Atopic Dermatitis

Maternal in utero exposure to antibiotics was associated with an increased risk for infantile seborrheic dermatitis (SD) regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD.

The findings come from a large analysis of data from the United Kingdom that was presented during a late-breaking abstract session at the annual meeting of the Society for Investigative Dermatology.

SD is a common skin disease “that shares similarities with atopic dermatitis or atopic eczema as both are prevalent inflammatory skin diseases that can present with a chronic relapsing, remitting course,” the study’s corresponding author Zelma C. Chiesa Fuxench, MD, MSCE, assistant professor of dermatology at the University of Pennsylvania, Philadelphia, said in an interview. “Like atopic dermatitis, the pathophysiology of seborrheic dermatitis is thought to be complex and involves an interplay between genetics, immune dysregulation, and alterations in lipid composition and the skin microbiome, among others.”

“We observed that antibiotic exposure in utero was primarily associated with an increased risk of infantile SD regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD,” Dr. Chiesa Fuxench said. “This would suggest that in utero exposure to antibiotics, particularly penicillin, may have its greatest effect on the colonization of skin microbiota in the newborn period leading to the development of infantile SD. Aside from seeking to improve our understanding of the pathophysiology of SD, our findings also suggest that infantile SD and childhood-onset SD may be separate entities with different risk factors, a hypothesis that needs to be further studied.”

She acknowledged certain limitations of the analysis, including the potential for unrecorded diagnoses of SD or misclassified cases in the database. For example, AD and psoriasis “may appear clinically like SD,” she said, although they performed sensitivity analysis excluding patients with these diagnoses and found similar results. In addition, there is the possibility that not all antibiotic exposures were captured in this database, and data on antibiotic exposure may be missing, she added.

Dr. Chiesa Fuxench disclosed that she received research grants from Lilly, LEO Pharma, Regeneron, Sanofi, Tioga, Vanda, and Incyte for work related to AD and from Menlo Therapeutics and Galderma for work related to prurigo nodularis. She has served as a consultant for the Asthma and Allergy Foundation of America, National Eczema Association, AbbVie, Incyte Corporation, and Pfizer and received honoraria for CME work in AD sponsored by education grants from Regeneron/Sanofi and Pfizer and from Beiersdorf for work related to skin cancer and sun protection.

A version of this article appeared on Medscape.com .

Maternal in utero exposure to antibiotics was associated with an increased risk for infantile seborrheic dermatitis (SD) regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD.

The findings come from a large analysis of data from the United Kingdom that was presented during a late-breaking abstract session at the annual meeting of the Society for Investigative Dermatology.

SD is a common skin disease “that shares similarities with atopic dermatitis or atopic eczema as both are prevalent inflammatory skin diseases that can present with a chronic relapsing, remitting course,” the study’s corresponding author Zelma C. Chiesa Fuxench, MD, MSCE, assistant professor of dermatology at the University of Pennsylvania, Philadelphia, said in an interview. “Like atopic dermatitis, the pathophysiology of seborrheic dermatitis is thought to be complex and involves an interplay between genetics, immune dysregulation, and alterations in lipid composition and the skin microbiome, among others.”

“We observed that antibiotic exposure in utero was primarily associated with an increased risk of infantile SD regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD,” Dr. Chiesa Fuxench said. “This would suggest that in utero exposure to antibiotics, particularly penicillin, may have its greatest effect on the colonization of skin microbiota in the newborn period leading to the development of infantile SD. Aside from seeking to improve our understanding of the pathophysiology of SD, our findings also suggest that infantile SD and childhood-onset SD may be separate entities with different risk factors, a hypothesis that needs to be further studied.”

She acknowledged certain limitations of the analysis, including the potential for unrecorded diagnoses of SD or misclassified cases in the database. For example, AD and psoriasis “may appear clinically like SD,” she said, although they performed sensitivity analysis excluding patients with these diagnoses and found similar results. In addition, there is the possibility that not all antibiotic exposures were captured in this database, and data on antibiotic exposure may be missing, she added.

Dr. Chiesa Fuxench disclosed that she received research grants from Lilly, LEO Pharma, Regeneron, Sanofi, Tioga, Vanda, and Incyte for work related to AD and from Menlo Therapeutics and Galderma for work related to prurigo nodularis. She has served as a consultant for the Asthma and Allergy Foundation of America, National Eczema Association, AbbVie, Incyte Corporation, and Pfizer and received honoraria for CME work in AD sponsored by education grants from Regeneron/Sanofi and Pfizer and from Beiersdorf for work related to skin cancer and sun protection.

A version of this article appeared on Medscape.com .

Maternal in utero exposure to antibiotics was associated with an increased risk for infantile seborrheic dermatitis (SD) regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD.

The findings come from a large analysis of data from the United Kingdom that was presented during a late-breaking abstract session at the annual meeting of the Society for Investigative Dermatology.

SD is a common skin disease “that shares similarities with atopic dermatitis or atopic eczema as both are prevalent inflammatory skin diseases that can present with a chronic relapsing, remitting course,” the study’s corresponding author Zelma C. Chiesa Fuxench, MD, MSCE, assistant professor of dermatology at the University of Pennsylvania, Philadelphia, said in an interview. “Like atopic dermatitis, the pathophysiology of seborrheic dermatitis is thought to be complex and involves an interplay between genetics, immune dysregulation, and alterations in lipid composition and the skin microbiome, among others.”

“We observed that antibiotic exposure in utero was primarily associated with an increased risk of infantile SD regardless of the mother’s history of SD, but this association was not as strong for childhood-onset SD,” Dr. Chiesa Fuxench said. “This would suggest that in utero exposure to antibiotics, particularly penicillin, may have its greatest effect on the colonization of skin microbiota in the newborn period leading to the development of infantile SD. Aside from seeking to improve our understanding of the pathophysiology of SD, our findings also suggest that infantile SD and childhood-onset SD may be separate entities with different risk factors, a hypothesis that needs to be further studied.”

She acknowledged certain limitations of the analysis, including the potential for unrecorded diagnoses of SD or misclassified cases in the database. For example, AD and psoriasis “may appear clinically like SD,” she said, although they performed sensitivity analysis excluding patients with these diagnoses and found similar results. In addition, there is the possibility that not all antibiotic exposures were captured in this database, and data on antibiotic exposure may be missing, she added.

Dr. Chiesa Fuxench disclosed that she received research grants from Lilly, LEO Pharma, Regeneron, Sanofi, Tioga, Vanda, and Incyte for work related to AD and from Menlo Therapeutics and Galderma for work related to prurigo nodularis. She has served as a consultant for the Asthma and Allergy Foundation of America, National Eczema Association, AbbVie, Incyte Corporation, and Pfizer and received honoraria for CME work in AD sponsored by education grants from Regeneron/Sanofi and Pfizer and from Beiersdorf for work related to skin cancer and sun protection.

A version of this article appeared on Medscape.com .

Clinicians should incorporate at least one of three validated instruments to measure signs of atopic dermatitis (AD) in their clinical practice, the authors of a new consensus statement recommended.

These include the Eczema Area and Severity Index (EASI), the Validated Investigator Global Assessment for AD (vIGAAD), and the Investigator’s Global Assessment (IGA) multiplied by or measured concurrently with a body surface area (BSA) assessment.

