MedicalResearch.com Interview with:
Emma Guttman, MD, PhD
Professor, Dermatology, Medicine and Clinical Immunology
Vice Chair of Research in the Dermatology Department
Director of the center for Excellence
Eczema in the Occupational/Contact Dermatitis clinic
Director of the Laboratory of Inflammatory Skin Diseases
Icahn School of Medicine at Mount Sinai Medical Center
MedicalResearch.com: Would you briefly explain what is meant by atopic dermatitis? How many people are affected by this disorder?
Response: Atopic dermatitis or eczema as most people know it is an itchy red scaly skin disorder characterized by a very severe itch, that disrupts daily activities, and sleep and severely impairs the quality of life of patients. In the US 30 million people are affected by it, and 1/3 of these we expect to be moderate to severe.
MedicalResearch.com: What is the background for Dupilumab therapy? How does it differ from emollients, steroids or topical immunomodulator treatments for eczema ie Protopic?
Response: The background is that we currently do not have good treatments for long term use for our moderate to severe patients. The only approved drug by the FDA for atopic dermatitis in the US is oral prednisone, that has many long term side effects and causes disease rebound upon discontinuation. Other treatments with many side effects
are broad immune suppressants–Cyclopsorin A, Mycophenolate mofetyl and phototherapy that is not feasible for most patients.
Thus there is a large unmet need for safer and better treatments for moderate to severe atopic dermatitis patients.
Dupilumab is different since it only targets one immune axis–Th2 axis, providing a safer alternative, with high efficacy, that is equal or even better than cyclosporin A, that is the current gold standard immune suppressant, and harbors many side effects including permanent effects on the kidneys after long term use. Topical treatments, while useful for mild patients, are often not adequate or sufficient to control moderate to severe patients that usually have more than 10% body surface area involved and need a systemic treatment.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Patients are well controlled clinically with the drug in the three years studied, and the safety profile is very good. A minority of patients may exhibit a conjunctivitis, allergic in nature that often goes away with appropriate treatment. We now need long term safety data abut so far it looks very good.
MedicalResearch.com: Is there anything else you would like to add?
Response: It is a very hopeful time with increased understanding of atopic dermatitis, that led to development of targeted therapeutics. Dupilumab is the first of many treatments going into atopic dermatitis now and being tested in clinical trials, with better safety and efficacy.
I have been a consultant for Reegneron/Sanofi but also for many other companies developing drugs for atopic dermatitis.
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