PHILADELPHIA – An international group of researchers has proposed the first classification criteria for chronic nonbacterial osteomyelitis (CNO) and a severe form of it, chronic recurrent multifocal osteomyelitis (CRMO).

CNO/CRMO most frequently affect children and adolescents and can significantly affect quality of life.

Yongdong (Dan) Zhao, MD, PhD, a pediatric rheumatologist at Seattle Children’s Hospital, Seattle, Washington, and Seza Ozen, MD, MSc, medical faculty head at Hacettepe University in Ankara, Turkey – members of the expert panel for criteria development – explained the proposed criteria, developed over 6 years, at the American College of Rheumatology 2022 Annual Meeting.

They gave examples of the point system that will help researchers correctly classify CNO/CRMO if the criteria are approved by ACR and the European Alliance of Associations for Rheumatology (EULAR).

Melissa S. Oliver, MD, a pediatric rheumatologist at Riley Children’s Hospital and Indiana University, Indianapolis, told this news organization: “This proposal is important because CNO/CRMO has primarily been a diagnosis of exclusion. There are no specific tests or biomarkers for this disease. It can mimic malignancy and infectious osteomyelitis in its presentation, and these must be ruled out thoroughly first.”

However, she noted, this can be challenging and can delay diagnosis and treatment.

The classification criteria are novel, she said, because an international collaborative group used a consensus process involving physicians managing CNO and patients or caregivers of children with CNO.
 

Findings for and against CNO

Dr. Ozen summarized some examples of findings for and against a CNO/CRMO classification.

Statistically significant findings in favor of CNO/CRMO, she said, include intermittent bone pain; bone pain in upper torso; swelling of upper torso; presence of symmetric lesions; and presence of adaptive immune cell and/or fibrosis in biopsy.

Conversely, findings against CNO/CRMO include fever; signs of infection by labs; signs of cancer by biopsy; specific abnormal x-ray/CT scan; specific abnormal MRI; or pain resolved with antibiotics alone.

Dr. Zhao described a point system with a threshold of 55 points for classification of CNO/CRMO.

He gave actual examples from the registry to demonstrate high and low probability of CNO/CRMO.
 

Pro-CNO example

The first was a boy, aged 7 years 10 months, who had a year and a half of pain in his back and legs, but no fever. Pain was constant, waxing and waning. He had a personal and family history of psoriasis and was tender to palpation at multiple sites. Labs were normal and bone biopsy and vitamin C tests were not done; imaging findings showed multiple bones were affected. There was no antibiotic treatment.

That patient was scored 81, much higher than the threshold of 55, and would be classified as having CNO.
 

Non-CNO example

Conversely, the following example of a patient would score 47 – under the threshold – and would not be classified as having CNO.

That patient was an 11-year-old boy who had 2 months of pain in his right thigh with no fever. The pain was constantly waxing and waning. He was tender to palpation at only his right thigh without swelling. Labs were normal. He had no coexisting conditions. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were not measured, and no vitamin C test was performed. Imaging showed one right femur lesion on a PET-CT scan. There was no antibiotic treatment, and a bone biopsy culture showed malignancy but no inflammation or fibrosis.

Dr. Zhao said the mimickers most likely to be misclassified are vitamin C deficiency; hypophosphatasia; benign bone tumor, such as osteogenic osteoma; and a malignancy with normal labs and multifocal pattern of bone lesions.

The classification criteria will be “extremely helpful to diagnose patients with CNO/CRMO earlier,” said Dr. Oliver, who helped develop the criteria.

“The goal is that the proposed classification criteria will be used by all physicians to diagnose suspected CNO patients earlier and refer to a rheumatologist earlier so that appropriate therapies will not be delayed.”

The group will seek ACR and EULAR endorsement, and if granted, work toward widespread implementation. The criteria will allow researchers to have a more homogeneous study population for future clinical trials, Dr. Zhao said.

Dr. Zhao, Dr. Ozen, and Dr. Oliver declared no relevant financial relationships. Dr. Oliver helped develop the proposed guidelines.

A version of this article first appeared on Medscape.com.

PHILADELPHIA – An international group of researchers has proposed the first classification criteria for chronic nonbacterial osteomyelitis (CNO) and a severe form of it, chronic recurrent multifocal osteomyelitis (CRMO).