The recommendations are part of a consensus statement based on an updated systematic review conducted by the Harmonizing Outcome Measures for Eczema Clinical Practice (HOME-CP) initiative, whose goal is to identify validated, feasible outcome instruments designed to measure AD in the clinical setting. In the statement, which was published in JAMA Dermatology on May 22, 2024, corresponding author Eric L. Simpson, MD, MCR, professor of dermatology at Oregon Health & Science University, Portland, and coauthors described HOME-CP as “a ‘pick-and-choose’ list of valid and feasible OMIs [outcome measure instruments] that can be incorporated into the practice setting depending on the particular need of that clinic or health system.”

For the effort, the authors implemented a mixed methods design and incorporated systematic reviews and qualitative consensus methods modeled after the HOME core outcome set initiative, which developed a set of consensus-based core outcome sets for clinical trials and clinical practice. In October of 2022, a daylong in-person consensus exercise was held in Montreal, Canada, where attendees met to reach consensus on recommended instruments to measure AD clinical signs in clinical practice, based on an updated systematic review evaluating the validity of clinical signs instruments.

The review included 22 studies describing 16 instruments that assessed AD clinical signs and an additional 12 variants of instruments. The meeting was attended by 34 individuals from 13 countries, including patient and patient advocate research partners, health care professionals, researchers, methodologists, and industry representatives. Consensus was defined as less than 30% disagreement.

Following their daylong consensus exercise, the stakeholders reached consensus on recommendations to use the EASI, the vIGAAD, and an IGA multiplied or measured alongside a BSA measurement to measure the domain of clinical signs of AD in the clinical practice setting. “The use of multiple IGAs, most with insufficient validation, and the diverse methods used to assess BSA prevented participants from making specific recommendations for the exact IGA/BSA instrument,” the authors wrote. “We recommend that clinicians include at least one of the recommended instruments in their clinical practices and in documentation.” 

They explained that the ideal method of measuring BSA was difficult to assess “because multiple techniques exist for its measurement, including regional percentages, the Rule of Nines, or the handprint method. Most studies did not report which method was performed, and to our knowledge, no studies have been performed in patients with AD that have formally compared them.”

During the consensus exercise, the authors noted, several clinicians “expressed concern whether the EASI was feasible for universal use in clinical practice given its complexity, long completion time, and documentation/calculation requirements.” But clinicians who commonly perform the EASI in clinical practice said that the time it takes to complete this measure “has dropped substantially and now is not a considerable burden,” they wrote, adding that, “studies have shown that with trained investigators, EASI completion times can be as low as nearly 2 minutes.”

The authors acknowledged certain limitations of their recommendations, including the lack of input from primary care clinicians. “It is unknown whether ClinROMs [clinician-reported outcome measures] for AD clinical signs are used in the primary care setting, especially given the large amount of conditions that are managed simultaneously and the ever-increasing number of primary care documentation requirements,” they wrote.

Robert Sidbury, MD, MPH, chief of the division of dermatology at Seattle Children’s Hospital, who was asked to comment on the consensus statement, said that with the advent of new, improved, and more expensive medications for AD, “it is ever more important that [the clinical] assessment is reliable and reproducible.”

Insurers “are understandably less willing to rubber-stamp approval of more expensive medications without a reliable standard by which to justify such decisions,” he added. “This is even more important in a disease state like atopic dermatitis that lacks a reliable biomarker. Therefore, one or several practical, reliable, validated severity metrics will help standardize and improve AD care.”

Dr. Sidbury, who cochaired the 2023 American Academy of Dermatology guidelines of care for the management of AD in adults with phototherapy and systemic therapies, added that the instruments evaluated in the review “can be challenging for anyone,” not just primary care providers. “The EASI isn’t that easy, and while there is a learning curve and it ultimately does, like anything, become more efficient in the gathering, it is unclear if non-AD researchers will be willing to invest the time” to routinely use it, he said.

Dr. Simpson and several coauthors reported receiving grants and personal fees from multiple pharmaceutical companies. Dr. Sidbury reported that he serves as an investigator for Regeneron, Galderma, UCB, Castle, and Pfizer; is a consultant for LEO, Lilly, Arcutis, Dermavant, and Pierre Fabre; and a speaker for Beiersdorf.

A version of this article appeared on Medscape.com .

Clinicians should incorporate at least one of three validated instruments to measure signs of atopic dermatitis (AD) in their clinical practice, the authors of a new consensus statement recommended.

These include the Eczema Area and Severity Index (EASI), the Validated Investigator Global Assessment for AD (vIGAAD), and the Investigator’s Global Assessment (IGA) multiplied by or measured concurrently with a body surface area (BSA) assessment.

The recommendations are part of a consensus statement based on an updated systematic review conducted by the Harmonizing Outcome Measures for Eczema Clinical Practice (HOME-CP) initiative, whose goal is to identify validated, feasible outcome instruments designed to measure AD in the clinical setting. In the statement, which was published in JAMA Dermatology on May 22, 2024, corresponding author Eric L. Simpson, MD, MCR, professor of dermatology at Oregon Health & Science University, Portland, and coauthors described HOME-CP as “a ‘pick-and-choose’ list of valid and feasible OMIs [outcome measure instruments] that can be incorporated into the practice setting depending on the particular need of that clinic or health system.”

For the effort, the authors implemented a mixed methods design and incorporated systematic reviews and qualitative consensus methods modeled after the HOME core outcome set initiative, which developed a set of consensus-based core outcome sets for clinical trials and clinical practice. In October of 2022, a daylong in-person consensus exercise was held in Montreal, Canada, where attendees met to reach consensus on recommended instruments to measure AD clinical signs in clinical practice, based on an updated systematic review evaluating the validity of clinical signs instruments.

The review included 22 studies describing 16 instruments that assessed AD clinical signs and an additional 12 variants of instruments. The meeting was attended by 34 individuals from 13 countries, including patient and patient advocate research partners, health care professionals, researchers, methodologists, and industry representatives. Consensus was defined as less than 30% disagreement.

Following their daylong consensus exercise, the stakeholders reached consensus on recommendations to use the EASI, the vIGAAD, and an IGA multiplied or measured alongside a BSA measurement to measure the domain of clinical signs of AD in the clinical practice setting. “The use of multiple IGAs, most with insufficient validation, and the diverse methods used to assess BSA prevented participants from making specific recommendations for the exact IGA/BSA instrument,” the authors wrote. “We recommend that clinicians include at least one of the recommended instruments in their clinical practices and in documentation.” 

They explained that the ideal method of measuring BSA was difficult to assess “because multiple techniques exist for its measurement, including regional percentages, the Rule of Nines, or the handprint method. Most studies did not report which method was performed, and to our knowledge, no studies have been performed in patients with AD that have formally compared them.”

During the consensus exercise, the authors noted, several clinicians “expressed concern whether the EASI was feasible for universal use in clinical practice given its complexity, long completion time, and documentation/calculation requirements.” But clinicians who commonly perform the EASI in clinical practice said that the time it takes to complete this measure “has dropped substantially and now is not a considerable burden,” they wrote, adding that, “studies have shown that with trained investigators, EASI completion times can be as low as nearly 2 minutes.”

