Real‐World Efficacy and Safety of Abrocitinib in Chinese Atopic Dermatitis Patients: A Single‐Center Prospective Study

Allergy, Год журнала: 2025, Номер unknown

Опубликована: Фев. 10, 2025

Phase 3 trials have demonstrated the efficacy and safety of abrocitinib for atopic dermatitis (AD), but real-world evidence remains limited. This study prospectively enrolled 117 moderate-to-severe AD patients at Huashan Hospital, Shanghai, China. Physician- patient-reported outcomes were evaluated multiple time points. Blood eosinophil counts, serum IgE, 24 cytokines/chemokines measured. Abrocitinib treatment led to rapid potent improvements in disease severity. At week 12, 74.3% 50.5% achieved least 75% 90% improvement eczema area severity index (EASI), respectively. Compared dupilumab, showed greater Itch-NRS 2 a higher proportion EASI-75 4. Adverse events occurred 42.7% patients, with gastrointestinal symptoms being most common (17.1%). No tuberculosis (TB) reactivation was observed who screened positive TB received isoniazid prophylaxis during period. Lower body mass (BMI < 24; adjusted OR: 4.01, 95% CI: 1.36-11.73) no prior dupilumab use (adjusted 5.81, 1.8-18.7) identified as predictors good response. By 4, blood counts IgE significantly decreased. Reductions Th2-, Th1-, Treg-related after 4 weeks treatment, including IL-5, CCL17, CCL18, TNF-α, IL-6, IL-10, CD25/IL-2Rα, more pronounced responders. robust well-tolerated profile Chinese routine clinical practice, accompanied by normalization elevated biomarkers. ChiCRT Identifier: ChiCTR2200063195.

Язык: Английский

---

Atopic dermatitis

The Lancet, Год журнала: 2025, Номер 405(10478), С. 583 - 596

Опубликована: Фев. 1, 2025

Язык: Английский

---

Fungal Head and Neck Dermatitis: Current Understanding and Management

Clinical Reviews in Allergy & Immunology, Год журнала: 2024, Номер 66(3), С. 363 - 375

Опубликована: Июль 20, 2024

Abstract Head and neck dermatitis (HND) is a form of atopic (AD) that affects the seborrheic areas body causes greater quality life detriments than other types AD. HND can be challenging to treat since first-line topical therapies may ineffective or intolerable for long-term use on affected by while dupilumab cause dupilumab-associated (DAHND). Current evidence implicates fungi, particularly Malassezia spp., in pathogenesis HND. Penetration fungal antigens through defective AD skin barrier activates innate adaptive immune systems cutaneous inflammation via T helper (Th)17 and/or Th2 axes. sensitization distinguish from forms Multiple double-blind, placebo-controlled trials have shown antifungals benefit HND, yet persistence symptom relief with sustained remains unclear. Oral appear more effective but harmful use. DAHND also fungal-mediated given improvement an overactive response against these patients. Janus kinase inhibitors are including DAHND, significant side effects when administered systemically. OX40/OX40L tralokinumab promising options horizon. Demographic environmental factors influence host mycobiome should considered future precision-medicine approaches as microbiome composition diversity linked severity

Язык: Английский

---

Recognizing Dupilumab‐Associated Head and Neck Dermatitis in Skin of Color: A Case Series

Clinical Case Reports, Год журнала: 2025, Номер 13(3)

Опубликована: Фев. 26, 2025

ABSTRACT Dupilumab‐associated head and neck dermatitis (HND) is a rare often underrecognized condition, especially in patients with skin of color. It can vary from subtle to severe presentations, violaceous hues seborrheic distribution after dupilumab initiation. Early recognition management are crucial prevent treatment discontinuation.