CNO/CRMO most frequently affect children and adolescents and can significantly affect quality of life.

Yongdong (Dan) Zhao, MD, PhD, a pediatric rheumatologist at Seattle Children’s Hospital, Seattle, Washington, and Seza Ozen, MD, MSc, medical faculty head at Hacettepe University in Ankara, Turkey – members of the expert panel for criteria development – explained the proposed criteria, developed over 6 years, at the American College of Rheumatology 2022 Annual Meeting.

They gave examples of the point system that will help researchers correctly classify CNO/CRMO if the criteria are approved by ACR and the European Alliance of Associations for Rheumatology (EULAR).

Melissa S. Oliver, MD, a pediatric rheumatologist at Riley Children’s Hospital and Indiana University, Indianapolis, told this news organization: “This proposal is important because CNO/CRMO has primarily been a diagnosis of exclusion. There are no specific tests or biomarkers for this disease. It can mimic malignancy and infectious osteomyelitis in its presentation, and these must be ruled out thoroughly first.”

However, she noted, this can be challenging and can delay diagnosis and treatment.

The classification criteria are novel, she said, because an international collaborative group used a consensus process involving physicians managing CNO and patients or caregivers of children with CNO.
 

Findings for and against CNO

Dr. Ozen summarized some examples of findings for and against a CNO/CRMO classification.

Statistically significant findings in favor of CNO/CRMO, she said, include intermittent bone pain; bone pain in upper torso; swelling of upper torso; presence of symmetric lesions; and presence of adaptive immune cell and/or fibrosis in biopsy.

Conversely, findings against CNO/CRMO include fever; signs of infection by labs; signs of cancer by biopsy; specific abnormal x-ray/CT scan; specific abnormal MRI; or pain resolved with antibiotics alone.

Dr. Zhao described a point system with a threshold of 55 points for classification of CNO/CRMO.

He gave actual examples from the registry to demonstrate high and low probability of CNO/CRMO.
 

Pro-CNO example

The first was a boy, aged 7 years 10 months, who had a year and a half of pain in his back and legs, but no fever. Pain was constant, waxing and waning. He had a personal and family history of psoriasis and was tender to palpation at multiple sites. Labs were normal and bone biopsy and vitamin C tests were not done; imaging findings showed multiple bones were affected. There was no antibiotic treatment.

That patient was scored 81, much higher than the threshold of 55, and would be classified as having CNO.
 

Non-CNO example

Conversely, the following example of a patient would score 47 – under the threshold – and would not be classified as having CNO.

That patient was an 11-year-old boy who had 2 months of pain in his right thigh with no fever. The pain was constantly waxing and waning. He was tender to palpation at only his right thigh without swelling. Labs were normal. He had no coexisting conditions. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were not measured, and no vitamin C test was performed. Imaging showed one right femur lesion on a PET-CT scan. There was no antibiotic treatment, and a bone biopsy culture showed malignancy but no inflammation or fibrosis.

Dr. Zhao said the mimickers most likely to be misclassified are vitamin C deficiency; hypophosphatasia; benign bone tumor, such as osteogenic osteoma; and a malignancy with normal labs and multifocal pattern of bone lesions.

The classification criteria will be “extremely helpful to diagnose patients with CNO/CRMO earlier,” said Dr. Oliver, who helped develop the criteria.

“The goal is that the proposed classification criteria will be used by all physicians to diagnose suspected CNO patients earlier and refer to a rheumatologist earlier so that appropriate therapies will not be delayed.”

The group will seek ACR and EULAR endorsement, and if granted, work toward widespread implementation. The criteria will allow researchers to have a more homogeneous study population for future clinical trials, Dr. Zhao said.

Dr. Zhao, Dr. Ozen, and Dr. Oliver declared no relevant financial relationships. Dr. Oliver helped develop the proposed guidelines.

A version of this article first appeared on Medscape.com.

PHILADELPHIA – An international group of researchers has proposed the first classification criteria for chronic nonbacterial osteomyelitis (CNO) and a severe form of it, chronic recurrent multifocal osteomyelitis (CRMO).

CNO/CRMO most frequently affect children and adolescents and can significantly affect quality of life.

Yongdong (Dan) Zhao, MD, PhD, a pediatric rheumatologist at Seattle Children’s Hospital, Seattle, Washington, and Seza Ozen, MD, MSc, medical faculty head at Hacettepe University in Ankara, Turkey – members of the expert panel for criteria development – explained the proposed criteria, developed over 6 years, at the American College of Rheumatology 2022 Annual Meeting.

