Effects of a gel containing the defined microalgae extract Spiralin® on the skin microbiome and clinical activity in atopic dermatitis - a double-blind, intraindividual vehicle-controlled proof-of-concept study.

Introduction: Changes in the skin microbiome in atopic dermatitis include a reduced bacterial diversity and increased abundance of Staphylococcus aureus. Topical antibiotics and antiseptics may decrease bacterial pathogens, but lack positive effects on microbiome diversity.

Methods: In this double-blind, intraindividual vehicle-controlled pilot study, n = 20 patients received a gel containing a defined extract (Spiralin®) of the microalgae Spirulina platensis, previously shown to exert anti-microbial effects, or vehicle on target lesions of similar size and clinical activity.

Implementing Federated Analysis using DataSHIELD in the DREAM TO TREAT Atopic Dermatitis Registries Collaboration.

Many new biologic treatments and small molecule agents are emerging and being approved for treating atopic dermatitis (AD). Robust evidence, based on large sample sizes from real-world clinical settings, are needed to investigate the use of these new therapies, However, adequate sample sizes of patient data are difficult to obtain within one country alone, requiring international collaboration and data aggregation. To address this need for cooperative research, we investigated the feasibility for an international collaboration of registries to gather data from real-world clinical settings on patients' use of new systemic treatments for AD by creating a federated network between national registries that enables an analysis environment protecting privacy of information and ensuring compliance with General Data Protection Regulation.

Defining "Flares" in Atopic Dermatitis: A Narrative Review.

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by fluctuating disease activity. Exacerbations of AD signs and/or symptoms, or flares, have a significant impact on patient quality of life and may require modification or escalation of treatment. However, research into preventing and managing flares may be hampered by the lack of consensus on a clear, clinically relevant, measurable definition of flare.

Improvement and maintenance of clinical outcome assessments in atopic dermatitis with amlitelimab.

Background: Amlitelimab, a fully human, nondepleting, anti-OX40 ligand monoclonal antibody, demonstrated reductions in lesional and pruritic endpoints in adults with moderate-to-severe atopic dermatitis (AD) in phase 2a and 2b trials.

Objectives: Here, we examined the effect and durability of amlitelimab on clinical outcome assessments (COAs) in the randomized STREAM-AD phase 2b trial.

Methods: Adults with moderate-to-severe AD with prior inadequate response to or inadvisability of topical medications received subcutaneous amlitelimab (250 mg with 500-mg loading dose, 250 mg, 125 mg or 62.

A pan-European register-based observational study of abrocitinib and conventional systemic therapies in moderate and severe atopic dermatitis: the DREAM TO TREAT AD study protocol.

Background: Atopic dermatitis (AD) is a common chronic inflammatory skin condition. Currently, there is a lack of real-world evidence regarding the effectiveness of systemic therapies for moderate-to-severe AD. Abrocitinib is a novel Janus kinase 1 selective inhibitor licensed for AD in adults and adolescents requiring systemic treatment.

Collagen XXIII (COL23A1): A novel risk factor for eczema herpeticum.

Background: Eczema herpeticum (EH) is a potentially life-threatening disseminated skin infection caused by herpes simplex virus (HSV) in a subset of patients with atopic dermatitis (AD). The occurrence of EH in a subset of patients with AD and its frequent recurrence imply the importance of genetic factors in its pathogenesis.

Objective: We sought to identify novel genetic risk factors for EH and to study their impact on HSV-1 infection.

Two-Year Efficacy and Safety of Lebrikizumab in Patients with Moderate-to-Severe Atopic Dermatitis: A Long-Term Extension (ADjoin).

Introduction: The efficacy and safety of lebrikizumab, a high-affinity monoclonal antibody targeting interleukin-13, were investigated in patients with moderate-to-severe atopic dermatitis (AD) up to 52 weeks in phase 3 trials. This analysis evaluates safety and maintenance of response through 104 weeks of lebrikizumab treatment in patients with moderate-to-severe AD who achieved clinical response with lebrikizumab at week 16.

Methods: ADjoin is a 100-week phase 3 long-term extension study.

Dissecting key contributions of T2 and T17 cytokines to atopic dermatitis pathophysiology.

Background: In atopic dermatitis (AD), epidermal disease hallmarks are driven by a complex cutaneous inflammatory milieu that varies between patients. How these variable inflammatory signals affect cellular and molecular epidermal AD phenotypes is difficult to study in vivo.

Objective: We aimed to unravel which AD-associated cytokines drive specific epidermal disease hallmarks.

Childhood Asthma and Allergy Are Related to Accelerated Epigenetic Aging.

Background: Few studies showed associations of childhood allergic diseases with epigenetic aging using traditional clocks trained mainly on adults. Tracking DNA methylation variation early in life has suggested poor performance of these clocks in children. Therefore, we aim to elucidate the association between allergic diseases and epigenetic age using a pediatric clock.

Inflammatory Skin Diseases: The Importance of Immunological Signatures.

Background: The understanding and classification of inflammatory skin diseases is shifting from a historical-descriptive perspective to a molecular-pathophysiological one based on immune response patterns. These are derived from a few key immunological mediators, each of which induces its own characteristic clinical, histopathological, and molecular patterns in the skin.