The authors acknowledged certain limitations of their recommendations, including the lack of input from primary care clinicians. “It is unknown whether ClinROMs [clinician-reported outcome measures] for AD clinical signs are used in the primary care setting, especially given the large amount of conditions that are managed simultaneously and the ever-increasing number of primary care documentation requirements,” they wrote.

Robert Sidbury, MD, MPH, chief of the division of dermatology at Seattle Children’s Hospital, who was asked to comment on the consensus statement, said that with the advent of new, improved, and more expensive medications for AD, “it is ever more important that [the clinical] assessment is reliable and reproducible.”

Insurers “are understandably less willing to rubber-stamp approval of more expensive medications without a reliable standard by which to justify such decisions,” he added. “This is even more important in a disease state like atopic dermatitis that lacks a reliable biomarker. Therefore, one or several practical, reliable, validated severity metrics will help standardize and improve AD care.”

Dr. Sidbury, who cochaired the 2023 American Academy of Dermatology guidelines of care for the management of AD in adults with phototherapy and systemic therapies, added that the instruments evaluated in the review “can be challenging for anyone,” not just primary care providers. “The EASI isn’t that easy, and while there is a learning curve and it ultimately does, like anything, become more efficient in the gathering, it is unclear if non-AD researchers will be willing to invest the time” to routinely use it, he said.

Dr. Simpson and several coauthors reported receiving grants and personal fees from multiple pharmaceutical companies. Dr. Sidbury reported that he serves as an investigator for Regeneron, Galderma, UCB, Castle, and Pfizer; is a consultant for LEO, Lilly, Arcutis, Dermavant, and Pierre Fabre; and a speaker for Beiersdorf.

A version of this article appeared on Medscape.com .

Clinicians should incorporate at least one of three validated instruments to measure signs of atopic dermatitis (AD) in their clinical practice, the authors of a new consensus statement recommended.

These include the Eczema Area and Severity Index (EASI), the Validated Investigator Global Assessment for AD (vIGAAD), and the Investigator’s Global Assessment (IGA) multiplied by or measured concurrently with a body surface area (BSA) assessment.

The recommendations are part of a consensus statement based on an updated systematic review conducted by the Harmonizing Outcome Measures for Eczema Clinical Practice (HOME-CP) initiative, whose goal is to identify validated, feasible outcome instruments designed to measure AD in the clinical setting. In the statement, which was published in JAMA Dermatology on May 22, 2024, corresponding author Eric L. Simpson, MD, MCR, professor of dermatology at Oregon Health & Science University, Portland, and coauthors described HOME-CP as “a ‘pick-and-choose’ list of valid and feasible OMIs [outcome measure instruments] that can be incorporated into the practice setting depending on the particular need of that clinic or health system.”

For the effort, the authors implemented a mixed methods design and incorporated systematic reviews and qualitative consensus methods modeled after the HOME core outcome set initiative, which developed a set of consensus-based core outcome sets for clinical trials and clinical practice. In October of 2022, a daylong in-person consensus exercise was held in Montreal, Canada, where attendees met to reach consensus on recommended instruments to measure AD clinical signs in clinical practice, based on an updated systematic review evaluating the validity of clinical signs instruments.

The review included 22 studies describing 16 instruments that assessed AD clinical signs and an additional 12 variants of instruments. The meeting was attended by 34 individuals from 13 countries, including patient and patient advocate research partners, health care professionals, researchers, methodologists, and industry representatives. Consensus was defined as less than 30% disagreement.

Following their daylong consensus exercise, the stakeholders reached consensus on recommendations to use the EASI, the vIGAAD, and an IGA multiplied or measured alongside a BSA measurement to measure the domain of clinical signs of AD in the clinical practice setting. “The use of multiple IGAs, most with insufficient validation, and the diverse methods used to assess BSA prevented participants from making specific recommendations for the exact IGA/BSA instrument,” the authors wrote. “We recommend that clinicians include at least one of the recommended instruments in their clinical practices and in documentation.” 

They explained that the ideal method of measuring BSA was difficult to assess “because multiple techniques exist for its measurement, including regional percentages, the Rule of Nines, or the handprint method. Most studies did not report which method was performed, and to our knowledge, no studies have been performed in patients with AD that have formally compared them.”

During the consensus exercise, the authors noted, several clinicians “expressed concern whether the EASI was feasible for universal use in clinical practice given its complexity, long completion time, and documentation/calculation requirements.” But clinicians who commonly perform the EASI in clinical practice said that the time it takes to complete this measure “has dropped substantially and now is not a considerable burden,” they wrote, adding that, “studies have shown that with trained investigators, EASI completion times can be as low as nearly 2 minutes.”

The authors acknowledged certain limitations of their recommendations, including the lack of input from primary care clinicians. “It is unknown whether ClinROMs [clinician-reported outcome measures] for AD clinical signs are used in the primary care setting, especially given the large amount of conditions that are managed simultaneously and the ever-increasing number of primary care documentation requirements,” they wrote.

Robert Sidbury, MD, MPH, chief of the division of dermatology at Seattle Children’s Hospital, who was asked to comment on the consensus statement, said that with the advent of new, improved, and more expensive medications for AD, “it is ever more important that [the clinical] assessment is reliable and reproducible.”

Insurers “are understandably less willing to rubber-stamp approval of more expensive medications without a reliable standard by which to justify such decisions,” he added. “This is even more important in a disease state like atopic dermatitis that lacks a reliable biomarker. Therefore, one or several practical, reliable, validated severity metrics will help standardize and improve AD care.”

Dr. Sidbury, who cochaired the 2023 American Academy of Dermatology guidelines of care for the management of AD in adults with phototherapy and systemic therapies, added that the instruments evaluated in the review “can be challenging for anyone,” not just primary care providers. “The EASI isn’t that easy, and while there is a learning curve and it ultimately does, like anything, become more efficient in the gathering, it is unclear if non-AD researchers will be willing to invest the time” to routinely use it, he said.

Dr. Simpson and several coauthors reported receiving grants and personal fees from multiple pharmaceutical companies. Dr. Sidbury reported that he serves as an investigator for Regeneron, Galderma, UCB, Castle, and Pfizer; is a consultant for LEO, Lilly, Arcutis, Dermavant, and Pierre Fabre; and a speaker for Beiersdorf.

A version of this article appeared on Medscape.com .

TOPLINE:

A new study found that use of e-cigarettes by parents was associated with an increased risk for atopic dermatitis (AD) in children.

METHODOLOGY:

• AD is one of the most common inflammatory conditions in children and is linked to environmental risk factors, such as exposure to secondhand smoke and prenatal exposure to tobacco.
• To address the effect of e-cigarettes use on children, researchers conducted a cross-sectional analysis of data from the 2014-2018 National Health Interview Survey, a nationally representative sample of the US population.
• The analysis included 48,637,111 individuals (mean age, 8.4 years), with 6,354,515 (13%) indicating a history of AD (mean age, 8 years).

TAKEAWAY:

• The prevalence of parental e-cigarette use was 18.0% among individuals with AD, compared with 14.4% among those without AD.
• This corresponded to a 24% higher risk for AD associated with parental e-cigarette use (adjusted odds ratio, 1.24; 95% CI, 1.08-1.42).
• The association between e-cigarette use and AD in children held regardless of parent’s sex.