They gave examples of the point system that will help researchers correctly classify CNO/CRMO if the criteria are approved by ACR and the European Alliance of Associations for Rheumatology (EULAR).

Melissa S. Oliver, MD, a pediatric rheumatologist at Riley Children’s Hospital and Indiana University, Indianapolis, told this news organization: “This proposal is important because CNO/CRMO has primarily been a diagnosis of exclusion. There are no specific tests or biomarkers for this disease. It can mimic malignancy and infectious osteomyelitis in its presentation, and these must be ruled out thoroughly first.”

However, she noted, this can be challenging and can delay diagnosis and treatment.

The classification criteria are novel, she said, because an international collaborative group used a consensus process involving physicians managing CNO and patients or caregivers of children with CNO.
 

Findings for and against CNO

Dr. Ozen summarized some examples of findings for and against a CNO/CRMO classification.

Statistically significant findings in favor of CNO/CRMO, she said, include intermittent bone pain; bone pain in upper torso; swelling of upper torso; presence of symmetric lesions; and presence of adaptive immune cell and/or fibrosis in biopsy.

Conversely, findings against CNO/CRMO include fever; signs of infection by labs; signs of cancer by biopsy; specific abnormal x-ray/CT scan; specific abnormal MRI; or pain resolved with antibiotics alone.

Dr. Zhao described a point system with a threshold of 55 points for classification of CNO/CRMO.

He gave actual examples from the registry to demonstrate high and low probability of CNO/CRMO.
 

Pro-CNO example

The first was a boy, aged 7 years 10 months, who had a year and a half of pain in his back and legs, but no fever. Pain was constant, waxing and waning. He had a personal and family history of psoriasis and was tender to palpation at multiple sites. Labs were normal and bone biopsy and vitamin C tests were not done; imaging findings showed multiple bones were affected. There was no antibiotic treatment.

That patient was scored 81, much higher than the threshold of 55, and would be classified as having CNO.
 

Non-CNO example

Conversely, the following example of a patient would score 47 – under the threshold – and would not be classified as having CNO.

That patient was an 11-year-old boy who had 2 months of pain in his right thigh with no fever. The pain was constantly waxing and waning. He was tender to palpation at only his right thigh without swelling. Labs were normal. He had no coexisting conditions. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were not measured, and no vitamin C test was performed. Imaging showed one right femur lesion on a PET-CT scan. There was no antibiotic treatment, and a bone biopsy culture showed malignancy but no inflammation or fibrosis.

Dr. Zhao said the mimickers most likely to be misclassified are vitamin C deficiency; hypophosphatasia; benign bone tumor, such as osteogenic osteoma; and a malignancy with normal labs and multifocal pattern of bone lesions.

The classification criteria will be “extremely helpful to diagnose patients with CNO/CRMO earlier,” said Dr. Oliver, who helped develop the criteria.

“The goal is that the proposed classification criteria will be used by all physicians to diagnose suspected CNO patients earlier and refer to a rheumatologist earlier so that appropriate therapies will not be delayed.”

The group will seek ACR and EULAR endorsement, and if granted, work toward widespread implementation. The criteria will allow researchers to have a more homogeneous study population for future clinical trials, Dr. Zhao said.

Dr. Zhao, Dr. Ozen, and Dr. Oliver declared no relevant financial relationships. Dr. Oliver helped develop the proposed guidelines.

A version of this article first appeared on Medscape.com.

Key clinical point: Daily continuous use of 10% phytosteryl/octyldodecyl lauroyl glutamate (POLG) nanoemulsion improved several dry skin symptoms and itchiness in patients with atopic dermatitis (AD).

Major finding: Significant improvement was observed with POLG nanoemulsion in itchiness as early as at 3 weeks (P < .05) and dryness at 6 weeks (P < .01). By 6 weeks, scaliness and smoothness of the skin were also significantly improved (P < .01).

Study details: Findings are from a clinical study including patients with AD who received 10% POLG nanoemulsion for 6 weeks.

