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Looking Ahead to Advancements in Vitiligo and Atopic Dermatitis

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David Rosmarin, MD, shares key points from phase 3 data of ruxolitinib for vitiligo, as well as highlights the potential for targeting the STAT pathway in upcoming atopic dermatitis therapeutics.

At the 2024 Revolutionizing Alopecia Areata, Vitiligo, and Eczema Conference (RAVE) in Chicago, Illinois, David Rosmarin, MD, presented developments and advancements in both vitiligo and atopic dermatitis. Rosmarin, chair of dermatology at Indiana University School of Medicine, first presented “Systemic Agents for Vitiligo: The Relationship of Therapies to Disease Pathogenesis,” at the Revolutionizing Vitiligo portion of RAVE.1 On day 2 of the meeting, Rosmarin presented “Futuristic Therapies for Atopic Dermatitis,” at the Revolutionizing Atopic Dermatitis portion of RAVE.2

In his vitiligo discussion, Rosmarin reviewed phase 3 data of ruxolitinib cream and key points from the subgroup analysis.

“One of the key points is that on subgroup analysis, it doesn't seem to matter the patient’s age or how long they've had the disease, their disease duration, the severity of disease at baseline, or if they've tried previously other treatments like phototherapy, calcium neuron inhibitors or steroids. Patients seem to do similarly well despite those different backgrounds, and that's really helpful and important to know. That’s very different in alopecia areata, where patients have had the disease for more than 10 years and they don't do as well with treatment,” said Rosmarin.

According to Rosmarin, what does seem to matter in vitiligo is anatomic location. Areas of the body that are more follicularly dense such as the head and neck will repigment easier. However, areas of the body that are more glabrous are much harder to repigment.

“Some of the key data also shows that patients who wait 6 months before treating their vitiligo, still at 2 years, never have caught up to the patients who didn't delay treatment at the 6-month mark initially. I think it's really important that patients are treated early and aggressively, and that we really give patients proper expectations because it's not a quick, rapid process to repigment patients,” said Rosmarin.

Switching to upcoming therapeutics in the atopic dermatitis pipeline, Rosmarin shared his excitement about therapeutics that will specifically target the STAT pathway, as well as those that will target STAT transcription factor directly to help achieve good selectivity.

“There's also a strategy of degrading the STAT protein, which can also hopefully give us JAK-like efficacy, great selectivity, and hopefully improve safety. Also, there's a strategy of using silencing RNA for targeting JAK inhibitors or the JAK protein. With silencing RNA, you can also perhaps achieve good selectivity, and that may form the basis for new topical or injectable,” said Rosmarin.

Rosmarin concluded his interview by sharing his continued interest in anti-IL-22 and anti-IL-18 agonists that will give clinicians dedicated to atopic dermatitis another treatment option to offer their patients.

References

  1. Rosmarin D. Systemic agents for vitiligo: the relationship of therapies to disease pathogenesis. Presented at: 2024 Revolutionizing Alopecia Areata, Vitiligo, and Atopic Dermatitis Conference; June 8-10, 2024; Chicago, IL.
  2. Rosmarin D. Futuristic therapies for atopic dermatitis. Presented at: 2024 Revolutionizing Alopecia Areata, Vitiligo, and Atopic Dermatitis Conference; June 8-10, 2024; Chicago, IL.
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