Atopic Dermatitis:

Course and Comorbidities Across the

Lifespan
Overview
Prevalence of Active AD Across the Lifespan
Heterogeneity in Disease Activity
Similar Childhood AD 'Trajectories'
Identified in European Birth Cohort Studies
Early-Onset Persistent (2% to 12%)
Early-Onset Resolving (8% to 17%)
Later-Onset (5% to 11%)
Associations With AD Trajectories
AD Trajectories in Childhood With Severity
AD Subtypes Into Adulthood
"Most People Develop Atopic Dermatitis
Within the First 2 Years of Life"
Data Show That > 40% of Patients Develop
AD as Adults
Differences in Adult-Onset Disease
AD Appears to be Increasing in Older
Adulthood
AD May Be More Active and Severe in Older
Adulthood
AD Comorbidities
Atopic Disease
Infections
Cancer
Cardiovascular Disease
Neuropsychiatric Disease
Bone Health
Practice Recommendations
AAP Diet Recommendations
USPSTF Recommendations: CVD
USPSTF Recommendations: Other
The Topical AD Toolbox
Topical Therapy in Atopic Dermatitis
Topical Therapy
Topicals for AD: Matching Quiz
Topical Ruxolitinib: 8 Week RDBVC and 52 Weeks Longer-
Term in Adults and Adolescents (12 to 17) With AD
Topical Ruxolitinib: How Well Does It Work?
Topical Ruxolitinib: Phase 3 RDBVC Studies
Topical Ruxolitinib: Data Drilldowns
Ruxolitinib: But How Is It Tolerated? And vs
TCS?
Topical Ruxolitinib: 52 Week Study
Topical Ruxolitinib: Long-Term Study: 52
Weeks
Prescribing Information of Ruxolitinib 1.5%
Cream for the Treatment of Mild to Moderate AD
Topical Ruxolitinib: Suggestions
Tapinarof
Topical Tapinarof Cream
Topical Tapinarof Cream
Tapinarof 1% Cr Program
Tapinarof 1% Cr: "ADORING" Phase 3
Tapinarof 1% Cr Phase 3: "ADORING" 3
Roflumilast
Roflumilast: Atopic Dermatitis
Roflumilast Cream: Vehicle Study
Bacterial Commensal for AD
Counseling: With Topical Care
TMVC in Epic
Resources to Improve Topical Care!
Resources to Educate
Atopic Dermatitis: Evolving Algorithm
New Data on Biologics for Atopic Dermatitis
Outline
Biological Response to IL-4 and IL-13
Targeting IL-4 and IL-13
Dupilumab