Methods: This discussion of the definition of the immune response patterns of inflammatory skin diseases is based on information from pertinent publications retrieved by a selective literature search.

Early Achievement of High Treatment Targets in Moderate-to-Severe Atopic Dermatitis with Upadacitinib: Real-World Evidence from the Observational UP-TAINED Study.

Introduction: Phase 3 clinical trials have demonstrated robust efficacy and favorable safety of upadacitinib for the treatment of atopic dermatitis (AD). However, real-world data are still sparse. The objectives of this study were to assess the effectiveness and safety of real-world treatment with upadacitinib in patients with moderate-to-severe AD.

The importance of registries in clinical practice: Insights from the national atopic dermatitis registry TREATgermany.

Atopic dermatitis (AD) is an inflammatory, multifactorial skin disease characterized by eczematous skin lesions, severe itching, and serious limitations in quality of life. Since 2016, TREATgermany has been a national clinical registry for patients with moderate to severe AD with around 2,550 participating patients, enabling the collection of physical, patient-reported social and psychological data as well as the collection of biosamples in routine care. TREATgermany is one of the largest academically managed AD registries in the world.

GWAS meta-analysis of psoriasis identifies new susceptibility alleles impacting disease mechanisms and therapeutic targets.

Psoriasis is a common, debilitating immune-mediated skin disease. Genetic studies have identified biological mechanisms of psoriasis risk, including those targeted by effective therapies. However, the genetic liability to psoriasis is not fully explained by variation at robustly identified risk loci.

Switching from Dupilumab to Abrocitinib in Patients With Moderate-to-Severe Atopic Dermatitis: A Post Hoc Analysis of Efficacy After Treatment With Dupilumab in JADE DARE.

Introduction: Primary results of the JADE DARE trial (NCT04345367) demonstrated that abrocitinib was superior to dupilumab in reducing the signs and symptoms of moderate-to-severe atopic dermatitis (AD). This post hoc analysis evaluated the efficacy and safety of abrocitinib in patients with moderate-to-severe AD who were responders or nonresponders to dupilumab using various definitions of response.

Methods: Data included dupilumab-treated patients from JADE DARE who switched to abrocitinib 200 mg when enrolled in the ongoing JADE EXTEND trial (NCT03422822).

The efficacy of longer-term lebrikizumab treatment in patients with moderate-to-severe atopic dermatitis who did not meet protocol-defined response criteria at week 16 in 2 randomized controlled clinical trials.

Background: Lebrikizumab demonstrated statistically significant improvements in patients with moderate-to-severe atopic dermatitis at week 16 with a durable response up to week 52.

Objective: To investigate the efficacy of lebrikizumab-treated patients at 52 weeks who did not achieve the ADvocate1 and ADvocate2 protocol-defined response criteria (≥75% improvement in the Eczema Area and Severity Index [EASI 75] or Investigator Global Assessment 0/1 with ≥2-point improvement without rescue medication) after 16 weeks.

Methods: This analysis includes observed data for patients who received lebrikizumab every 2 weeks during the induction period, did not achieve the protocol-defined response, and subsequently received open-label lebrikizumab treatment.

Tralokinumab Treatment of Atopic Dermatitis Induces a Progressive Transcriptomic Response.

Atopic dermatitis is characterized by a complex epidermal barrier deficiency and exaggerated immune responses dominated by type 2 mechanisms with variable contributions of additional immune axes. IL-13 is overexpressed in atopic dermatitis skin and a key driver of both barrier dysfunction and inflammation. In this study, we prospectively studied the effects of IL-13 inhibition with tralokinumab on cutaneous transcriptome profiles using RNA sequencing of biopsies from 16 patients with moderate-to-severe atopic dermatitis obtained at baseline, week 2, and week 16.

Predicting success with reduced dosing frequency of tralokinumab in patients with moderate-to-severe atopic dermatitis.

Background: Approved tralokinumab maintenance dosing regimens for treatment of moderate-to-severe atopic dermatitis (AD) include 300 mg every 2 weeks (Q2W) and every 4 weeks (Q4W). Clinicians may consider tralokinumab Q4W for patients whose skin has become clear or almost clear at week 16 with initial Q2W dosing.

Objectives: To identify predictive factors associated with maintained response after switching to tralokinumab Q4W, evaluate recapture of treatment response after relapse on Q4W, and assess treatment-emergent immunogenicity with tralokinumab Q4W.

Hand eczema.

Hand eczema is a highly prevalent skin disease and one of the most common work-related disorders. In up to two-thirds of individuals affected by hand eczema, the disease becomes chronic and results in substantial personal and occupational disability. Manifestations of chronic hand eczema vary in severity and appearance over time, and people with eczema typically experience itch, pain, and a burning sensation.

Phase 2b randomized clinical trial of amlitelimab, an anti-OX40 ligand antibody, in patients with moderate-to-severe atopic dermatitis.

Background: Amlitelimab, a fully human nondepleting mAb targeting OX40 ligand on antigen-presenting cells, could prevent T-cell-driven inflammation seen in atopic dermatitis (AD).

Objective: This trial evaluated the efficacy and safety of amlitelimab in adults with AD.

Methods: In this 2-part, phase 2b, randomized, double-blinded placebo-controlled trial (ClinicalTrials.