IN PRACTICE:

“Our results suggest that parental e-cigarette use was associated with pediatric AD,” the authors concluded. They noted that the authors of a previous study that associated e-cigarette use with AD in adults postulated that the cause was “the inflammatory state created by” e-cigarettes.

SOURCE:

This study, led by Gun Min Youn, Department of Dermatology, Stanford University School of Medicine, Stanford, California, was published online in JAMA Dermatology.

LIMITATIONS:

The cross-sectional survey design limited the ability to draw causal inferences. Defining e-cigarette use as a single past instance could affect the strength of the findings. Only past-year e-cigarette use was considered. Furthermore, data on pediatric cigarette or e-cigarette use, a potential confounder, were unavailable.

DISCLOSURES:

The study did not disclose funding information. One author reported receiving consultation fees outside the submitted work. No other disclosures were reported.

A version of this article appeared on Medscape.com.

TOPLINE:

A new study found that use of e-cigarettes by parents was associated with an increased risk for atopic dermatitis (AD) in children.

METHODOLOGY:

• AD is one of the most common inflammatory conditions in children and is linked to environmental risk factors, such as exposure to secondhand smoke and prenatal exposure to tobacco.
• To address the effect of e-cigarettes use on children, researchers conducted a cross-sectional analysis of data from the 2014-2018 National Health Interview Survey, a nationally representative sample of the US population.
• The analysis included 48,637,111 individuals (mean age, 8.4 years), with 6,354,515 (13%) indicating a history of AD (mean age, 8 years).

TAKEAWAY:

• The prevalence of parental e-cigarette use was 18.0% among individuals with AD, compared with 14.4% among those without AD.
• This corresponded to a 24% higher risk for AD associated with parental e-cigarette use (adjusted odds ratio, 1.24; 95% CI, 1.08-1.42).
• The association between e-cigarette use and AD in children held regardless of parent’s sex.

IN PRACTICE:

“Our results suggest that parental e-cigarette use was associated with pediatric AD,” the authors concluded. They noted that the authors of a previous study that associated e-cigarette use with AD in adults postulated that the cause was “the inflammatory state created by” e-cigarettes.

SOURCE:

This study, led by Gun Min Youn, Department of Dermatology, Stanford University School of Medicine, Stanford, California, was published online in JAMA Dermatology.

LIMITATIONS:

The cross-sectional survey design limited the ability to draw causal inferences. Defining e-cigarette use as a single past instance could affect the strength of the findings. Only past-year e-cigarette use was considered. Furthermore, data on pediatric cigarette or e-cigarette use, a potential confounder, were unavailable.

DISCLOSURES:

The study did not disclose funding information. One author reported receiving consultation fees outside the submitted work. No other disclosures were reported.

A version of this article appeared on Medscape.com.

TOPLINE:

A new study found that use of e-cigarettes by parents was associated with an increased risk for atopic dermatitis (AD) in children.

METHODOLOGY:

• AD is one of the most common inflammatory conditions in children and is linked to environmental risk factors, such as exposure to secondhand smoke and prenatal exposure to tobacco.
• To address the effect of e-cigarettes use on children, researchers conducted a cross-sectional analysis of data from the 2014-2018 National Health Interview Survey, a nationally representative sample of the US population.
• The analysis included 48,637,111 individuals (mean age, 8.4 years), with 6,354,515 (13%) indicating a history of AD (mean age, 8 years).

TAKEAWAY:

• The prevalence of parental e-cigarette use was 18.0% among individuals with AD, compared with 14.4% among those without AD.
• This corresponded to a 24% higher risk for AD associated with parental e-cigarette use (adjusted odds ratio, 1.24; 95% CI, 1.08-1.42).
• The association between e-cigarette use and AD in children held regardless of parent’s sex.

IN PRACTICE:

“Our results suggest that parental e-cigarette use was associated with pediatric AD,” the authors concluded. They noted that the authors of a previous study that associated e-cigarette use with AD in adults postulated that the cause was “the inflammatory state created by” e-cigarettes.

SOURCE:

This study, led by Gun Min Youn, Department of Dermatology, Stanford University School of Medicine, Stanford, California, was published online in JAMA Dermatology.

LIMITATIONS:

The cross-sectional survey design limited the ability to draw causal inferences. Defining e-cigarette use as a single past instance could affect the strength of the findings. Only past-year e-cigarette use was considered. Furthermore, data on pediatric cigarette or e-cigarette use, a potential confounder, were unavailable.

DISCLOSURES:

The study did not disclose funding information. One author reported receiving consultation fees outside the submitted work. No other disclosures were reported.

A version of this article appeared on Medscape.com.

Atopic dermatitis (AD) among older individuals presented most frequently on the extensor surfaces and trunk, with lichenification and nummular lesions being the most frequent rash characteristics, in a retrospective study of almost 800 patients aged 60 years and older.

The researchers reviewed charts of patients aged 60 years and older who were seen at either a private or county dermatology clinic in Houston between 2009 and 2020 and had been diagnosed with AD by a dermatologist. The findings of their cross-sectional study further supports that AD in this age group “presents as a unique phenotype compared to AD in younger ages, which may inform dermatologists’ diagnosis of AD in these patients” they wrote.

The 791 patients in the study had an average age of 69.3 years, were predominantly women (60.1%), and were racially diverse, with almost 40% being non-Hispanic White individuals. Others were non-Hispanic Black individuals (21.8%), Hispanics (20.4%), and non-Hispanic Asian/Pacific Islanders (11.7%).

Use of topicals, mainly topical corticosteroids (92.2%), was the most frequent treatment prescribed. Oral corticosteroids and antihistamines were “frequent systemic treatments” in this population, prescribed to 10.4% and 12.1%, respectively, “likely due to management prior to a diagnosis of AD by a dermatologist,” wrote first author Hannah Y. Wang, Baylor College of Medicine, Houston, and her coauthors, including Soo Jung Kim, MD, PhD, of the department of dermatology at Baylor.

Other treatments included dupilumab in 5.4%, systemic immunosuppressants (including methotrexate, cyclosporine, and mycophenolate) in 5.4%, and UVB-phototherapy in 2.7%.

Approximately 40% of the patients had a history of allergic rhinitis, while 20% had a history of asthma. Lichenification was noted in 14.5% of patients and nummular lesions in almost 13%. Other rash characteristics — ichthyosis and hyperpigmented patches — were less frequent, seen in 9.7% and 9.1%, respectively.

AD in this older population was most commonly documented on the extensors (49.9%) and the trunk (46%) and less commonly on the hands (19.8%) and feet (9%) — a distribution that is similar to past reports, the authors wrote.

Asked to comment on the findings, Adam Friedman, MD, professor and chair of dermatology at George Washington University, Washington, DC, told this news organization that the data relating to clinical morphology are consistent with past reports and with his own experiences. Lichenification is a “tell-tale sign of chronic disease” and may indicate undertreatment, and the frequency of nummular plaques is unsurprising because “nummular dermatitis as an independent eczema tends to occur more so in the elderly.”

A version of this article appeared on Medscape.com.

Atopic dermatitis (AD) among older individuals presented most frequently on the extensor surfaces and trunk, with lichenification and nummular lesions being the most frequent rash characteristics, in a retrospective study of almost 800 patients aged 60 years and older.

