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Unmet Needs in the Treatment of Atopic Dermatitis


An overview of limitations faced by payers and clinicians who play a role in the management of atopic dermatitis.

Peter A. Lio, MD: There are still a ton of unmet needs for atopic dermatitis. I think one of the biggest areas right now and a big focus is a primary prevention. We would love to figure out how to prevent this disease and right behind that is what do we do for our littlest ones?The babies, as we've talked about, we don’t have many things approved down to this range. We’re excited to see crisaborole, get down to the 3-month range, but I even have 6-week-old babies. These are really tough so we would love for some more research and insight into how we can help these babies the best with best practices. And is there a chance that we could actually prevent or alter the course and modify the disease course of this by treating it appropriately early on? Maybe there’s some work going on in that? For other patients, I think we still need a lot more in the ICH [International Conference on Harmonization] domain. We still need to understand the microbiome. We need to be able to modulate that better. I’m very bullish that fixing the microbiome may be a real pathway, like an independent, powerful pathway to help this disease. I’ve seen some experiences already where it seems the microbiome was playing a very powerful role in all of this. I’d love to see more work done on sleep. I would love to see even more advanced things on skin barrier healing because right now if you notice everything we talked about pretty much focuses on inflammation. So it’s sort of every other area I think is still underserved relatively speaking, besides the inflammation/itch part.

Bhavesh Shah, RPh, BCOP: There’s a lot of unmet need in atopic dermatitis. I think we don’t have a lot of data on the economic burden—on both patients and the healthcare system. So I think there needs to be more data, especially with new agents coming to market. I think that we definitely can provide more insight into the benefit that these agents are providing for the healthcare system and the patients. Because there’s a quality-of-life improvement that’s going to be directly tied to healthcare resource realization. These patients are not with a life-threatening disease, but there is an impact on disability claims. There’s an impact on healthcare resource realization due to symptoms and productivity loss. I think there needs to be more data that kind of provides even payers, in terms of knowledge of assurance that these agents are actually doing better than some of the previous agents that we have in the market. And then I think the other unmet need is that we need to have identification of biomarkers to really help manage the clinical management of atopic dermatitis in different stages of the disease. So I think it…really making it personalized. I think that’s another unmet need because when you have so many agents in the market, which one are you going to be using? There needs to be more of a targeted approach or more of a pathway-driven approach, in terms of indications, comorbidities, and severity. And then biomarkers would kind of incorporate it all to be this predictive model of which patients are going to do better.That would definitely change the perspective on how we manage patients with all the different stages of atopic dermatitis.

Transcript edited for clarity.

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