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

Source: Takada M et al. A nano-emulsion containing ceramide-like lipo-amino acid cholesteryl derivatives improves skin symptoms in patients with atopic dermatitis by ameliorating the water-holding function. Int J Mol Sci. 2022;23(21):13362 (Nov 1). Doi: 10.3390/ijms232113362

Key clinical point: Daily continuous use of 10% phytosteryl/octyldodecyl lauroyl glutamate (POLG) nanoemulsion improved several dry skin symptoms and itchiness in patients with atopic dermatitis (AD).

Major finding: Significant improvement was observed with POLG nanoemulsion in itchiness as early as at 3 weeks (P < .05) and dryness at 6 weeks (P < .01). By 6 weeks, scaliness and smoothness of the skin were also significantly improved (P < .01).

Study details: Findings are from a clinical study including patients with AD who received 10% POLG nanoemulsion for 6 weeks.

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

Source: Takada M et al. A nano-emulsion containing ceramide-like lipo-amino acid cholesteryl derivatives improves skin symptoms in patients with atopic dermatitis by ameliorating the water-holding function. Int J Mol Sci. 2022;23(21):13362 (Nov 1). Doi: 10.3390/ijms232113362

Key clinical point: Daily continuous use of 10% phytosteryl/octyldodecyl lauroyl glutamate (POLG) nanoemulsion improved several dry skin symptoms and itchiness in patients with atopic dermatitis (AD).

Major finding: Significant improvement was observed with POLG nanoemulsion in itchiness as early as at 3 weeks (P < .05) and dryness at 6 weeks (P < .01). By 6 weeks, scaliness and smoothness of the skin were also significantly improved (P < .01).

Study details: Findings are from a clinical study including patients with AD who received 10% POLG nanoemulsion for 6 weeks.

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

Source: Takada M et al. A nano-emulsion containing ceramide-like lipo-amino acid cholesteryl derivatives improves skin symptoms in patients with atopic dermatitis by ameliorating the water-holding function. Int J Mol Sci. 2022;23(21):13362 (Nov 1). Doi: 10.3390/ijms232113362

Key clinical point: Daily application of emollients during the first year of life did not prevent the development of atopic dermatitis (AD) in the long term.

Major finding: A similar proportion of children in the emollient and standard skincare groups were clinically diagnosed with AD between 12 and 60 months (31% and 28%, respectively; adjusted relative risk 1.10; 95% CI 0.93-1.30).

Study details: Findings are from the multicenter, parallel, Barrier Enhancement for Eczema Prevention trial including 1394 infants at high risk of developing AD who were randomly assigned to receive emollient for the first year plus standard skincare or only standard skincare.

Disclosures: This study was funded by the UK National Institute for Health and Care Research Health Technology Assessment. Some authors declared receiving personal fees, grants, or research funding from or serving as an investigator or director for several sources.

Source: Bradshaw LE et al. Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial. Allergy. 2022 (Oct 19). Doi: 10.1111/all.15555

Key clinical point: Daily application of emollients during the first year of life did not prevent the development of atopic dermatitis (AD) in the long term.

Major finding: A similar proportion of children in the emollient and standard skincare groups were clinically diagnosed with AD between 12 and 60 months (31% and 28%, respectively; adjusted relative risk 1.10; 95% CI 0.93-1.30).

Study details: Findings are from the multicenter, parallel, Barrier Enhancement for Eczema Prevention trial including 1394 infants at high risk of developing AD who were randomly assigned to receive emollient for the first year plus standard skincare or only standard skincare.

Disclosures: This study was funded by the UK National Institute for Health and Care Research Health Technology Assessment. Some authors declared receiving personal fees, grants, or research funding from or serving as an investigator or director for several sources.

Source: Bradshaw LE et al. Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial. Allergy. 2022 (Oct 19). Doi: 10.1111/all.15555

Key clinical point: Daily application of emollients during the first year of life did not prevent the development of atopic dermatitis (AD) in the long term.

Major finding: A similar proportion of children in the emollient and standard skincare groups were clinically diagnosed with AD between 12 and 60 months (31% and 28%, respectively; adjusted relative risk 1.10; 95% CI 0.93-1.30).

Study details: Findings are from the multicenter, parallel, Barrier Enhancement for Eczema Prevention trial including 1394 infants at high risk of developing AD who were randomly assigned to receive emollient for the first year plus standard skincare or only standard skincare.

Disclosures: This study was funded by the UK National Institute for Health and Care Research Health Technology Assessment. Some authors declared receiving personal fees, grants, or research funding from or serving as an investigator or director for several sources.