The researchers reviewed charts of patients aged 60 years and older who were seen at either a private or county dermatology clinic in Houston between 2009 and 2020 and had been diagnosed with AD by a dermatologist. The findings of their cross-sectional study further supports that AD in this age group “presents as a unique phenotype compared to AD in younger ages, which may inform dermatologists’ diagnosis of AD in these patients” they wrote.

The 791 patients in the study had an average age of 69.3 years, were predominantly women (60.1%), and were racially diverse, with almost 40% being non-Hispanic White individuals. Others were non-Hispanic Black individuals (21.8%), Hispanics (20.4%), and non-Hispanic Asian/Pacific Islanders (11.7%).

Use of topicals, mainly topical corticosteroids (92.2%), was the most frequent treatment prescribed. Oral corticosteroids and antihistamines were “frequent systemic treatments” in this population, prescribed to 10.4% and 12.1%, respectively, “likely due to management prior to a diagnosis of AD by a dermatologist,” wrote first author Hannah Y. Wang, Baylor College of Medicine, Houston, and her coauthors, including Soo Jung Kim, MD, PhD, of the department of dermatology at Baylor.

Other treatments included dupilumab in 5.4%, systemic immunosuppressants (including methotrexate, cyclosporine, and mycophenolate) in 5.4%, and UVB-phototherapy in 2.7%.

Approximately 40% of the patients had a history of allergic rhinitis, while 20% had a history of asthma. Lichenification was noted in 14.5% of patients and nummular lesions in almost 13%. Other rash characteristics — ichthyosis and hyperpigmented patches — were less frequent, seen in 9.7% and 9.1%, respectively.

AD in this older population was most commonly documented on the extensors (49.9%) and the trunk (46%) and less commonly on the hands (19.8%) and feet (9%) — a distribution that is similar to past reports, the authors wrote.

Asked to comment on the findings, Adam Friedman, MD, professor and chair of dermatology at George Washington University, Washington, DC, told this news organization that the data relating to clinical morphology are consistent with past reports and with his own experiences. Lichenification is a “tell-tale sign of chronic disease” and may indicate undertreatment, and the frequency of nummular plaques is unsurprising because “nummular dermatitis as an independent eczema tends to occur more so in the elderly.”

A version of this article appeared on Medscape.com.

Atopic dermatitis (AD) among older individuals presented most frequently on the extensor surfaces and trunk, with lichenification and nummular lesions being the most frequent rash characteristics, in a retrospective study of almost 800 patients aged 60 years and older.

The researchers reviewed charts of patients aged 60 years and older who were seen at either a private or county dermatology clinic in Houston between 2009 and 2020 and had been diagnosed with AD by a dermatologist. The findings of their cross-sectional study further supports that AD in this age group “presents as a unique phenotype compared to AD in younger ages, which may inform dermatologists’ diagnosis of AD in these patients” they wrote.

The 791 patients in the study had an average age of 69.3 years, were predominantly women (60.1%), and were racially diverse, with almost 40% being non-Hispanic White individuals. Others were non-Hispanic Black individuals (21.8%), Hispanics (20.4%), and non-Hispanic Asian/Pacific Islanders (11.7%).

Use of topicals, mainly topical corticosteroids (92.2%), was the most frequent treatment prescribed. Oral corticosteroids and antihistamines were “frequent systemic treatments” in this population, prescribed to 10.4% and 12.1%, respectively, “likely due to management prior to a diagnosis of AD by a dermatologist,” wrote first author Hannah Y. Wang, Baylor College of Medicine, Houston, and her coauthors, including Soo Jung Kim, MD, PhD, of the department of dermatology at Baylor.

Other treatments included dupilumab in 5.4%, systemic immunosuppressants (including methotrexate, cyclosporine, and mycophenolate) in 5.4%, and UVB-phototherapy in 2.7%.

Approximately 40% of the patients had a history of allergic rhinitis, while 20% had a history of asthma. Lichenification was noted in 14.5% of patients and nummular lesions in almost 13%. Other rash characteristics — ichthyosis and hyperpigmented patches — were less frequent, seen in 9.7% and 9.1%, respectively.

AD in this older population was most commonly documented on the extensors (49.9%) and the trunk (46%) and less commonly on the hands (19.8%) and feet (9%) — a distribution that is similar to past reports, the authors wrote.

Asked to comment on the findings, Adam Friedman, MD, professor and chair of dermatology at George Washington University, Washington, DC, told this news organization that the data relating to clinical morphology are consistent with past reports and with his own experiences. Lichenification is a “tell-tale sign of chronic disease” and may indicate undertreatment, and the frequency of nummular plaques is unsurprising because “nummular dermatitis as an independent eczema tends to occur more so in the elderly.”

A version of this article appeared on Medscape.com.

Traidl and colleagues report that obesity was linked to worse AD in German patients. The authors hit the nail on the head with their conclusions: "In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance." What might account for the small difference in disease severity? Adherence to treatment is highly variable among patients with AD. A small tendency toward worse adherence in patients with obesity could easily explain the small differences seen in disease severity.

Eichenfeld and colleagues report that topical ruxolitinib maintained good efficacy over a year in open-label use. Topical ruxolitinib is a very effective treatment for AD. If real-life AD patients on topical ruxolitinib were to lose efficacy over time, I'd consider the possibility that they've developed mutant Janus kinase (JAK) enzymes that are no longer responsive to the drug. Just kidding. I doubt that such mutations ever occur. If topical ruxolitinib in AD patients were to lose efficacy over time, I'd strongly consider the possibility that patients' adherence to the treatment is no longer as good as it was before. Long-term adherence to topical treatment can be abysmal. Adherence in clinical trials is probably a lot better than in clinical practice. When we see topical treatments that are effective in clinical trials failing in real-life patients with AD, it may be prudent to address the possibility of poor adherence.

I'd love to see a head-to-head trial of tralokinumab vs dupilumab in the treatment of moderate to severe AD. Lacking that, Torres and colleagues report an indirect comparison of the two drugs in patients also treated with topical steroids. This study, funded by the manufacturer of tralokinumab, reported that the two drugs have similar efficacy. How much of the efficacy was due to the topical steroid use is not clear to me. I'd still love to see a head-to-head trial of tralokinumab vs dupilumab to have a better, more confident sense of their relative efficacy.

Is AD associated with brain cancer, as reported by Xin and colleagues? I'm not an expert in their methodology, but they did find a statistically significant increased risk, with an odds ratio of 1.0005. I understand the odds ratio for smoking and lung cancer to be about 80. Even if the increased odds of 1.005 — no, wait, that's 1.0005 — is truly due to AD, this tiny difference doesn't seem meaningful in any way.

Traidl and colleagues report that obesity was linked to worse AD in German patients. The authors hit the nail on the head with their conclusions: "In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance." What might account for the small difference in disease severity? Adherence to treatment is highly variable among patients with AD. A small tendency toward worse adherence in patients with obesity could easily explain the small differences seen in disease severity.

