touchMEETING HIGHLIGHTS Pathophysiological mechanisms and emerging concepts in the management of Type 2 dermatological diseases
Watch leading experts discuss the pathophysiology of AD, PN, and CSU, and the concepts of AD remission and disease modification.
Watch Michele Ramien describe the growing evidence for considering AD as a systemic disease and pathophysiological mechanisms, including Type 2 inflammation, that contribute to disease symptomsÂ
Watch Raj Chovatiya outline the multiple pathological factors, including Type 2 inflammation, neuronal dysfunction and dermal fibrosis, which contribute to the vicious itch-scratch cycle that characterizes PN
Watch Thomas Casale outline the role of mast cells in CSU, including how inflammatory mediators promote neuroimmune sensitization and Type 2 inflammation
Watch Michele Ramien highlight the concept of disease modification, including impact on the disease and associated comorbidities
Watch Eric Simpson outline current knowledge of the impact of systemic disease therapies on disease control in AD, and what this tells us about the potential for achieving disease remission
Watch Amy Paller outline the impact of systemic therapies on AD-associated comorbidities, including food allergies, asthma and allergic rhinitis
Overview & Learning Objectives
Overview
The dermatological diseases, atopic dermatitis (AD), prurigo nodularis (PN) and chronic spontaneous urticaria (CSU) are distinct but share common symptoms, such as itch and underlying disease mechanisms, including Type 2 inflammation.1–4 In AD, increased understanding of the underlying pathological mechanisms and identification of treatments to target these processes has led to the evolution of the concepts of disease modification and remission.5–8
In this touchMEETING HIGHLIGHTS, leading experts discuss the unique and shared neuroimmune mechanisms underlying disease symptoms in AD, PN, and CSU. They then go on to explore the systemic impact of AD and the emerging concepts of disease modification and remission in AD.
Learning Objectives
After watching this activity, participants should be better able to:
- Outline the evidence of the systemic burden of AD
- Explore the concept of disease modification in AD
- Review existing data on disease control with therapeutic interventions and discuss the markers that could be used to define remission in AD
- Discuss the multiple pathological factors that contribute to the itch-scratch cycle that characterize PN
- Outline the role of mast cells in CSU, including how inflammatory mediators promote neuroimmune sensitization and Type 2 inflammation
To watch all the FORUM presentations in full, please click below.
Faculty & Disclosures
Dr Michele Ramien
Alberta Children’s Hospital in Calgary, Alberta, Canada
Michele L. Ramien, MD, is a Clinician-Investigator at the Alberta Children’s Hospital in Calgary, Alberta. Her practice is focused on the clinical care of medically or dermatologically complex children, with particular emphasis on patient and family-centered care in inflammation and health outcomes in rare diseases, and pharmacotherapy. She was involved in the development of a validated Eczema Action Plan initiative to facilitate effective, coordinated care of eczema for patients, doctors and pharmacists. She has published and presented at local, national and international congresses.
Dr Michele L. Ramien discloses: Research funding from Pediatric Dermatology Research Alliance. Speaker and/or consultant for AbbVie, Leo Pharma, Novartis, Pfizer, and Sanofi.
Dr Raj Chovatiya
Northwestern University Feinberg School of Medicine, Chicago, Illinois, US
Raj Chovatiya, MD, PhD, MSCI, is Assistant Professor of Dermatology at the Northwestern University Feinberg School of Medicine in Chicago. His research focus includes the intersection of cutaneous immunology and inflammatory disease, and he has a particular interest in optimizing patient-centered care, understanding chronic disease burden especially in understudied inflammatory diseases, and improving care across diverse skin types. He has published numerous abstracts and manuscripts.
Dr Raj Chovatiya discloses: Speaker, advisory board member, and/or investigator for AbbVie, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Galderma, Genentech, GSK, Incyte, Janssen, LEO Pharma, L’Oréal, Nektar Therapeutics, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, and UCB.
Dr Thomas Casale
University of South Florida, Tampa, Florida, US
Thomas Casale, MD, is Professor of Medicine and Pediatrics, and Chief of Clinical and Translational Research at the University of South Florida Division of Allergy and Immunology in Tampa. His research interests include the determination and treatment of the pathophysiologic mechanisms involved in asthma, chronic obstructive pulmonary disease and allergic diseases, and has published over 500 scientific papers, reviews, and chapters on these topics. He is a Past President of the American Academy of Allergy Asthma and Immunology, and was Executive Vice President for 10 years.