Source: Bradshaw LE et al. Emollients for prevention of atopic dermatitis: 5-year findings from the BEEP randomized trial. Allergy. 2022 (Oct 19). Doi: 10.1111/all.15555

Key clinical point: A topical formulation containing a mixture of prebiotics and postbiotics was effective and well tolerated in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: After 15 weeks, the SCORing AD index (−59.2%; P < .001) and the PRURISCORE (−64.1%; P < .001) reduced significantly, with 68.0% of patients reporting the tolerability of the drug as “very good” or “excellent.”

Study details: Findings are from a study including 396 patients with mild or moderate AD who received a topical formulation containing a mixture of prebiotics and postbiotics.

Disclosures: This work was supported by the Istituto Ganassini di Ricerche Biochimiche, Italy. The authors declared no conflicts of interest.

Source: Gelmetti C et al. Topical prebiotics/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients. J Dermatolog Treat. 2022 (Oct 17). Doi: 10.1080/09546634.2022.2131703

Key clinical point: A topical formulation containing a mixture of prebiotics and postbiotics was effective and well tolerated in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: After 15 weeks, the SCORing AD index (−59.2%; P < .001) and the PRURISCORE (−64.1%; P < .001) reduced significantly, with 68.0% of patients reporting the tolerability of the drug as “very good” or “excellent.”

Study details: Findings are from a study including 396 patients with mild or moderate AD who received a topical formulation containing a mixture of prebiotics and postbiotics.

Disclosures: This work was supported by the Istituto Ganassini di Ricerche Biochimiche, Italy. The authors declared no conflicts of interest.

Source: Gelmetti C et al. Topical prebiotics/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients. J Dermatolog Treat. 2022 (Oct 17). Doi: 10.1080/09546634.2022.2131703

Key clinical point: A topical formulation containing a mixture of prebiotics and postbiotics was effective and well tolerated in patients with mild-to-moderate atopic dermatitis (AD).

Major finding: After 15 weeks, the SCORing AD index (−59.2%; P < .001) and the PRURISCORE (−64.1%; P < .001) reduced significantly, with 68.0% of patients reporting the tolerability of the drug as “very good” or “excellent.”

Study details: Findings are from a study including 396 patients with mild or moderate AD who received a topical formulation containing a mixture of prebiotics and postbiotics.

Disclosures: This work was supported by the Istituto Ganassini di Ricerche Biochimiche, Italy. The authors declared no conflicts of interest.

Source: Gelmetti C et al. Topical prebiotics/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients. J Dermatolog Treat. 2022 (Oct 17). Doi: 10.1080/09546634.2022.2131703

Key clinical point: A longer dupilumab dosing interval might be a good treatment option for patients with atopic dermatitis (AD) who have achieved good clinical response (GCR) or report treatment-related conjunctivitis with a previous dupilumab treatment (600 mg followed by 300 mg every 2 weeks).

Major finding: In the GCR group, the mean Eczema Area and Severity Index (EASI) score was 28.22, which reduced significantly to 0.44 among patients receiving dupilumab once every 3 weeks (Q3W) and to 0.19 among patients receiving dupilumab once every 4 weeks (Q4W) after >60 weeks (both P < .0001). EASI improved after 18 weeks in the treatment-resistant conjunctivitis group (P < .0001).

Study details: Findings are retrospectively collected data of 59 adult patients with AD who implemented Q3W (84.75%) or Q4W (15.25%) dupilumab dosing interval due to GCR or conjunctivitis.

Disclosures: This study did not receive any funding. Some authors declared serving as speakers, investigators, consultants, or advisory board members, or receiving personal fees from several sources.

Source: Patruno C et al. Dupilumab dose spacing after initial successful treatment or adverse events in adult patients with atopic dermatitis: A retrospective analysis. Dermatol Ther. 2022 (Oct 13). Doi: 10.1111/dth.15933

Key clinical point: A longer dupilumab dosing interval might be a good treatment option for patients with atopic dermatitis (AD) who have achieved good clinical response (GCR) or report treatment-related conjunctivitis with a previous dupilumab treatment (600 mg followed by 300 mg every 2 weeks).

