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Background The efficacy and safety of dupilumab in atopic dermatitis (AD) have been defined in clinical trials but limited real-world evidence on long-term treatment outcomes is currently available to inform clinical decisions. Objectives To describe the long-term effectiveness and safety of dupilumab up to 48 months in patients with moderate-to-severe AD. Methods A multicentre, retrospective, dynamic cohort study was conducted to assess long-term effectiveness and safety of dupilumab in patients with moderate-to-severe AD in a real-world setting. Predictors of minimal disease activity (MDA) optimal treatment target criteria [defined as the simultaneous achievement of a 90% reduction in Eczema Area and Severity Index score, itch-numeric rating scale (NRS) score ≤ 1, sleep-NRS score ≤ 1 and Dermatology Life Quality Index ≤ 1] were investigated. Results In total, 2576 patients were enrolled from June 2018 to July 2022. MDA optimal treatment target criteria were achieved by 506/2309 (21.9%), 769/1959 (39.3%), 628/1247 (50.4%), 330/596 (55.4%) and 58/106 (54.7%) of those that reached 4, 12, 24, 36 and 48 months of follow-up, respectively. Logistic regression revealed a negative effect on MDA achievement for conjunctivitis and food allergy at all timepoints. Adverse events (AEs) were mild and were observed in 373/2364 (15.8%), 166/2066 (8.0%), 83/1291 (6.4%), 27/601 (4.5%) and 5/110 (4.5%) of those that reached 4, 12, 24, 36 and 48 months of follow-up. Conjunctivitis was the most frequently reported AE during the available follow-up. AEs led to treatment discontinuation in < 1% of patients during the evaluated time periods. Conclusions The high long-term effectiveness and safety of dupilumab were confirmed in this dynamic cohort of patients with moderate-to-severe AD, regardless of clinical phenotype and course (persisting or relapsing) at baseline. Further research will be needed to investigate the effect of T helper cell 2 comorbidities and disease duration on the response to dupilumab and other newer therapeutics for AD. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic, intensely pruritic disease associated with significant patient burden. Recent advancements in AD pathogenesis have expanded its therapeutics pipeline. Tralokinumab is a fully human monoclonal antibody that binds specifically Interleukin (IL)-13, inhibiting the downstream IL-13 signaling. Phase 3 clinical trials and some real-world studies showed that tralokinumab, as monotherapy or in combination with topical corticosteroids, is efficacious and safe in adult patients with moderate-to-severe AD. Similar results were reported in a phase 3 trial in adolescents (aged ≥12 years). We review the role of IL-13 in AD and discuss the value of tralokinumab for treating moderate-to-severe AD, comparing efficacy and safety results derived from clinical trials and real-life data. The role of IL-13 in AD supports a targeted therapeutic approach. Tralokinumab has proven efficacious and well-tolerated in a large proportion of patients confirming its value for treating moderate-to-severe AD from age 12 years onwards; it quickly improves itching and can maintain a high-level of response over time; it can be administered with flexible dosing schedules. Future studies will further clarify the role of IL-13 pathway and which patients would be best suited to tralokinumab, shifting AD treatment into an era of precision medicine. [ABSTRACT FROM AUTHOR]

This article reports on a study that investigated the long-term efficacy and safety of tralokinumab, a treatment for moderate-to-severe atopic dermatitis (AD), in adult patients. The study followed 171 AD patients for up to 52 weeks and found that 96.5% of patients were still using tralokinumab at the end of the study. There was a significant improvement in AD symptoms, including a decrease in Eczema Area and Severity Index (EASI) scores, itch, sleep loss, and improvement in quality of life. Adverse events were generally mild, with conjunctivitis being the most common. The study suggests that tralokinumab is a well-tolerated and effective long-term treatment option for AD. [Extracted from the article]