Язык: Английский

---

Long-Term Disease Control and Minimal Disease Activity of Head and Neck Atopic Dermatitis in Patients Treated with Tralokinumab up to 4 Years

American Journal of Clinical Dermatology, Год журнала: 2025, Номер unknown

Опубликована: Март 14, 2025

There is a need for long-term atopic dermatitis (AD) treatments that can effectively improve AD involvement of the head and neck (H&N) region (referred to as H&N AD). Tralokinumab, high-affinity monoclonal antibody neutralizes interleukin-13, approved treatment moderate-to-severe AD. Recent real-world studies have observed effectiveness tralokinumab Here, data from phase III parent trials, ECZTRA 1 2, extension trial, ECZTEND, were used assess impacts on association between improvements in patient quality life, evaluate whether proportion patients developed paradoxical erythema. These post hoc analyses included all initiated or 2. Patients treated up 4 years (i.e., 52 weeks 2 plus 152 ECZTEND). Outcomes body subscores Eczema Area Severity Index (EASI; H&N, upper limbs, trunk, lower limbs) Dermatology Life Quality (DLQI). Correlations EASI DLQI assessed with Spearman's correlation coefficient (ρ). The incidence erythema (defined increasing baseline score 3, while other regional are 0 1, during two more consecutive visits) was also assessed. Overall, 1192 who whom 523 opted continue analyzed. Percentages had ≤ increased 12.2% at trial 87.2% by week ECZTEND. Improvements subscore outcomes comparable across regions throughout timepoints study. At 16, moderately correlated total (ρ = 0.47), strongest numerical correlations questions regarding skin discomfort 0.43) embarrassment due 0.40). During treatment, seven tralokinumab-treated exhibited erythema, five improved absent mild continued treatment. Tralokinumab provided progressive sustained AD, 0/1 nearly 90% years. similar associated particularly self-consciousness/embarrassment skin. NCT03131648 (ECZTRA 1); study start date: 30 May, 2017; primary completion 7 August, 2018; 10 October, 2019. NCT03160885 2); 12 June, September, 2019; 14 NCT03587805 (ECZTEND); 18 March, cut-off April, 2022; 3 July, 2024; 2024. an injectable capable providing disease control region. Atopic chronic affect multiple areas. occurring AD) be especially burdensome owing part its high visibility. Additionally, challenging treat may show clinical response than Therefore, there demand provide complete/almost complete clearance, around face. medication treating It has been shown settings. trials 2) (ECZTEND), funded LEO Pharma A/S, examine impact adults We found severity including facial redness erythema), Worsening new sometimes certain treatments. Very few showed specific compared sites. Most these cases resolved findings treats

Язык: Английский

---

Recognizing secondary infection in patients with atopic dermatitis: Head & neck atopic dermatitis

Meditsinskiy sovet = Medical Council, Год журнала: 2025, Номер 2, С. 42 - 48

Опубликована: Март 30, 2025

Atopic dermatitis is a hereditary chronic skin disease characterized by severe itching, recurrent course and association with other diseases of atopic nature, as well numerous complications, which include the addition secondary infection. Head neck (HNAD) special phenotype that occurs in adolescents adults. A characteristic feature HNAD lesion areas rich sebaceous glands (face, neck, upper third chest back), associated active participation Malassezia fungi pathogenesis dermatosis. The multifactorial HNAD, often persistent course, impossibility complete elimination provoking factor, bacterial infection against background necessitate comprehensive approach to treatment this condition use combination drugs containing glucocorticosteroid, an antimycotic antibiotic relieve exacerbations. article examines etiology, mechanisms development clinical features, modern methods therapy, practical application demonstrated example: patient, 19 years old, complaining itchy, flaky rashes face area, existing for 3 weeks. Based on picture, diagnosis was made: neck. Given multifaceted cause condition, namely both pronounced immune response AD, colonization fungi, open “gates” form erosions, prescription topical glucocorticosteroid pathogenetically justified.

Язык: Английский

---

Enabling precision medicine with biomarkers of response to treatment in atopic dermatitis: where are we now? A narrative review

Frontiers in Medicine, Год журнала: 2025, Номер 12

Опубликована: Апрель 10, 2025

Atopic dermatitis (AD) is a complex systemic disease characterized by high heterogeneity both at clinical and pathophysiology levels. While advances in drug development toward more targeted approach are made, treatment management of AD patients still happening according to the one-size-fits-all approach. To enhance precision medicine improve care, identifying predicting factors response therapy driving tailored treatments will be utmost importance. Here, we discuss available evidence regarding predictive biomarkers, as well their possible debated impact practice.

