigo nodularis (PN)?

Dr. Weiss: PN is a disease that was largely ignored – a symptom often of systemic pruritus or other skin diseases like atopic dermatitis or psoriasis. PN is a cutaneous manifestation of a response to itch or the skin’s reaction to trauma triggered by itch. We are now learning that blocking interleukin-31 will shut down itch quite effectively. The elimination of the underlying trigger will heal PN. Big data will help tell that story better.