From the Research Center to the Clinic: Biologics and Other Systemic Therapies Part 2

In episode 50 of Derms and Conditions, our host James Q. Del Rosso, DO, continues his conversation with Andrew Blauvelt, MD, MBA, a clinical trials investigator and former President and Owner of the Oregon Medical Research Center. Dr. Blauvelt has conducted almost 200 clinical trials on biologics and JAK inhibitors for the treatment of psoriasis and atopic dermatitis. While part 1 of this series focused on psoriasis, part 2 takes a deep dive into new therapies for atopic dermatitis.

Dr. Blauvelt first discusses dupilumab and how this medication blazed the trail for the treatment of severe atopic dermatitis in patients with very limited options. Dr. Del Rosso clarifies the difference in mechanism of action between dupilumab and the newer drugs tralokinumab and lebrikizumab, and the two comment on how this impacts efficacy and safety. A common adverse effect seen with these drugs is eye related issues such as conjunctivitis and keratoconjunctivitis sicca, and they advise how to manage these conditions if they arise.

Next, Dr. Del Rosso switches focus to the FDA-approved oral JAK inhibitors for atopic dermatitis, abrocitinib and upadacitinib. The biggest concern with JAK inhibitors has been their safety profile and black box warnings. However, Dr. Blauvelt discusses how these black box warnings came from a trial for tofacitinib to treat rheumatoid arthritis in a patient population featuring older patients with cardiac comorbidities that were taking prednisone and methotrexate concomitantly. This episode is full of clinical pearls for using the newest and most efficacious drugs for atopic dermatitis, so tune in to learn more!