Eichenfeld and colleagues report that topical ruxolitinib maintained good efficacy over a year in open-label use. Topical ruxolitinib is a very effective treatment for AD. If real-life AD patients on topical ruxolitinib were to lose efficacy over time, I'd consider the possibility that they've developed mutant Janus kinase (JAK) enzymes that are no longer responsive to the drug. Just kidding. I doubt that such mutations ever occur. If topical ruxolitinib in AD patients were to lose efficacy over time, I'd strongly consider the possibility that patients' adherence to the treatment is no longer as good as it was before. Long-term adherence to topical treatment can be abysmal. Adherence in clinical trials is probably a lot better than in clinical practice. When we see topical treatments that are effective in clinical trials failing in real-life patients with AD, it may be prudent to address the possibility of poor adherence.

I'd love to see a head-to-head trial of tralokinumab vs dupilumab in the treatment of moderate to severe AD. Lacking that, Torres and colleagues report an indirect comparison of the two drugs in patients also treated with topical steroids. This study, funded by the manufacturer of tralokinumab, reported that the two drugs have similar efficacy. How much of the efficacy was due to the topical steroid use is not clear to me. I'd still love to see a head-to-head trial of tralokinumab vs dupilumab to have a better, more confident sense of their relative efficacy.

Is AD associated with brain cancer, as reported by Xin and colleagues? I'm not an expert in their methodology, but they did find a statistically significant increased risk, with an odds ratio of 1.0005. I understand the odds ratio for smoking and lung cancer to be about 80. Even if the increased odds of 1.005 — no, wait, that's 1.0005 — is truly due to AD, this tiny difference doesn't seem meaningful in any way.

Traidl and colleagues report that obesity was linked to worse AD in German patients. The authors hit the nail on the head with their conclusions: "In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance." What might account for the small difference in disease severity? Adherence to treatment is highly variable among patients with AD. A small tendency toward worse adherence in patients with obesity could easily explain the small differences seen in disease severity.

Eichenfeld and colleagues report that topical ruxolitinib maintained good efficacy over a year in open-label use. Topical ruxolitinib is a very effective treatment for AD. If real-life AD patients on topical ruxolitinib were to lose efficacy over time, I'd consider the possibility that they've developed mutant Janus kinase (JAK) enzymes that are no longer responsive to the drug. Just kidding. I doubt that such mutations ever occur. If topical ruxolitinib in AD patients were to lose efficacy over time, I'd strongly consider the possibility that patients' adherence to the treatment is no longer as good as it was before. Long-term adherence to topical treatment can be abysmal. Adherence in clinical trials is probably a lot better than in clinical practice. When we see topical treatments that are effective in clinical trials failing in real-life patients with AD, it may be prudent to address the possibility of poor adherence.

I'd love to see a head-to-head trial of tralokinumab vs dupilumab in the treatment of moderate to severe AD. Lacking that, Torres and colleagues report an indirect comparison of the two drugs in patients also treated with topical steroids. This study, funded by the manufacturer of tralokinumab, reported that the two drugs have similar efficacy. How much of the efficacy was due to the topical steroid use is not clear to me. I'd still love to see a head-to-head trial of tralokinumab vs dupilumab to have a better, more confident sense of their relative efficacy.

Is AD associated with brain cancer, as reported by Xin and colleagues? I'm not an expert in their methodology, but they did find a statistically significant increased risk, with an odds ratio of 1.0005. I understand the odds ratio for smoking and lung cancer to be about 80. Even if the increased odds of 1.005 — no, wait, that's 1.0005 — is truly due to AD, this tiny difference doesn't seem meaningful in any way.

Key clinical point: Treatment with 15 mg or 30 mg upadacitinib demonstrated rapid and durable improvements in symptoms and quality of life in adults with moderate to severe atopic dermatitis (AD), based on a treat-to-target approach.

Major finding: Overall, >80%, >78%, and ≥87% of patients achieved the 3-month initial acceptable target, whereas ≥53%, >61%, and >73% of patients achieved the 6-month optimal target goal with 15 mg or 30 mg upadacitinib vs placebo at weeks 2, 16, and 52, respectively. The proportion of patients achieving a higher number of individual target criteria increased over time for both 3- and 6-month target goals.

Study details: This treat-to-target analysis of Measure Up 1 and Measure Up 2 phase 3 studies included 1282 adults with moderate to severe AD who were randomly assigned to receive 15 mg upadacitinib (n = 428), 30 mg upadacitinib (n = 424), or placebo (n = 430).

Disclosures: This study was funded by AbbVie. Five authors declared being employees of AbbVie or holding AbbVie stock, stock options, or patents. Several authors declared having ties with various sources, including AbbVie.

Source: Kwatra SG, de Bruin-Weller M, Silverberg JI, et al. Targeted combined endpoint improvement in patient and disease domains in atopic dermatitis: A treat-to-target analysis of adults with moderate-to-severe atopic dermatitis treated with upadacitinib. Acta Derm Venereol. 2024;104:adv18452 (May 6). doi: 10.2340/actadv.v104.18452 Source

Key clinical point: Treatment with 15 mg or 30 mg upadacitinib demonstrated rapid and durable improvements in symptoms and quality of life in adults with moderate to severe atopic dermatitis (AD), based on a treat-to-target approach.

Major finding: Overall, >80%, >78%, and ≥87% of patients achieved the 3-month initial acceptable target, whereas ≥53%, >61%, and >73% of patients achieved the 6-month optimal target goal with 15 mg or 30 mg upadacitinib vs placebo at weeks 2, 16, and 52, respectively. The proportion of patients achieving a higher number of individual target criteria increased over time for both 3- and 6-month target goals.

Study details: This treat-to-target analysis of Measure Up 1 and Measure Up 2 phase 3 studies included 1282 adults with moderate to severe AD who were randomly assigned to receive 15 mg upadacitinib (n = 428), 30 mg upadacitinib (n = 424), or placebo (n = 430).

Disclosures: This study was funded by AbbVie. Five authors declared being employees of AbbVie or holding AbbVie stock, stock options, or patents. Several authors declared having ties with various sources, including AbbVie.

Source: Kwatra SG, de Bruin-Weller M, Silverberg JI, et al. Targeted combined endpoint improvement in patient and disease domains in atopic dermatitis: A treat-to-target analysis of adults with moderate-to-severe atopic dermatitis treated with upadacitinib. Acta Derm Venereol. 2024;104:adv18452 (May 6). doi: 10.2340/actadv.v104.18452 Source

Key clinical point: Treatment with 15 mg or 30 mg upadacitinib demonstrated rapid and durable improvements in symptoms and quality of life in adults with moderate to severe atopic dermatitis (AD), based on a treat-to-target approach.

Major finding: Overall, >80%, >78%, and ≥87% of patients achieved the 3-month initial acceptable target, whereas ≥53%, >61%, and >73% of patients achieved the 6-month optimal target goal with 15 mg or 30 mg upadacitinib vs placebo at weeks 2, 16, and 52, respectively. The proportion of patients achieving a higher number of individual target criteria increased over time for both 3- and 6-month target goals.

Study details: This treat-to-target analysis of Measure Up 1 and Measure Up 2 phase 3 studies included 1282 adults with moderate to severe AD who were randomly assigned to receive 15 mg upadacitinib (n = 428), 30 mg upadacitinib (n = 424), or placebo (n = 430).

Disclosures: This study was funded by AbbVie. Five authors declared being employees of AbbVie or holding AbbVie stock, stock options, or patents. Several authors declared having ties with various sources, including AbbVie.

