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Therapeutic Evolutions in the Treatment Landscape of Atopic Dermatitis


Jennifer Holman, MD, FAAD, reflects on the improvements in therapeutic treatments and outcomes for patients like Audrey Dean, and how her experience and quality of life has also improved with these medical advances.


Jennifer Holman, MD, FAAD: You know, it’s interesting, as we talk through atopic dermatitis and the therapeutic landscape, I feel like what we did over 10 and 15 years ago in psoriasis…. We’ve started to understand these cytokines, which 20 years ago we didn’t understand at all; we’ve started to understand JAK inhibitors, those types of things. It’s really disrupted our treatment for atopic dermatitis. As I said before, I was putting patients on systemic immunosuppression. A [patient] would walk in and I’d have to put them on cyclosporine to get things under control quickly, or those round robins of systemic steroids, antibiotics, those types of things. Dupilumab was the first one on the market. And it’s awesome because…now I’ve got something [for patients as young as] 6 months where I don’t have to do blood work, monitoring, worry about growth or immunosuppression, those kind of things—dupilumab changed the landscape. But there was still a need, and upadacitinib has really met that need in atopic dermatitis, and it’s also really addressed that quality-of-life issue.... Do we need to add therapies? …Both of these therapies have been huge landmarks in the treatment of atopic dermatitis. And I’m so very thankful for them. You know, over the years we used to just suppress the immune system or give [patients] a tube of topical steroids. We’ve got steroid-sparing agents now because of the risk of long-term topical steroid use. Certainly we see skin atrophy, bruising, skin tearing, those kinds of things, or over time, they just quit working as well as they once did…. Ruxolitinib is a newer one that’s out there and it’s a great one. It’s a topical form of the medicine that you’re on as well. Clearly, you needed way more than topicals for the extent of what you had involved.... But having some of these steroid-sparing agents…has changed the landscape as well, because a lot of times parents don’t want [their children to take a lot of steroids] if they don’t really have to. So having other agents that we can use early and often, it’s been a great thing….

Transcript was AI-generated and edited for clarity.

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