Major finding: In the GCR group, the mean Eczema Area and Severity Index (EASI) score was 28.22, which reduced significantly to 0.44 among patients receiving dupilumab once every 3 weeks (Q3W) and to 0.19 among patients receiving dupilumab once every 4 weeks (Q4W) after >60 weeks (both P < .0001). EASI improved after 18 weeks in the treatment-resistant conjunctivitis group (P < .0001).

Study details: Findings are retrospectively collected data of 59 adult patients with AD who implemented Q3W (84.75%) or Q4W (15.25%) dupilumab dosing interval due to GCR or conjunctivitis.

Disclosures: This study did not receive any funding. Some authors declared serving as speakers, investigators, consultants, or advisory board members, or receiving personal fees from several sources.

Source: Patruno C et al. Dupilumab dose spacing after initial successful treatment or adverse events in adult patients with atopic dermatitis: A retrospective analysis. Dermatol Ther. 2022 (Oct 13). Doi: 10.1111/dth.15933

Key clinical point: A longer dupilumab dosing interval might be a good treatment option for patients with atopic dermatitis (AD) who have achieved good clinical response (GCR) or report treatment-related conjunctivitis with a previous dupilumab treatment (600 mg followed by 300 mg every 2 weeks).

Major finding: In the GCR group, the mean Eczema Area and Severity Index (EASI) score was 28.22, which reduced significantly to 0.44 among patients receiving dupilumab once every 3 weeks (Q3W) and to 0.19 among patients receiving dupilumab once every 4 weeks (Q4W) after >60 weeks (both P < .0001). EASI improved after 18 weeks in the treatment-resistant conjunctivitis group (P < .0001).

Study details: Findings are retrospectively collected data of 59 adult patients with AD who implemented Q3W (84.75%) or Q4W (15.25%) dupilumab dosing interval due to GCR or conjunctivitis.

Disclosures: This study did not receive any funding. Some authors declared serving as speakers, investigators, consultants, or advisory board members, or receiving personal fees from several sources.

Source: Patruno C et al. Dupilumab dose spacing after initial successful treatment or adverse events in adult patients with atopic dermatitis: A retrospective analysis. Dermatol Ther. 2022 (Oct 13). Doi: 10.1111/dth.15933

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: Baricitinib demonstrated long-term (52 weeks) efficacy in reducing disease severity in patients with moderate-to-severe atopic dermatitis (AD).

Major finding: At week 52, >45% of patients achieved ≥75% improvement in the Eczema Area and Severity Index (EASI), with a mean improvement of 56.8 points in the total EASI score.

Study details: Findings are from the phase 3, BREEZE-AD5 study including 146 patients with moderate-to-severe AD who were assigned to receive 2 mg baricitinib, of which 98 patients participated in the open-label extension, BREEZE-AD6 study.

Disclosures: This study was funded by Eli Lilly and Company, under license from Incyte Corporation. Five authors declared being employees and shareholders of Eli Lilly, and the other authors reported ties with several sources, including Eli Lily.

Source: Simpson E et al. Baricitinib 2 mg for the treatment of atopic dermatitis in North America: Long-term efficacy and patient-reported outcomes. Dermatol Ther. 2022 (Oct 21). Doi: 10.1111/dth.15954

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), continuous long-term dupilumab treatment was not associated with an increased risk for overall systemic/cutaneous infections.

Major finding: At 4 years, the overall infection rate was 71.27 number of patients with ≥1 event per 100 patient-years (nP/100 PY), with most infections being mild to moderate in severity, and only a very small number of infections resulted in treatment discontinuation (0.34 nP/100 PY). The rate of total skin infections decreased from 28.10 to 11.48 nP/100 PY from week 16 to year 4.

Study details: Findings are from the analysis of the LIBERTY AD OLE study including 2677 patients with moderate-to-severe AD who received dupilumab, of which 13.1% completed treatment up to week 204.

Disclosures: This research was sponsored by Sanofi and Regeneron Pharmaceuticals, Inc. Four authors declared being employees and shareholders of Regeneron Pharmaceuticals. Three authors declared being employees or holding stock options in Sanofi. The other authors reported ties with several sources, including Regeneron and Sanofi.

Source: Blauvelt A et al. No increased risk of overall infection in adults with moderate-to-severe atopic dermatitis treated for up to 4 years with dupilumab. Adv Ther. 2022 (Nov 1). Doi: 10.1007/s12325-022-02322-y

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), continuous long-term dupilumab treatment was not associated with an increased risk for overall systemic/cutaneous infections.

