Discovering Dermatology Times: May 2024 Enhancing Atopic Dermatitis Care Supplement

The May Frontline Forum supplement of Dermatology Times includes a collection of thought-provoking discussions and strategies surrounding the challenges and opportunities to enhance atopic dermatitis management from Linda Stein Gold, MD; Michael Cameron, MD; James Del Rosso, DO; Brad Glick, DO, MPH; and Lisa Swanson, MD. Be sure to take a look at the highlights from the supplement below. Also, don’t miss a moment of Dermatology Times by signing up for our eNewsletters and subscribing to receive the free print issue and supplement each month.

Part 1

“We need to go beyond what we’ve had in the past,” Linda Stein Gold, MD, director of dermatology clinical research at Henry Ford Health in Detroit, Michigan, said, setting the tone for a recent Dermatology Times Frontline Forum video series, "Beyond Steroids: Topical Dermatological Efficacy and Patient-Centric Perspectives." Stein Gold moderated a discussion exploring the unmet needs in nonsteroidal topical treatment for atopic dermatitis (AD), safety and efficacy data from the SCRATCH-AD (NCT04839380) and TRuE-AD3 (NCT04921969) studies, and approaches to discussing black box warnings with patients. According to results from a patient survey published recently, a majority of patients ranked the reduction of itch and the improvement of skin dryness and cracking as top priorities.

Guidelines and Recommendations

Stein Gold emphasized the significance of evidence-based guidelines updated by the American Academy of Dermatology (AAD) in the past year, stating, “Guidelines provide a road map for delivering high-quality care based on the best available evidence.” Brad Glick, DO, MPH, of the Glick Skin Institute in Margate and Wellington, Florida, echoed this sentiment and said, “Guidelines help health care providers make informed decisions about patient care and treatment strategies.” The panel discussed the significance of considering barrier restoration, corticosteroids, topical calcineurin inhibitors, PDE4 inhibitors, and Janus kinase (JAK) inhibitors into the treatment armamentarium.

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Part 2

Exploring Beyond Steroids

The panel discussed strategies aimed at exploring treatment options beyond traditional steroid therapies for AD. Stein Gold highlighted the necessity for alternative approaches, saying, “We need to be in a more holistic approach to treatment.” The conversation shed light on the limitations of nonsteroidal treatments in adequately addressing the diverse needs of patients with mild to moderate AD.

Glick emphasized the importance of advancing topical therapeutics, noting, “We need to go beyond what we’ve had in the past.” The entire panel agreed that ruxolitinib samples are highly sought after in their office due to the data available. Cameron added, “The company [Incyte] has done great work over the past few months in ensuring access. As prescribers, we don’t have to worry about access....That wasn’t the case at launch. I think they would be the first to admit that, but now there’s going to be a consistent response in terms of access, particularly for commercial insurance.”

Del Rosso added, “We published a couple of cases and showed them [to payers and stakeholders] on different webinars and things: patients having very intense itching and, within a matter of days, started sleeping comfortably and consistently with ruxolitinib.” Swanson addressed how some patients were skeptical about insurance approvals and said, “People got discouraged and stopped trying. This drug is so good. It’s worth trying
again to get it for your patients.”

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Part 3

Patient-Centered Care

Stein Gold emphasized the significance of prioritizing patients’ needs and preferences, stating, “We must focus on patient-centered care to ensure optimal outcomes.” Glick agreed with this sentiment, highlighting the value of tailoring treatment plans to meet the individual needs of patients. He said, “Patient-centered care involves actively involving patients in decision-making and treatment planning.” Glick emphasized the importance of patient-centered care by discussing the need for topical therapies that are well tolerated, are effective, and do not cause stinging or burning, highlighting the focus on patient comfort and treatment experience. The experts engaged in a comprehensive dialogue on the principles of patient-centered care, emphasizing the importance of empathy, communication, and shared decision-making in clinical practice.

Key Takeaways

The Frontline Forum panel concluded with Stein Gold asking each expert to share their key pearls from the discussion. “The first key takeaway from my perspective is [that] the extra effort has gotten a lot better,” Cameron said. “If you have not written [a prescription for] ruxolitinib cream recently, the vast majority of plans or all the plans are now only 1-step edit, and they have guaranteed access with pretty much all commercial plans. So that perception of access has changed, and it’s less effort than you may realize. We’ve also never seen a topical with such an elegant mechanism of action that’s so pertinent to so many of the mediators of AD, both inflammation and itch. It’s hitting 5 or 6 cytokines that are pertinent to AD pathophysiology.”

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Click here to view the full video program.

Click here to view the full supplement.