IL-4 Receptor α Inhibitor

Dupilumab Decreases Concomitant Therapy Use in Adults With
Atopic Dermatitis (AD): Long-Term Data from the RELIEVE-AD
Study
Early and Sustained Improvement in Atopic Dermatitis (AD) Disease Control and
Treatment Satisfaction With Dupilumab in Clinical Practice: Long-Term Data From
the RELIEVE-AD Study
Dupilumab Significantly Improves Sleep Disturbance in Adults
With Moderate to Severe Atopic Dermatitis: Results of the
DUPISTAD Study
Safety of Long-Term Dupilumab Treatment in Adults With Moderate to
Severe Atopic Dermatitis: Results From an Open-Label Extension
(OLE) Trial Up to 4 Years
Long-Term Efficacy of Dupilumab in Adults With Moderate to Severe
Atopic Dermatitis (AD): Results From an Open-Label Extension (OLE)
Trial Up to 4 Years
Tralokinumab
Long-Term Safety and Efficacy of Tralokinumab in More Than 1400
Moderate to Severe Atopic Dermatitis Patients Treated for up to 42
Months: An Interim Analysis of ECZTEND
Lebrikizumab
Efficacy and Safety of Lebrikizumab in Moderate to Severe Atopic Dermatitis:
Results From Two Phase 3, Randomized, Double-Blinded, Placebo-Controlled
Trials
Nemolizumab
Efficacy of Nemolizumab in Atopic Dermatitis:
Rapid Impact on EASI and SCORAD Components
Study of Nemolizumab Pharmacokinetics, Safety,
and Efficacy in Adolescents With Atopic Dermatitis
Amlitelimab
Treatment With Amlitelimab (KY1005, SAR445229) - A Novel Non-Depleting
Anti-OX40 Ligand (OX40L) mAb - Reduces IL-13 Serum Levels in a Phase 2a
Randomised Placebo-Controlled Trial in Patients With Moderate to Severe Atopic
Dermatitis
Eblasakimab
Eblasakimab, a Human IL-13Rα1 Monoclonal Antibody, in Adults With Moderate
to Severe Atopic Dermatitis: A Randomized, Double-Blinded, Placebo-Controlled,
Proof of Concept Study
The Evolving Landscape of
Oral Systemic AD Therapies
Disclaimer
Meditation
Loops
Hurdles
Goal
When to Use Systemic Agents
Oral Systemic Agents: Options
Systemic Corticosteroids
Systemic Corticosteroids
Discontinuation Rate of Immunosuppressants
Mechanisms
JAK: Proportion of Clear/Almost Clear at
Week 12
JAK Inhibitors
JAK Inhibitors: Indications
JAK Inhibitors: Warnings
JAK Inhibitors: Monitoring (My Personal
Approach)
Comparing
Comparing
Comparing
Comparing
Comparing
ICER Review
Shared Decision Making
Atopic Dermatitis Guidelines in Context
Outline
What Is a Guideline?
American Academy of Dermatology AD
Guidelines
2022 Guideline Methodology
Comorbidities
Table III: AD Comorbidity Statements
AAD Guidelines: Comorbidities Takeaways
AD Guidelines Parts 2 to 4
AD Yardstick
AAD Guidelines: Topical Therapy
AAD Guidelines: Systemic Therapy
Handicapping the Race to Next Best AD
Therapy
Handicapping the Race to Next Best AD
Therapy
AAD Guidelines: Systemic Therapy
Summary
The Itch Factor
How Does the Skin Sense Itch?
The Emergence of Itch Neurobiology
The Emergence of Itch Neurobiology
How Does the Skin Become Inflamed and
Itchy?
How Does the Skin Become Inflamed and
Itchy?
The Evolving Paradigm of AD Pathogenesis
The Evolving Paradigm of Atopic Itch
The Evolving Paradigm of Atopic Itch
Anti-IL-4RA mAb Limits Neural Itch
Hypersensitivity
IL-4RA Broadly Expressed on Itch Neurons
Dupilumab May Be Broadly Efficacious
Across Multiple Chronic Itch Conditions
Dupilumab May Be Broadly Efficacious
Across Multiple Chronic Itch Conditions
CPUO Patients Treated With Dupilumab
Downstream JAK1 Is Another Major Itch
Target
Prediction: JAK Inhibitors Will Be Broad, Rapid,
and Potent in Itch
JAK1-Selective Inhibitors Are Potently Anti-
Itch
JAK1-Selective Inhibitors Are Potently Anti-
Itch
First FDA-Approved JAK Inhibitor for AD
Do JAK Inhibitors Work in CPUO?
The Sensory Paradigm of Cytokine/JAK
Signaling
What About Acute Itch in AD?
Divergent Mechanisms May Drive Acute on
Chronic Itch Flares in AD
Our Evolving Understanding of Itch
Context-Dependent Role of IL-33 in Itch
IL-33R on Sensory Neurons Mediates Dry
Skin Itch
Unclear Role of IL-33 in AD Itch
Unclear Role of IL-33 in AD Itch
New Pathways for Itch: KOR Agonism
DFK Likely Has Direct Itch-Suppressive
Properties
DFK Demonstrates Efficacy in Mild to
Moderate AD Itch
Itch Therapeutics Can Leverage Their Unique
MOA
The Translational Itch Paradigm
The Translational Itch Paradigm
Acknowledgements