Atopic dermatitis (AD) is a chronic dermatosis characterized by an impaired cutaneous barrier with relapsing eczema and pruritus.[1] Corticosteroids and systemic immunosuppressants, traditionally standard of care for difficult-to-treat disease, have many undesirable side effects.[2] Conversely, dupilumab, a fully human monoclonal antibody that binds IL-4Ra, has a long-term efficacy and safety profile in the management of moderate-to-severe AD patients, although it does not achieve a clinical response in terms of an improvement over 50% and 75% in Eczema Area and Severity Index (EASI) after16 weeks, in a proportion which has been reported as high as 37% and 55% of cases, respectively.[[3], [5]] Tralokinumab, a fully human monoclonal antibody targeting IL-13, is a new treatment option for adult patients with moderate-to-severe AD candidate to systemic therapies.[6] Limited data are available in patients who have inadequate response to previous systemic therapies. Two-third of patients (8 out of 12, 66.6%) presented classical flexural AD, two patients presented prurigo nodularis (PN)-like type AD, one patient presented nummular type AD and one patient presented portrait AD. Notably, two patients exhibited a complete and a marked remission of PN-like lesions. SP 10 sp No serious adverse effect was reported, and the conjunctivitis observed in four patients during the previous treatment with dupilumab did not relapse. [Extracted from the article]

Data on the psoriasis incidence and prevalence in the Italian population are limited, and a timely and accurate understanding of the disease epidemiology is needed. This ad hoc study investigated psoriasis incidence and lifetime prevalence in a representative sample (n = 14,705) of the Italian population. Information on lifetime history of skin disorders with details about their onset, duration, and treatment was collected. Psoriasis incidence showed a bimodal distribution pattern, with peaks in age classes characteristic of early-onset (35-44 years) and late-onset (65-74 years) psoriasis. Late-onset psoriasis showed some variations according to the sex, with females being diagnosed earlier than males. Lifetime prevalence of psoriasis was 2.7% (95% confidence interval: 2.5-3.0): it increased to 3.5% at age 60-64 years, then decreased steadily after age 64, to 1.7% at age > 74 years. This decrease, despite a peak in incidence rates, after age 64, may suggest a higher mortality rate among psoriasis patients in older age classes, compared to the general population. [ABSTRACT FROM AUTHOR]

Introduction: Smoking is the single most important cause of preventable mortality worldwide. Besides being associated with major cardiovascular and bronchopulmonary diseases, and several cancers, it has been linked with a number of immune-related conditions, including psoriasis and psoriatic arthritis (PsA) We aimed to summarize data on the role of smoking in the development and prognosis of psoriasis and PsA, pointing to the consequences in terms of disease management. Areas covered: Mechanisms, clinical manifestations, and comorbidities associated with smoking in psoriasis and PsA were reviewed by searching Medline, Embase and Cochrane Library databases for papers published between January 2000 and July 2018 using combination of terms. Articles not written in English were excluded. Expert commentary: Smoking is a risk factor for psoriasis development. As for PsA, smoking is positively associated with the disease at the population level, but it is negatively associated in patients with psoriasis. This phenomenon is referred to as the 'smoking paradox' of PsA. Smoking may cause poor response and reduced adherence to treatment of both psorasis and PsA. Physicians need to be aware of the smoking habits of their patients with psoriasis and PsA; whenever possible, smoking cessation programs should be considered. [ABSTRACT FROM AUTHOR]

Aim: Abrocitinib is a JAK-1 inhibitor approved for the treatment of moderate-to-severe atopic dermatitis (AD). We conducted a 16-week multicenter retrospective study to assess the short-term effectiveness and safety of abrocitinib in patients with moderate-to-severe AD., Our retrospective study included 85 adult patients from 14 Italian Dermatology Units affected by moderate-to-severe AD treated with abrocitinib 100/200 mg., Methods: Effectiveness of abrocitinib at weeks 4 and 16 was assessed by using the Eczema Area and Severity Index (EASI), the Investigator Global Assessment (IGA), the peak pruritus and sleep- Numerical Rating Scale (PP-NRS and S-NRS, respectively)., Results: At week 16, improvement of at least 90% in EASI (EASI90) and IGA 0/1 was observed in 49.4% and 61.2% of patients, respectively. A reduction of at least 4 points in PP-NRS and S-NRS compared with baseline was achieved by 70.6% of patients for both endpoints. No significant safety reports were observed during the study period. Naïve patients had better rates of EASI 90 compared to patients who previously failed dupilumab. Conclusion: Our data confirm the effectiveness of abrocitinib in a real-world setting with better clinical responses at weeks 4 and 16, compared with Phase-III clinical trials. Longer analyses are required to further establish the safety profile of abrocitinib.