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Addressing Itch and Remission in Atopic Dermatitis

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Raj Chovatiya, MD, PhD, discusses how approved AD therapeutics currently address itch and whether any therapeutics will eventually have a remittive effect.

“One of the most fun topics to talk about in the past few years has been itch, particularly as it relates to atopic dermatitis. In part because we know it's an incredibly burdensome symptom for our patients, but we finally have the tools to not only measure it appropriately, but treat it much better than we have before,” said Raj Chovatiya, MD, PhD, in an interview at the 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema (RAVE) Conference in Chicago, Illinois.

Chovatiya, associate professor at the Rosalind Franklin University Chicago Medical School, founder and director of the Center for Medical Dermatology and Immunology Research in Chicago, and Dermatology Times’ 2024 Fall Editor in Chief, presented 2 sessions at RAVE, “How Do Approved Therapies Stack Up” and “Can We Achieve Remission With Our Current Therapies.”1,2

In his first session, Chovatiya addressed why itch is so important to patients and how they consistently rank itch as a top concern. Chovatiya’s session also addressed specific therapeutics that can help patients achieve quick and effective itch resolution.

“In the case of biologics like dupilumab and tralokinumab, you definitely will see some early responses. Things will get better as you go on further along, perhaps even longer in the case of tralokinumab based on some speed differences compared to dupilumab, but similar depth overall by the end for good responders. In the case of oral JAK inhibitors, definitely a way to achieve some of the highest itch responses that we've seen, and you can maintain this over the course of a long period, even after people peak somewhere around 4 to 8 weeks. In the case of topicals, ruxolitinib is probably in a class by itself in terms of speed and depth of response as well,” said Chovatiya.

Chovatiya’s second session addressed achieving remission with currently available therapeutics and whether this can be possible. According to Chovatiya, there is a lot of discussion about the idea of whether a therapeutic can change the course of atopic dermatitis or if it’s modifying the disease in some way.

"I then reviewed our current treatments under a lens of remission and focused on some of the longer-term data where there's less frequent or completely absent dosing for people who've responded well to really see if we're there yet. Bottom line, probably not, but I do think the next generation of therapies has a little bit of stamina to get us over that hump and teach us something about disease remission,” concluded Chovatiya.

References

  1. Chovatiya R. How do approved therapies stack up. Presented at 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema Conference; June 8-10, 2024; Chicago, IL.
  2. Chovatiya R. Can we achieve remission with our current therapies. Presented at 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema Conference; June 8-10, 2024; Chicago, IL.
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