Source: Kwatra SG, de Bruin-Weller M, Silverberg JI, et al. Targeted combined endpoint improvement in patient and disease domains in atopic dermatitis: A treat-to-target analysis of adults with moderate-to-severe atopic dermatitis treated with upadacitinib. Acta Derm Venereol. 2024;104:adv18452 (May 6). doi: 10.2340/actadv.v104.18452 Source

Key clinical point: Dupilumab treatment was well-tolerated and demonstrated improved clinical and molecular responses in pediatric patients with moderate to severe atopic dermatitis (AD).

Major finding: Dupilumab significantly reduced Eczema Area and Severity Index, SCORing Atopic Dermatitis index, and Investigator’s Global Assessment scores at 3 and 6 months (all P < .05), along with significant reduction in AD-associated stratum corneum biomarker levels at 3 months (P < .01). Dupilumab showed good tolerability, with adverse events reported in only four patients.

Study details: This study included 314 pediatric patients with moderate to severe AD from the German TREATkids registry, of whom 87 received dupilumab.

Disclosures: TREATkids is the child and adolescent section of the TREATgermany registry, which is supported by AbbVie Deutschland GmbH & Co. KG, Almirall Hermal GmbH, Galderma S.A., LEO Pharma GmbH, Lilly Deutschland GmbH, Pfizer Inc., and Sanofi. Several authors declared receiving research grants, lecture, or consultancy fees from or having other ties with various sources, including the supporters of TREATgermany.

Source: Stölzl D, Sander N, Siegels D, et al, and the TREATgermany study group. Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry. Allergy. 2024 (May 7). doi: 0.1111/all.16147 Source

Key clinical point: Dupilumab treatment was well-tolerated and demonstrated improved clinical and molecular responses in pediatric patients with moderate to severe atopic dermatitis (AD).

Major finding: Dupilumab significantly reduced Eczema Area and Severity Index, SCORing Atopic Dermatitis index, and Investigator’s Global Assessment scores at 3 and 6 months (all P < .05), along with significant reduction in AD-associated stratum corneum biomarker levels at 3 months (P < .01). Dupilumab showed good tolerability, with adverse events reported in only four patients.

Study details: This study included 314 pediatric patients with moderate to severe AD from the German TREATkids registry, of whom 87 received dupilumab.

Disclosures: TREATkids is the child and adolescent section of the TREATgermany registry, which is supported by AbbVie Deutschland GmbH & Co. KG, Almirall Hermal GmbH, Galderma S.A., LEO Pharma GmbH, Lilly Deutschland GmbH, Pfizer Inc., and Sanofi. Several authors declared receiving research grants, lecture, or consultancy fees from or having other ties with various sources, including the supporters of TREATgermany.

Source: Stölzl D, Sander N, Siegels D, et al, and the TREATgermany study group. Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry. Allergy. 2024 (May 7). doi: 0.1111/all.16147 Source

Key clinical point: Dupilumab treatment was well-tolerated and demonstrated improved clinical and molecular responses in pediatric patients with moderate to severe atopic dermatitis (AD).

Major finding: Dupilumab significantly reduced Eczema Area and Severity Index, SCORing Atopic Dermatitis index, and Investigator’s Global Assessment scores at 3 and 6 months (all P < .05), along with significant reduction in AD-associated stratum corneum biomarker levels at 3 months (P < .01). Dupilumab showed good tolerability, with adverse events reported in only four patients.

Study details: This study included 314 pediatric patients with moderate to severe AD from the German TREATkids registry, of whom 87 received dupilumab.

Disclosures: TREATkids is the child and adolescent section of the TREATgermany registry, which is supported by AbbVie Deutschland GmbH & Co. KG, Almirall Hermal GmbH, Galderma S.A., LEO Pharma GmbH, Lilly Deutschland GmbH, Pfizer Inc., and Sanofi. Several authors declared receiving research grants, lecture, or consultancy fees from or having other ties with various sources, including the supporters of TREATgermany.

Source: Stölzl D, Sander N, Siegels D, et al, and the TREATgermany study group. Clinical and molecular response to dupilumab treatment in pediatric atopic dermatitis: Results of the German TREATkids registry. Allergy. 2024 (May 7). doi: 0.1111/all.16147 Source

Key clinical point: Lebrikizumab monotherapy rapidly and consistently reduced atopic dermatitis (AD) extent and severity in patients with moderate to severe AD across all Eczema Area and Severity Index (EASI) clinical signs and body regions.

Major finding: At week 16, lebrikizumab vs placebo led to greater improvements in EASI scores and clinical signs (both P < .001) across all body regions in ADvocate1 and ADvocate2, with improvements observed as early as week 2 for all signs except erythema on head/neck (P < .05) and lower extremity erythema, edema/papulation, and lichenification (all P < .001), which improved significantly only by week 4 in ADvocate2.

Study details: This post hoc analysis of ADvocate1 (n = 424) and ADvocate2 (n = 427) included adolescent and adult patients with moderate to severe AD who were randomly assigned to receive 250 mg lebrikizumab biweekly or placebo.

Disclosures: This study was funded by Dermira, Inc., a wholly owned subsidiary of Eli Lilly and Company. Several authors declared having various ties with Dermira, Eli Lilly, and others. Five authors declared being employees or stockholders of Eli Lilly.

Source: Simpson EL, de Bruin-Weller M, Hong HC, et al. Lebrikizumab provides rapid clinical responses across all Eczema Area and Severity Index body regions and clinical signs in adolescents and adults with moderate-to-severe atopic dermatitis. Dermatol Ther (Heidelb). 2024 (May 3). doi: 10.1007/s13555-024-01158-4 Source

Key clinical point: Lebrikizumab monotherapy rapidly and consistently reduced atopic dermatitis (AD) extent and severity in patients with moderate to severe AD across all Eczema Area and Severity Index (EASI) clinical signs and body regions.

Major finding: At week 16, lebrikizumab vs placebo led to greater improvements in EASI scores and clinical signs (both P < .001) across all body regions in ADvocate1 and ADvocate2, with improvements observed as early as week 2 for all signs except erythema on head/neck (P < .05) and lower extremity erythema, edema/papulation, and lichenification (all P < .001), which improved significantly only by week 4 in ADvocate2.

Study details: This post hoc analysis of ADvocate1 (n = 424) and ADvocate2 (n = 427) included adolescent and adult patients with moderate to severe AD who were randomly assigned to receive 250 mg lebrikizumab biweekly or placebo.

Disclosures: This study was funded by Dermira, Inc., a wholly owned subsidiary of Eli Lilly and Company. Several authors declared having various ties with Dermira, Eli Lilly, and others. Five authors declared being employees or stockholders of Eli Lilly.

Source: Simpson EL, de Bruin-Weller M, Hong HC, et al. Lebrikizumab provides rapid clinical responses across all Eczema Area and Severity Index body regions and clinical signs in adolescents and adults with moderate-to-severe atopic dermatitis. Dermatol Ther (Heidelb). 2024 (May 3). doi: 10.1007/s13555-024-01158-4 Source

Key clinical point: Lebrikizumab monotherapy rapidly and consistently reduced atopic dermatitis (AD) extent and severity in patients with moderate to severe AD across all Eczema Area and Severity Index (EASI) clinical signs and body regions.

