Systemic Treatment, Immunosuppressants, and JAK Inhibitor Session Highlights

Jonathan Silverberg, MD, PhD, MPH, a board-certified dermatologist and professor at George Washington University School of Medicine and Health Sciences, discusses highlights and key takeaways from his day 1 sessions.

Silverberg: So we covered a lot of really cool topics in some of my talks today. So we started with a really engaging and entertaining session called Battle of the Titans, and this is sort of the second time we've done this kind of session where I sparred with Andy Blauvelt out in Portland, Oregon, really trying to understand who is the right patient, and who should be considered eligible for systemic therapy? It seems like, oh, wow, isn't that obvious? And everyone always says, "Oh, I just know." But boy, it turns out, it's not that obvious, and we're not doing such a great job in clinical practice identifying these patients, and we're really missing them, and compromising long-term control for patients. So we talked about some very important considerations about how to properly identify those patients -- making sure we don't miss them. I also discussed the safety of oral immunosuppressants for atopic dermatitis, and this is something that, like it or not, I think and more often than not, we wish we didn't have to use some of those old-fashioned oral immunosuppressants in the era of modern therapies. But whether it's because of paraconstraints, or if it was for other reasons, we have to turn to them. It's really important for us to understand the safety data and and sort of think of them as the benchmark, and how do they compare to some of our newer therapies, and where the improvements are coming from safety readouts for our newer therapy. So I got to talk a little bit about the laboratory monitoring requirements, some of the challenges we face with issues around long-term control and drug persistence, and some of the challenges navigating that. And I also got to discuss, sort of on the other end of the spectrum, some of the new insights into oral JAK inhibitors -- such an important new class in dermatology, and understanding: What are the new insights into different subsets of patients that have done well with this? But also thinking about some of the future indications that are already sort of under investigation. And what is the next generation, of where we may be using our atopic dermatitis drugs, within atopic dermatitis, patient subsets, but even beyond?