During their session, “The Newest in Dermatology: Acne, Atopic Dermatitis, Actinic Keratoses, Psoriasis, Skin Cancer, and More,” presented at the 2022 Fall Clinical Dermatology Conference, James Q. Del Rosso, DO; Mark Lebwohl, MD; and Joshua Zeichner, MD, hosted a panel discussion regarding the latest updates in treatment presented in recent posters.

They started with the efficacy and safety of lebrikizumab, which is an anti-IL-13 antibody studied over 52 weeks for atopic dermatitis where results showed a high level of efficacy. Its durability not only helped achieve clear or almost clear results but there was significant improvement in itch as well. In terms of adverse events, conjunctivitis was seen in around 13% of the population.

However, regarding this adverse event, Dr Del Rosso stated, “I think it's important for everybody to understand what this conjunctivitis cluster is. Because if you look at the subscript, it says, ‘bacterial conjunctivitis, viral conjunctivitis, or just conjunctivitis.’ They didn't prove those specific diagnoses. Those were pure clinical diagnoses. So, somebody looked at it and said, ‘viral conjunctivitis,’ but that wasn't confirmed. Those are just general terms that are used, and it could be very misleading.”

Next, they looked at a new investigational drug that will be coming to the market for acne. A combination of adapalene, benzoyl peroxide, and clindamycin, this treatment uses a special polymeric emulsion to allow the ingredients to come together. Once it becomes an aqueous gel, the clindamycin is suspended in the background. Also, there is a “honeycomb mesh” in which the adapting benzoyl peroxide scatters throughout the holes of the mesh. This triple combination showed statistically superior improvements compared with its constituents or combination of constituents. They added that this could hopefully be seen within the year.

Continuing onto psoriasis, they first looked at the fixed-dose combination of halobetasol propionate and tazarotene lotion. They presented a study that looked at the TNF alpha levels within treated plaques where there were improvements in the Investigator’s Global Assessment score of the plaques at baseline out to week 12. Next, they presented data on the treatment of psoriasis initially with halobetasol foam combined with calcipotriene foam. This was done as a double therapy at first but was then maintained with the calcipotriene foam in the treatment progression. Another treatment that was recently approved is deucravacitinib, which is a tyrosine kinase 2 inhibitor that showcased significant long-term safety, efficacy, and durability in plaque type psoriasis after 2 years.

Dr Lebwohl added, “It's very safe. Compared to the other JAK inhibitors that have box warnings, this treatment has none. It doesn't affect any blood parameters, making it a very safe drug.”

Then, they presented data on roflumilast cream for the face and intertriginous genital areas in patients with psoriasis. It showcased a high success rate, with equal efficacy across these different areas. Not only were patients reaching clear or almost clear compared with the overall body surface area, but there was also an improvement in itch during the course of treatment.

They concluded their psoriasis presentations with tapinarof cream 1%, dosed daily for patients with plaque psoriasis. The poster they presented looked at quality of life during phase 3 studies. Results showed a significant improvement by week 4 that was maintained up to week 12. Looking at the images in the studies, they added that, although the US Food and Drug Administration’s primary end points are clear or almost clear skin with a 2-grade improvement, this does not consider real-world effectiveness. In the real world, the medication may not be used as a monotherapy and could be used for longer than the end point of the study.

Dr Zeichner concluded, “Just take primary end points with a grain of salt and realize that it's not really the absolute number that matters.”

Reference
Del Rosso J, Lebwohl M, Zeichner J. The newest in dermatology: acne, atopic dermatitis, actinic keratoses, psoriasis, skin cancer, and more. Presented at: Fall Clinical Dermatology Conference 2022; October 20–23, 2022; Las Vegas, NV.