Major finding: At 4 years, the overall infection rate was 71.27 number of patients with ≥1 event per 100 patient-years (nP/100 PY), with most infections being mild to moderate in severity, and only a very small number of infections resulted in treatment discontinuation (0.34 nP/100 PY). The rate of total skin infections decreased from 28.10 to 11.48 nP/100 PY from week 16 to year 4.

Study details: Findings are from the analysis of the LIBERTY AD OLE study including 2677 patients with moderate-to-severe AD who received dupilumab, of which 13.1% completed treatment up to week 204.

Disclosures: This research was sponsored by Sanofi and Regeneron Pharmaceuticals, Inc. Four authors declared being employees and shareholders of Regeneron Pharmaceuticals. Three authors declared being employees or holding stock options in Sanofi. The other authors reported ties with several sources, including Regeneron and Sanofi.

Source: Blauvelt A et al. No increased risk of overall infection in adults with moderate-to-severe atopic dermatitis treated for up to 4 years with dupilumab. Adv Ther. 2022 (Nov 1). Doi: 10.1007/s12325-022-02322-y

Key clinical point: In patients with moderate-to-severe atopic dermatitis (AD), continuous long-term dupilumab treatment was not associated with an increased risk for overall systemic/cutaneous infections.

Major finding: At 4 years, the overall infection rate was 71.27 number of patients with ≥1 event per 100 patient-years (nP/100 PY), with most infections being mild to moderate in severity, and only a very small number of infections resulted in treatment discontinuation (0.34 nP/100 PY). The rate of total skin infections decreased from 28.10 to 11.48 nP/100 PY from week 16 to year 4.

Study details: Findings are from the analysis of the LIBERTY AD OLE study including 2677 patients with moderate-to-severe AD who received dupilumab, of which 13.1% completed treatment up to week 204.

Disclosures: This research was sponsored by Sanofi and Regeneron Pharmaceuticals, Inc. Four authors declared being employees and shareholders of Regeneron Pharmaceuticals. Three authors declared being employees or holding stock options in Sanofi. The other authors reported ties with several sources, including Regeneron and Sanofi.

Source: Blauvelt A et al. No increased risk of overall infection in adults with moderate-to-severe atopic dermatitis treated for up to 4 years with dupilumab. Adv Ther. 2022 (Nov 1). Doi: 10.1007/s12325-022-02322-y

Key clinical point: Air pollution due to a wildfire increased the rate of clinic visits for atopic dermatitis (AD), especially at a 0-week lag, in adults aged ≥65 years.

Major finding: In adults aged ≥65 years, the adjusted rate of clinic visits for AD during a week with a wildfire was 1.4 (95% CI 1.1-1.9) times the rate during weeks without wildfire and every 1-unit increase in the mean weekly smoke plume density score increased the rate of clinic visits for AD by 1.3 (95% CI 1.1-1.6) times.

Study details: This study analyzed the data of outpatient dermatology visits for AD (5529 visits) and itch (1319 visits).

Disclosures: This study did not report the source of funding. Dr. Grimes declared receiving grants from the University of California, San Francisco.

Source: Fadadu RP et al. Association of exposure to wildfire air pollution with exacerbations of atopic dermatitis and itch among older adults. JAMA Netw Open. 2022;5(10):e2238594 (Oct 26). Doi: 10.1001/jamanetworkopen.2022.38594

Key clinical point: Air pollution due to a wildfire increased the rate of clinic visits for atopic dermatitis (AD), especially at a 0-week lag, in adults aged ≥65 years.

Major finding: In adults aged ≥65 years, the adjusted rate of clinic visits for AD during a week with a wildfire was 1.4 (95% CI 1.1-1.9) times the rate during weeks without wildfire and every 1-unit increase in the mean weekly smoke plume density score increased the rate of clinic visits for AD by 1.3 (95% CI 1.1-1.6) times.

Study details: This study analyzed the data of outpatient dermatology visits for AD (5529 visits) and itch (1319 visits).

Disclosures: This study did not report the source of funding. Dr. Grimes declared receiving grants from the University of California, San Francisco.

