Facing Eczema at Four Months Old
Jaylin Anderson, from Mason City, Iowa, shares her experience of trying to get her daughter’s eczema diagnosed and treated when she was an infant.
Published On: Nov 30, 2022
Last Updated On: Dec 6, 2022
It’s time for our annual treatment roundup, and 2022 proved to be a landmark year for the eczema treatment landscape. The FDA approved two new oral JAK inhibitors, expanding the newest therapeutic category for people with moderate-to-severe atopic dermatitis (AD). Since our last roundup, the FDA also approved one new biologic treatment, as well as a new indication for an existing biologic. We’re here to unpack each of these exciting updates:
This year, two first-in-class oral JAK inhibitors for AD were approved:
In AD, inflammation is caused in part by an increase in immune system messagers, or cytokines, in the blood and skin. Janus Associated Kinases (JAKs) are a family of proteins with four members: JAK1, JAK2, JAK3 and JAK4. By targeting one or more of these members, JAK inhibitors work to block certain immune signals and inhibit the inflammatory effects of key cytokines involved in AD. Similar to biologics, JAK inhibitors can help combat AD symptoms at the immune system level. A biologic has a specific target in the immune system on the outside of cells, whereas a JAK inhibitor can inhibit an immune system target inside of cells.
Both treatments were approved with a boxed warning, or ‘black box’ warning issued by the FDA. All medications come with the risk of potential side effects that can range from mild to moderate or severe, so it’s important to talk with a healthcare provider when it comes to weighing potential risks and benefits.
Learn more about how JAK inhibitors work here.
Approved in January 2022, Rinvoq (upadacitinib) is an oral JAK1 inhibitor approved by the FDA for adults and adolescents aged 12+ years with moderate-to-severe AD whose disease is not adequately controlled with other systemic drug products, including biologics or when use of those therapies is inadvisable. Rinvoq works by selectively blocking JAK1, which is associated with several cytokines and other pathways that drive inflammation and itch in AD. Rinvoq is a pill taken by mouth once daily.
For more information on Rinvoq, see frequently asked questions here.
Also approved in January 2022, Cibinqo (abrocitinib) is an oral JAK1 inhibitor approved by the FDA for adults with refractory moderate-to-severe AD whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies is inadvisable. Cibinqo works by selectively blocking JAK1, which is a JAK family member associated with several cytokines and other pathways that drive inflammation and itch in AD. Cibinqo is a pill taken by mouth once daily.
For more information on Cibinqo, see frequently asked questions here.
At the close of last year, the FDA approved Adbry™ (tralokinumab-ldrm) for the treatment of moderate-to-severe AD in adults whose AD is not adequately controlled with topical prescription therapies used on the skin (topical therapies) or when those therapies are not advisable.
As a biologic, Adbry works by blocking a type of protein called interleukins (IL), specifically IL-13, from binding to its cell surface receptors (IL-13R alpha 1 and IL-13R alpha 2). IL-13 can be produced by many cells of the immune system and has been found to contribute to the inflammatory processes and decreased barrier functions in AD. Adbry is taken as an injection under the skin and is not available as a pill or a cream.
For more information on Adbry, see frequently asked questions here.
While Dupixient has been approved for adults with AD since 2017, this year, Dupixient received FDA approval for children aged 6 months to 5 years with moderate-to-severe AD. Dupixent is the first and only biologic medicine approved to treat moderate-to-severe AD from infancy through adulthood.
Dupixent works by blocking IL-4 and IL-13 from binding to their cell surface receptors. IL-4 and IL-13 can be produced by many cells of the immune system and have been found to contribute to the inflammatory processes and decreased barrier functions in AD. Dupixent is taken as an injection under the skin and is not available as a pill or cream.
For more information on Dupixient, see frequently asked questions here.
Among current eczema therapies in development, Arcutis Biotherapeutics recently announced positive topline results from their Phase 3 clinical trial for roflumilast foam 0.3% for seborrheic dermatitis.
Roflumilast foam is a once-daily topical foam formulation of roflumilast, a highly potent and selective PDE4 inhibitor, which is in development for both seborrheic dermatitis and scalp and body psoriasis.1 In clinical trials, once-daily roflumilast foam has demonstrated robust efficacy coupled with favorable safety and tolerability that, if approved, could enable chronic use anywhere on the body.1 Based on positive data from STRATUM (STudy of Roflumilast foam Applied Topically for the redUction of seborrheic derMatitis), Arcutis plans to submit a New Drug Application (NDA) to the FDA in the first quarter of 2023.1
Lebrikizumab is an injectable biologic designed to inhibit the biological effects of IL-13 in a targeted and efficient fashion.2 This past September, detailed results from Eli Lilly and Company’s phase 3 monotherapy studies in AD showed investigational lebrikizumab provided robust and durable improvements in skin clearance and itch for patients who achieved a clinical response at week 16 through one year of treatment.2 Responders were defined as those achieving a 75% reduction in the Eczema Area and Severity Index from baseline (EASI-75) or an IGA 0 or 1 (“clear” or “almost clear”) with a 2-point improvement and without rescue medication use at Week 16.2
To learn more about all eczema treatments currently in development, including injectable, oral and topical treatments, see here.
For a complete list of all currently available eczema treatments, read more here.
References:
Jaylin Anderson, from Mason City, Iowa, shares her experience of trying to get her daughter’s eczema diagnosed and treated when she was an infant.
Colloidal oatmeal baths can be a good natural remedy for reducing itch caused by eczema. Learn about how to make colloidal oatmeal at home and the science about how it reduces itch.
Researchers at the National Eczema Association publish a new letter Journal of Investigative Dermatology evaluating the prevalence of different forms of eczema.
Dulce Marilyn Morán shares how she overcame fear of judgment over her skin and built a greater sense of self-confidence.
Evidence-based articles, expert-sourced lifestyle tips and stories from your community.