Major finding: At week 16, lebrikizumab vs placebo led to greater improvements in EASI scores and clinical signs (both P < .001) across all body regions in ADvocate1 and ADvocate2, with improvements observed as early as week 2 for all signs except erythema on head/neck (P < .05) and lower extremity erythema, edema/papulation, and lichenification (all P < .001), which improved significantly only by week 4 in ADvocate2.

Study details: This post hoc analysis of ADvocate1 (n = 424) and ADvocate2 (n = 427) included adolescent and adult patients with moderate to severe AD who were randomly assigned to receive 250 mg lebrikizumab biweekly or placebo.

Disclosures: This study was funded by Dermira, Inc., a wholly owned subsidiary of Eli Lilly and Company. Several authors declared having various ties with Dermira, Eli Lilly, and others. Five authors declared being employees or stockholders of Eli Lilly.

Source: Simpson EL, de Bruin-Weller M, Hong HC, et al. Lebrikizumab provides rapid clinical responses across all Eczema Area and Severity Index body regions and clinical signs in adolescents and adults with moderate-to-severe atopic dermatitis. Dermatol Ther (Heidelb). 2024 (May 3). doi: 10.1007/s13555-024-01158-4 Source

Key clinical point: A causal relationship was observed between genetically related atopic dermatitis (AD) and brain cancer, delineating AD as a potential risk factor for brain cancer.

Major finding: The presence of AD led to an increased risk for brain cancer (odds ratio 1.0005; P = .0096); however, no significant causal association was observed on conducting reverse Mendelian randomization analysis.

Study details: This cohort study analyzed the data on AD-associated single nucleotide polymorphisms of patients with AD (n = 15,208) and control individuals without AD (n = 367,046) from the FinnGen database (10^th release) and the summary data of patients with brain cancer (n = 606) and control individuals without cancer (n = 372,016) from the IEU Open GWAS database.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Xin Y, Yuan T, Wang J. The causal relationship between atopic dermatitis and brain cancer: A bidirectional Mendelian randomization study. Skin Res Technol. 2024;30(4):e13715. doi: 10.1111/srt.13715 Source

Key clinical point: A causal relationship was observed between genetically related atopic dermatitis (AD) and brain cancer, delineating AD as a potential risk factor for brain cancer.

Major finding: The presence of AD led to an increased risk for brain cancer (odds ratio 1.0005; P = .0096); however, no significant causal association was observed on conducting reverse Mendelian randomization analysis.

Study details: This cohort study analyzed the data on AD-associated single nucleotide polymorphisms of patients with AD (n = 15,208) and control individuals without AD (n = 367,046) from the FinnGen database (10^th release) and the summary data of patients with brain cancer (n = 606) and control individuals without cancer (n = 372,016) from the IEU Open GWAS database.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Xin Y, Yuan T, Wang J. The causal relationship between atopic dermatitis and brain cancer: A bidirectional Mendelian randomization study. Skin Res Technol. 2024;30(4):e13715. doi: 10.1111/srt.13715 Source

Key clinical point: A causal relationship was observed between genetically related atopic dermatitis (AD) and brain cancer, delineating AD as a potential risk factor for brain cancer.

Major finding: The presence of AD led to an increased risk for brain cancer (odds ratio 1.0005; P = .0096); however, no significant causal association was observed on conducting reverse Mendelian randomization analysis.

Study details: This cohort study analyzed the data on AD-associated single nucleotide polymorphisms of patients with AD (n = 15,208) and control individuals without AD (n = 367,046) from the FinnGen database (10^th release) and the summary data of patients with brain cancer (n = 606) and control individuals without cancer (n = 372,016) from the IEU Open GWAS database.

Disclosures: This study did not disclose any funding source. The authors declared no conflicts of interest.

Source: Xin Y, Yuan T, Wang J. The causal relationship between atopic dermatitis and brain cancer: A bidirectional Mendelian randomization study. Skin Res Technol. 2024;30(4):e13715. doi: 10.1111/srt.13715 Source

Key clinical point: Maternal probiotic supplementation was effective in preventing atopic dermatitis (AD) in children regardless of their filaggrin (FLG) gene mutation status.

Major finding: Heterozygous FLG mutations were observed in 7% of children. The risk for AD after maternal probiotic supplementation was similar between children who expressed a FLG mutation (risk ratio [RR] 0.6; 95% CI 0.1-4.1) and those having a wild-type FLG (RR 0.6; 95% CI 0.4-0.9).

Study details: This exploratory study included the data of 228 children from the Probiotic in the Prevention of Allergy among Children in Trondheim (ProPACT) study who did or did not have FLG mutations and whose mothers received probiotic or placebo milk from 36 weeks of gestation until 3 months post delivery while breastfeeding.

Disclosures: This study was funded by the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Zakiudin DP, Thyssen JP, Zachariae C, Videm V, Øien T, Simpson MR. Filaggrin mutation status and prevention of atopic dermatitis with maternal probiotic supplementation. Acta Derm Venereol. 2024;104:adv24360 (Apr 24). doi: 10.2340/actadv.v104.24360  Source

Key clinical point: Maternal probiotic supplementation was effective in preventing atopic dermatitis (AD) in children regardless of their filaggrin (FLG) gene mutation status.

Major finding: Heterozygous FLG mutations were observed in 7% of children. The risk for AD after maternal probiotic supplementation was similar between children who expressed a FLG mutation (risk ratio [RR] 0.6; 95% CI 0.1-4.1) and those having a wild-type FLG (RR 0.6; 95% CI 0.4-0.9).

Study details: This exploratory study included the data of 228 children from the Probiotic in the Prevention of Allergy among Children in Trondheim (ProPACT) study who did or did not have FLG mutations and whose mothers received probiotic or placebo milk from 36 weeks of gestation until 3 months post delivery while breastfeeding.

Disclosures: This study was funded by the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Zakiudin DP, Thyssen JP, Zachariae C, Videm V, Øien T, Simpson MR. Filaggrin mutation status and prevention of atopic dermatitis with maternal probiotic supplementation. Acta Derm Venereol. 2024;104:adv24360 (Apr 24). doi: 10.2340/actadv.v104.24360  Source

Key clinical point: Maternal probiotic supplementation was effective in preventing atopic dermatitis (AD) in children regardless of their filaggrin (FLG) gene mutation status.

Major finding: Heterozygous FLG mutations were observed in 7% of children. The risk for AD after maternal probiotic supplementation was similar between children who expressed a FLG mutation (risk ratio [RR] 0.6; 95% CI 0.1-4.1) and those having a wild-type FLG (RR 0.6; 95% CI 0.4-0.9).

Study details: This exploratory study included the data of 228 children from the Probiotic in the Prevention of Allergy among Children in Trondheim (ProPACT) study who did or did not have FLG mutations and whose mothers received probiotic or placebo milk from 36 weeks of gestation until 3 months post delivery while breastfeeding.

Disclosures: This study was funded by the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology, and the Norwegian Research Council. The authors declared no conflicts of interest.

Source: Zakiudin DP, Thyssen JP, Zachariae C, Videm V, Øien T, Simpson MR. Filaggrin mutation status and prevention of atopic dermatitis with maternal probiotic supplementation. Acta Derm Venereol. 2024;104:adv24360 (Apr 24). doi: 10.2340/actadv.v104.24360  Source