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Facial erythema in patients with atopic dermatitis treated with dupilumab
( Jiyoung Ahn ),( Dong Heon Lee ),( Chan Ho Na ),( Dong Hyun Shim ),( Yu Sung Choi ),( Hye Jung Jung ),( Eric L. Simpson ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.1
Background: The development of an eczematous rash on face and neck, which was not described in phase 3 clinical trials, is being reported in the literature in patients treated with dupilumab. Little is known regarding the causes or features of the facial dermatitis. Objectives: We conducted surveys of 162 severe AD patients treated with dupilumab to describe its clinical features, morphology, and etiology. Methods: A multicenter prospective cohort study was conducted from January 1, 2020, to December 31, 2020. A total of 162 patients under dupilumab treatment were asked to complete a questionnaire and patients were evaluated by dermatologists. Results: Out of all 162 patients, 84.6 percent had pre-existing facial dermatitis PRIOR to dupilumab therapy. 121 (88.3 %) patients of them got better after the treatment, 9 (6.6 %) patients of them had no change after the treatment, but 7 (4.3 %) patients of them got worse after the treatment. Out of 25 patients who had not pre-existing facial dermatitis PRIOR to the therapy, 6 (3.7 %) patients of total experienced new-onset facial erythema after the treatment. A large proportion of the patients in both groups had a history of TCS use. Conclusion: In severe AD patients treated with dupilumab, additional or new-onset development of an eczematous rash on face and neck after dupilumab treatment did not frequently occur. Although the mechanisms of this adverse event remains unclear, the possibility of topical corticosteroids withdrawal cannot be excluded.
Therapeutic New Era for Atopic Dermatitis: Part 2. Small Molecules
( Jiyoung Ahn ),( Yusung Choi ),( Eric Lawrence Simpson ) 대한피부과학회 2021 Annals of Dermatology Vol.33 No.2
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. Currently, we are experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. In contrast to biologics, small molecules are similar to conventional pharmacologic chemical agents used as drugs and are generally prepared by chemical synthesis. Unlike biologics, these drugs often are taken orally or formulated for topical use. The purpose of this review is to summarize the efficacy and safety of the current topical and systemic new therapies in AD by reviewing recently published papers on therapies currently in phase 2 or 3 clinical trials. In this review, it is important to note the characteristics of the study population, the primary endpoints, and whether or not there was concomitant topical therapy allowed. These study design elements may significantly alter the results of studies and should be taken into account. Targeted therapy help push AD treatment into a new era of personalized medicine. (Ann Dermatol 33(2) 101 ∼107, 2021)
Therapeutic New Era for Atopic Dermatitis: Part 1. Biologics
( Jiyoung Ahn ),( Yusung Choi ),( Eric Lawrence Simpson ) 대한피부과학회 2021 Annals of Dermatology Vol.33 No.1
Atopic dermatitis (AD) is a chronic, inflammatory cutaneous disease driven by immune dysregulation and skin barrier dysfunction. We are currently experiencing a new era of understanding of the pathogenesis of AD and, as a consequence, a new era of innovation in therapeutics, including small molecules and biologic therapy. Recently, advances in translational research have challenged the traditional AD pathogenesis paradigm of AD being solely a Th2-dominant disease. Other immune pathways seem to play a role in the complex AD pathophysiology, although the clinical relevance of these additional immune pathway abnormalities is unclear. Type 1, type 22, and type 17 pathway activation (with related cytokines/chemokines) have been demonstrated in the skin and blood of AD patients. Type 2 (interleukin [IL]-4, IL-13), IL-31, and type 22 (IL-22) pathway cytokines are increased in AD acute lesions. IL-22 induces both an epidermal hyperplasia at the onset of acute AD and a marked increase in the terminal differentiation S100 genes. This understanding of pathogenesis corresponds to a historic increase in therapeutic development in AD. The extreme clinical heterogeneity and the chronic progression of AD establish the need for newer, safer, and more effective treatments, control the disease, and improve the quality of life of affected patients. (Ann Dermatol 33(1) 1∼10, 2021)
FC 1-1 : Facial erythema in patients with atopic dermatitis treated with dupilumab
( Jiyoung Ahn ),( Dong Heon Lee ),( Chan Ho Na ),( Dong Hyun Shim ),( Yu Sung Choi ),( Hye Jung Jung ),( Eric L. Simpson ) 대한피부과학회 2021 대한피부과학회 학술발표대회집 Vol.73 No.-
Background: The development of an eczematous rash on face and neck, which was not described in phase 3 clinical trials, is being reported in the literature in patients treated with dupilumab. Little is known regarding the causes or features of the facial dermatitis. Objectives: We conducted surveys of 162 severe AD patients treated with dupilumab to describe its clinical features, morphology, and etiology. Methods: A multicenter prospective cohort study was conducted from January 1, 2020, to December 31, 2020. A total of 162 patients under dupilumab treatment were asked to complete a questionnaire and patients were evaluated by dermatologists. Results: Out of all 162 patients, 84.6 percent had pre-existing facial dermatitis PRIOR to dupilumab therapy. 121 (88.3 %) patients of them got better after the treatment, 9 (6.6 %) patients of them had no change after the treatment, but 7 (4.3 %) patients of them got worse after the treatment. Out of 25 patients who had not pre-existing facial dermatitis PRIOR to the therapy, 6 (3.7 %) patients of total experienced new-onset facial erythema after the treatment. A large proportion of the patients in both groups had a history of TCS use. Conclusion: In severe AD patients treated with dupilumab, additional or new-onset development of an eczematous rash on face and neck after dupilumab treatment did not frequently occur. Although the mechanisms of this adverse event remains unclear, the possibility of topical corticosteroids withdrawal cannot be excluded.