Dr Thomas Casale discloses: Speaker, advisory board member, and/or investigator for AstraZeneca, American Lung Association, Boehringer Ingelheim, Genentech, NIH, Novartis, PCORI, Regeneron, and Sanofi.
Dr Eric Simpson
Oregon Health & Science University, Portland, Oregon, US
Eric Simpson, MD, MCR, is Professor of Dermatology Oregon Health & Science University. He is actively involved in clinical research to study new approaches to chronic skin disease treatment and prevention, and has published over 290 scientific articles in several high-impact peer-reviewed journals. He is serving as Chair of the NEA Research Advisory Committee.Â
Dr Eric Simpson discloses: Speaker, advisory board member, and/or investigator for AbbVie, Advances in Cosmetic Medical Derm Hawaii LLC, Amgen, AOBiome LLC, Arcutis Biotherapeutics, Arena Pharmaceuticals, Aslan Pharma, Boehringer Ingelheim USA, Boston Consulting Group, Bristol Myers Squibb, Castle Biosciences, Collective Acumen LLC, CorEvitas, Dermavant, Dermira, Eli Lilly, Evelo Biosciences, Evidera, Excerpta Medica, FIDE, Galderma, Gesellschaft Z, GlaxoSmithKline, Incyte, Janssen, Johnson & Johnson, Kymab, Kyowa Kirin, LEO Pharma, Medscape LLC, Merck, Maui Derm, MLG Operating, MJH Holding, National Jewish Hospital, Pfizer, Physicians World LLC, PRIme, Regeneron, Revolutionizing Atopic Dermatitis, Roivant, Sanofi Target RWE, Trevi Therapeutics, Valeant, Vindico Medical Education, WebMD outside of submitted work.
Dr Amy Paller
Northwestern University, Evanston, Illinois, US
Amy Paller, MS, MD, is the Walter J. Hamlin Professor and Chair of Dermatology, Professor of Pediatrics, and Principal Investigator of the NIH-funded Skin Biology and Diseases Resource-based Center (SBDRC) at Northwestern. She is a lead investigator on several landmark trials in pediatric skin diseases and her research focuses on cell-cell communication in inflammatory skin diseases and impaired wound healing. She is current President of the International Society for Pediatric Dermatology, is an author of more than 600 peer-reviewed publications, and has written or edited several major textbooks in dermatology.
Dr Amy Paller discloses: Research funding from AbbVie, Applied Pharma Research, Dermavant, Eli Lilly, Incyte, Janssen, Krystal, Regeneron, and UCB. Speaker, advisory board member, and/or investigator for Aegerion Pharma, AbbVie, Abeona, Azitra, BioCryst, Boehringer Ingelheim, Bristol Myers Squibb, Castel Creek, Catawba, Eli Lilly, Gilead, InMed, Janssen, Krystal, LEO Pharma, Novartis, Regeneron, Sanofi/Genzyme, Seanergy (consultant with honorarium), TWI Biotechnology, and UCB.
References
- Langan SM, et al. Atopic dermatitis. Lancet. 2020; 396(10247):345-360.
- Liao V, et al. Prurigo nodularis: new insights into pathogenesis and novel therapeutics. Br J Dermatol. 2024;190(6):798-810.Â
- Garcovich S, et al. Pruritus as a Distinctive Feature of Type 2 Inflammation. Vaccines (Basel). 2021;9(3):303.Â
- Kim B, et al. Neuroimmune interplay during type 2 inflammation: Symptoms, mechanisms, and therapeutic targets in atopic diseases. J Allergy Clin Immunol. 2024;153(4):879-893Â
- Worm M, et al. Efficacy and Safety of Multiple Dupilumab Dose Regimens After Initial Successful Treatment in Patients With Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2020;156(2):131-143Â
- Simpson EL, et al. Tralokinumab Efficacy Over 1Â Year in Adults with Moderate-to-Severe Atopic Dermatitis: Pooled Data from Two Phase III Trials. Am J Clin Dermatol. 2023;24(6):939-952Â
- Blauvelt A, et al. Efficacy and safety of lebrikizumab in moderate-to-severe atopic dermatitis: 52-week results of two randomized double-blinded placebo-controlled phase III trials. Br J Dermatol. 2023;188(6):740-748.
- Bieber T. Disease modification in inflammatory skin disorders: opportunities and challenges. Nat Rev Drug Discov. 2023;22(8):662-680.
