Collaborative Consult: Cases, Patient Reflection, and Discussions – What’s New in Pediatric Atopic Dermatitis – Tweetorial Activity

Please review the content below, and then proceed to complete the posttest. 

 The PEDISTAD trial found that children <12 years of age had significant disease burden from their atopic dermatitis (AD), reflecting major unmet needs. Listed below are the symptoms of moderate-to-severe AD:

Meet Camden, who has had AD his whole life, and his mom, Jill. Watch below to see the effect AD has had on their lives.

There are plenty of hurdles and roadblocks in the management of AD in children, including the list below (not exhaustive):

Patients who have AD also experience challenges in care. Watch below as Jill talks about some of the barriers and challenges encountered with Camden’s care.

AD is primarily driven by the Th2 pathway, but with contributions from the Th22 pathway, the Th1 and Th17 axes, epidermal barrier dysfunction, pruritus, and JAK/STAT signaling. Increased understanding has led to identification of specific treatment targets, including IL-4 and IL-13, and small molecules.

The following targeted drugs have recently been approved for children with moderate-to-severe AD:

Dupilumab inhibits both IL-4 and IL-13 and is approved for moderate-to-severe AD in patients ≥6 months of age. The LIBERTY AD trial program evaluated efficacy in patients 12-17 years of age, 6-12 years of age, and 6 months to 6 years of age. The most recent data for patients 6 months to 6 years of age is presented below.

Ruxolitinib is a topical cream that inhibits JAK 1/JAK2 and was approved in September 2021 for noncontinuous treatment of mild-to-moderate AD in patients ≥12 years of age. See the chart below for the TRuE-AD trial program data.

Upadacitinib is an oral JAK1 inhibitor that was approved in January 2022 for moderate-to-severe AD in patients ≥12 years of age. Upadacitinib + topical corticosteroids (TCS) improved skin and itch symptoms in adults and adolescents 12-17 years of age.

Assessing AD severity is an important step in deciding to prescribe a targeted therapy. There are a number of clinical tools available for severity assessment, detailed in the chart below. You can also click here for more information on clinical assessment tools.

Here are some effective care strategy acronyms to remember in the treatment of AD:

These strategies provide optimal management of AD, improve response to therapies, and overcome adherence barriers.

Collaboration of care is key!

As our patient advocate Jill says, “It takes a village.” Watch below to hear about the village that covers Camden’s care and the value of shared decision-making.

Here are important key points to keep in mind when treating patients with AD:

 

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