Source: Fadadu RP et al. Association of exposure to wildfire air pollution with exacerbations of atopic dermatitis and itch among older adults. JAMA Netw Open. 2022;5(10):e2238594 (Oct 26). Doi: 10.1001/jamanetworkopen.2022.38594

Key clinical point: Air pollution due to a wildfire increased the rate of clinic visits for atopic dermatitis (AD), especially at a 0-week lag, in adults aged ≥65 years.

Major finding: In adults aged ≥65 years, the adjusted rate of clinic visits for AD during a week with a wildfire was 1.4 (95% CI 1.1-1.9) times the rate during weeks without wildfire and every 1-unit increase in the mean weekly smoke plume density score increased the rate of clinic visits for AD by 1.3 (95% CI 1.1-1.6) times.

Study details: This study analyzed the data of outpatient dermatology visits for AD (5529 visits) and itch (1319 visits).

Disclosures: This study did not report the source of funding. Dr. Grimes declared receiving grants from the University of California, San Francisco.

Source: Fadadu RP et al. Association of exposure to wildfire air pollution with exacerbations of atopic dermatitis and itch among older adults. JAMA Netw Open. 2022;5(10):e2238594 (Oct 26). Doi: 10.1001/jamanetworkopen.2022.38594

Key clinical point: In patients with atopic dermatitis (AD), serum dupilumab levels at week 16 were not associated with treatment response or adverse effects due to dupilumab during the first year of treatment.

Major finding: Serum dupilumab levels at 16 weeks were not associated with the prediction of treatment response at 52 weeks (≥90% improvement in the Eczema Area and Severity Index; odds ratio [OR] 0.96; P = .34) or adverse events during the first year of treatment (OR 1.01; P = .83).

Study details: Findings are from a prospective clinical cohort study including 295 patients with AD who started dupilumab and had treatment week 16 serum samples available.

Disclosures: This study was funded by AbbVie, Eli Lilly, and other sources. The authors declared receiving consulting fees, speaking fees, investigator fees, or research funding from several sources.

Source: Spekhorst LS et al. Association of serum dupilumab levels at 16 weeks with treatment response and adverse effects in patients with atopic dermatitis: A prospective clinical cohort study from the BioDay registry. JAMA Dermatol. 2022 (Nov 2). Doi: 10.1001/jamadermatol.2022.4639

Key clinical point: In patients with atopic dermatitis (AD), serum dupilumab levels at week 16 were not associated with treatment response or adverse effects due to dupilumab during the first year of treatment.

Major finding: Serum dupilumab levels at 16 weeks were not associated with the prediction of treatment response at 52 weeks (≥90% improvement in the Eczema Area and Severity Index; odds ratio [OR] 0.96; P = .34) or adverse events during the first year of treatment (OR 1.01; P = .83).

Study details: Findings are from a prospective clinical cohort study including 295 patients with AD who started dupilumab and had treatment week 16 serum samples available.

Disclosures: This study was funded by AbbVie, Eli Lilly, and other sources. The authors declared receiving consulting fees, speaking fees, investigator fees, or research funding from several sources.

Source: Spekhorst LS et al. Association of serum dupilumab levels at 16 weeks with treatment response and adverse effects in patients with atopic dermatitis: A prospective clinical cohort study from the BioDay registry. JAMA Dermatol. 2022 (Nov 2). Doi: 10.1001/jamadermatol.2022.4639

Key clinical point: In patients with atopic dermatitis (AD), serum dupilumab levels at week 16 were not associated with treatment response or adverse effects due to dupilumab during the first year of treatment.

Major finding: Serum dupilumab levels at 16 weeks were not associated with the prediction of treatment response at 52 weeks (≥90% improvement in the Eczema Area and Severity Index; odds ratio [OR] 0.96; P = .34) or adverse events during the first year of treatment (OR 1.01; P = .83).

Study details: Findings are from a prospective clinical cohort study including 295 patients with AD who started dupilumab and had treatment week 16 serum samples available.

Disclosures: This study was funded by AbbVie, Eli Lilly, and other sources. The authors declared receiving consulting fees, speaking fees, investigator fees, or research funding from several sources.

Source: Spekhorst LS et al. Association of serum dupilumab levels at 16 weeks with treatment response and adverse effects in patients with atopic dermatitis: A prospective clinical cohort study from the BioDay registry. JAMA Dermatol. 2022 (Nov 2). Doi: 10.1001/jamadermatol.2022.4639