Язык: Английский

---

Head and neck dermatitis: a variant of atopic dermatitis

Italian Journal of Dermatology and Venereology, Год журнала: 2025, Номер 160(2)

Опубликована: Апрель 1, 2025

Atopic dermatitis involves the head and neck area across all age groups. This manifestation is frequently referred to as "the dermatitis." Aside from a considerable deterioration of quality life, it poses significant diagnostic therapeutic challenge. The may be mimicked by other inflammatory conditions such seborrheic or contact dermatitis. Furthermore, can associated with wide range infectious, ocular, psychiatric hair disorders, which should raise clinical alertness encourage multidisciplinary management affected individuals. Skin lesions in are often difficult treat, particularly because exposure this region exacerbating factors limitations regarding use some pharmaceuticals. Although several hypotheses explaining recalcitrant course have been proposed, none them provide successful solutions applicable daily practice. comprehensive review comprises current insights on pathogenesis, presentation, comorbidities Recommendations possible treatments condition antifungals, well special considerations for choice biologics JAK inhibitors candidates systemic treatment outlined.

Язык: Английский

---

Atopic dermatitis: pathogenesis and therapeutic intervention

MedComm, Год журнала: 2024, Номер 5(12)

Опубликована: Дек. 1, 2024

Abstract The skin serves as the first protective barrier for nonspecific immunity and encompasses a vast network of skin‐associated immune cells. Atopic dermatitis (AD) is prevalent inflammatory disease that affects individuals all ages races, with complex pathogenesis intricately linked to genetic, environmental factors, dysfunction well dysfunction. Individuals diagnosed AD frequently exhibit genetic predispositions, characterized by mutations impact structural integrity barrier. This leads release alarmins, activating type 2 pathway recruiting various cells skin, where they coordinate cutaneous responses. In this review, we summarize experimental models provide an overview its therapeutic interventions. We focus on elucidating intricate interplay between system regulatory mechanisms, commonly used treatments AD, aiming systematically understand cellular molecular crosstalk in AD‐affected skin. Our overarching objective novel insights inform potential clinical interventions reduce incidence AD.

Язык: Английский

---

Durable improvements in atopic dermatitis in the head and neck and across other anatomic regions with rocatinlimab

Archives of Dermatological Research, Год журнала: 2024, Номер 316(10)

Опубликована: Ноя. 6, 2024

In a randomized phase 2b trial (NCT03703102) for adult patients with moderate-to-severe atopic dermatitis (AD), treatment the T cell rebalancing anti-OX40 receptor antibody rocatinlimab (AMG 451/KHK4083) led to significant improvements in clinical measurements versus placebo including whole-body Eczema Area and Severity Index (EASI) score. AD manifestations can impact variable anatomic regions, involvement of head neck, sensitive, hard-to-treat area, negatively quality life. this post hoc analysis, we investigated response across neck. Least squares mean change from baseline Week 56 EASI score was analyzed by region (head trunk, upper extremities, or lower extremities) respective region, using mixed models repeated measures. Rocatinlimab groups were compared at 16. The proportion achieving least 75% reduction (EASI-75) calculated. Probability relapsing EASI-75 during off-treatment follow-up period (Weeks 36–56) estimated Kaplan − Meier approach. At 16, decrease greater all regimens regions (all P < 0.001). scores continued improve on after 16 maintained regions. Among neck (n = 219; rocatinlimab, n 174; placebo, 45), difference (rocatinlimab vs placebo) LS percent ranged 30.4% 42.6% regimens. who received start trial, 47% 71% achieved 36. responders 36, probability any low (< 25% neck) 20 weeks discontinuation until 56. durable multiple sensitive region.

Язык: Английский

---