Topical and Oral Therapies for Childhood Atopic Dermatitis and Plaque Psoriasis

Frantz, Travis; Wright, E; Balogh, Esther A.; Cline, Abigail; Adler-Neal, Adrienne L.; Feldman, Steven R.

doi:10.3390/children6110125

Cited by 20 publications

(14 citation statements)

References 59 publications

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“…[1][2][3] As a key representative of the small group of so-called "atopic" diseases, AD carries a high burden of disease for affected individuals and their families, and is often triggered or aggravated by psychoemotional stress. 4,5 Since AD steadily increases in incidence and absorbs major health care resources, the development of optimized AD therapeutics that combine efficiency with long-term safety and affordability, especially for children with AD, 6 remains a major unmet challenge. 7,8 Moreover, distinct clinical AD phenotypes exist, with excessive Th2 immune responses not always being the clinically dominant ones, 9 supporting the need for a personalized medicine approach to future AD management.…”

Section: Introductionmentioning

confidence: 99%

Mouse models of atopic dermatitis: a critical reappraisal

Gilhar

Reich

Keren

et al. 2021

Experimental Dermatology

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Mouse models for atopic dermatitis (AD) are an indispensable preclinical research tool for testing new candidate AD therapeutics and for interrogating AD pathobiology in vivo. In this Viewpoint, we delineate why, unfortunately, none of the currently available so-called "AD" mouse models satisfactorily reflect the clinical complexity of human AD, but imitate more "allergic" or "irriant" contact dermatitis conditions. This limits the predictive value of AD models for clinical outcomes of new tested candidate AD therapeutics and the instructiveness of mouse models for human AD pathophysiology research. Here, we propose to initiate a rational debate on the minimal criteria that a mouse model should meet in order to be considered relevant for human AD. We

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Section: Introductionmentioning

confidence: 99%

Mouse models of atopic dermatitis: a critical reappraisal

Gilhar

Reich

Keren

et al. 2021

Experimental Dermatology

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“…For children with severe atopic dermatitis (AD), use of systemic corticosteroids and other immunosuppressive therapies is associated with safety risks [ 1 – 3 ]. Standard-of-care use of these drugs requires baseline and follow-up laboratory tests to monitor for evidence of myelosuppression, lipid abnormalities, and/or organ toxicity [ 4 ]. The need for serial venipuncture with such therapies may have significant tolerability implications in children, particularly when access to dedicated pediatric phlebotomy is not available [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Laboratory Safety of Dupilumab in Patients Aged 6–11 Years with Severe Atopic Dermatitis: Results from a Phase III Clinical Trial

et al. 2021

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Background Previous studies of dupilumab in adolescents and adults with moderate-to-severe atopic dermatitis (AD) showed no clinically meaningful adverse changes in laboratory parameters. Objective The aim of this study was to assess laboratory outcomes in children aged 6-11 years with severe AD in a randomized, placebo-controlled, phase III trial of dupilumab. Methods Children aged 6-11 years with severe AD were randomized 1:1:1 to 16 weeks of dupilumab 300 mg every 4 weeks, 100 or 200 mg every 2 weeks, or matching placebo, all with concomitant topical corticosteroids (TCS). Blood samples were collected at baseline and Weeks 4, 8, and 16; urine samples were collected at baseline and Weeks 4 and 16. Results Of 367 patients enrolled in the study, 362 were included in the safety analysis, 351 completed study treatment, and 4 withdrew due to treatment-emergent adverse events not related to laboratory abnormalities. Both dupilumab + TCS groups showed overall trends toward increases in mean blood levels of eosinophils and alkaline phosphatase, and decreases in mean blood levels of platelets, neutrophils, and lactate dehydrogenase levels, without corresponding mean changes in the placebo + TCS group. None of these changes were associated with symptoms or clinically meaningful adverse outcomes, and none led to treatment modification. No clinically significant changes or trends were observed for other measured laboratory parameters. Conclusion There were no clinically meaningful adverse changes in routine laboratory parameters attributable to treatment with dupilumab + TCS. Changes in platelet counts and lactate dehydrogenase levels likely reflect reduced inflammation. These results confirm similar findings in adults and adolescents, and suggest that there is no need for routine laboratory monitoring of children aged 6-11 years treated with dupilumab + TCS for severe AD. Trial Registration ClinicalTrials.gov Identifier: NCT03345914.

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“…Cutaneous atrophy and striae are common side effects associated with local application of corticosteroids. 22…”

Section: Pharmacologic Treatmentsmentioning

confidence: 99%

Recent insights into the management of treatment-resistant pediatric atopic dermatitis

Naik¹

2022

International Journal of Women’s Dermatology

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Atopic dermatitis (AD) is a prevalent protracted inflammatory skin condition that affects approximately 12% of children globally. Topical remedies, such as pharmacologic and nonpharmacologic management, and off-label systemic medicines, have traditionally been used to treat pediatric AD patients. To minimize comorbidities, sleep disturbances, pruritus, and signs of inflammation and improve the patient’s quality of life, it is vital to optimize severe AD management in pediatric patients. Treatment resistance can be caused by a variety of circumstances, including deficient obedience or inappropriate medicine usage, a shortage of adequate pharmaceuticals, hypersensitivity reciprocation to local application of therapeutics, cutaneous infections, and other infuriating ecological provoking factors. If these elements are eliminated, a skin biopsy is required to exclude other AD-like cutaneous disorders. New regimens that target peculiar avenues with improved proficiency and promise minimal adverse events have resulted from recent developments and understanding of the etiology of AD. Although the condition of most patients improves quickly with this treatment, some do not respond well. In this review, the author discusses the management of treatment-resistant atopic dermatitis, with an emphasis on the pediatric population.

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Topical and Oral Therapies for Childhood Atopic Dermatitis and Plaque Psoriasis

Cited by 20 publications

References 59 publications

Mouse models of atopic dermatitis: a critical reappraisal

Mouse models of atopic dermatitis: a critical reappraisal

Laboratory Safety of Dupilumab in Patients Aged 6–11 Years with Severe Atopic Dermatitis: Results from a Phase III Clinical Trial

Recent insights into the management of treatment-resistant pediatric atopic dermatitis

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