Learn more about what in-depth topics were covered in the January 2023 issue of Dermatology Times.
The January issue of Dermatology Times® includes a collection of thought-provoking articles and topics ranging from JAK inhibitor safety to the upcoming 2023 dermatology drug pipeline. Highlights from the issue are listed below.
Dermatologists have been concerned about the safety profile of Janus Kinase (JAK) inhibitors like upadacitinib and abrocitinib for the treatment of atopic dermatitis (AD) due to their boxed safety warnings. A study published this month in the Journal of Drugs in Dermatology and conducted by Stefano Daniele, MD/PhD candidate at the Yale School of Medicine, in New Haven, Connecticut, and Christopher Bunick, MD/PhD, associate professor of dermatology at the same institution, compared the safety of JAK inhibitors to that of traditional systemic therapy in AD.1
“Interestingly, what we found is that the JAK inhibitors tended to be safer than systemic agents that we didn’t think twice about using for severe atopic dermatitis patients in the past, like methotrexate, cyclosporine, and oral steroids like prednisone. In fact, oral prednisone, which does not have a box warning, had some of the highest rates of adverse effects,” said Bunick.
A recent study1 has confirmed long-held suspicions that inflammatory bowel disease (IBD), particularly Crohn's disease, is a causal risk factor for psoriasis and psoriatic arthritis. This knowledge can be very useful and help clinicians optimize the treatment and management of patients with these conditions, ideally in a multidisciplinary setting.
Psoriasis and IBD (including ulcerative colitis and Crohn's disease) are chronic and systemic immune-mediated inflammatory conditions with a lifelong relapsing-remitting course. They share immune dysregulation in pathogenesis, determined by genetic predisposition and environmental factors. Although novel therapies targeting pathways and proinflammatory cytokines like IL-23 and IL-17 have proven useful, many unanswered questions still remain with respect to optimal treatment for these separate yet overlapping diseases.
“This review was inspired by questions from my patients,” said senior author Arash Mostaghimi, MD, MPH, MPA, assistant professor of dermatology at Harvard Medical School. “Some patients with hair loss have questions about whether they should start taking nutritional supplements they see in advertisements or that are recommended by friends and family. Other patients are already spending a lot of money on supplements and wonder if they should continue taking them. Dermatologists are experts on pharmaceuticals but not on supplements and I wanted better answers.”
The review is the first step in understanding the body of evidence to help support dietary and nutritional supplement interventions.
The authors searched the MEDLINE, Embase, and CINAHL databases from inception through October 20, 2021, to identify articles written in English with original findings from investigations of dietary and nutritional interventions in individuals with alopecia and without a known baseline nutritional deficiency.
The skin is the body’s largest organ, and dermatologists must be able to treat a variety of pathologies, including infectious, neoplastic, autoimmune, inflammatory, genetic, and traumatic. They must also know how to apply the many therapies developed to treat these different conditions, among them monoclonal antibodies, JAK inhibitors, DMARDs, steroids, antibiotics, and chemotherapeutic agents whose administration may be topical, oral, intravenous, intralesional, subcutaneous, or intramuscular. As a result, dermatology has always been one of the most robust markets for pharmaceuticals, one that is expected to reach $64 billion by 2027, which represents a compound annual growth rate of 12.9%.1 Such growth is driven not only by an increased incidence of common dermatoses such as acne, atopic dermatitis, and psoriasis, but also by patient demand for medications to treat common diseases for which there are no approved therapies and rare ones like epidermolysis bullosa.