Dermatology Month in Review: August 2024

In August 2024, a number of major news stories and advancements were made in the field of dermatology, some of which included polling results on patient drug preferences, the US Food and Drug Administration (FDA) approval of nemolizumab, and positive findings on guselkumab.

Each of these examples of dermatology coverage represent highlights of this month’s developments. This review by the HCPLive editorial team included news identified due to its significance in the dermatology space:

FDA Approves Nemolizumab for Treatment of Prurigo Nodularis

A major story covered was the FDA approval of nemolizumab (Nemluvio) on August 13 for the treatment of adult patients with the chronic neuroimmune skin condition known as prurigo nodularis. The medication is administered subcutaneously with a pre-filled pen and had been previously granted Priority Review in February 2024.

“I’m delighted that (nemolizumab) has received US FDA approval and I’m looking forward to offering this treatment option to the prurigo nodularis patients in my practice who are in desperate need of fast relief from itch, which negatively impacts their quality of life,” Shawn Kwatra, MD, associate professor of dermatology at Johns Hopkins University School of Medicine, noted in a statement. “By inhibiting the signaling of IL-31, (nemolizumab) addresses a key driver of prurigo nodularis, safely and effectively improving itch as well as skin nodules.”

TYK2 Inhibition with Zasocitinib Results in Significant Skin Clearance for Psoriasis

One study covered in August suggested that selective tyrosine kinase 2 (TYK2) inhibition through oral zasocitinib 5 mg once-per-day leads to significant levels of skin clearance among individuals with plaque psoriasis over 12 weeks. This study was published in JAMA Dermatology and authored in part by April W. Armstrong, MD, MPH, professor and chief of dermatology at UCLA and Chair Emeritus of the Medical Board of the National Psoriasis Foundation.

Armstrong and colleagues had sought to assess patients with moderate to severe psoriasis in treated with zasocitinib, looking at the medication’s efficacy, safety, and general tolerability. The investigators also noted that the previous phase 1 findings indicated that the drug modulates psoriasis through its impact on the IL-23/Th-17 axis primarily.

Poll Suggests Patients with Psoriasis Prefer Topicals to Injectable, Oral Medications

Another story covered in August was news of a Harris Poll conducted to improve understanding of the preferences of those with psoriasis within the US patients. The survey results suggested that patients with psoriasis prefer topical therapies to injections or pills as well as that these patients are likely to be interested in using a new topical medication.

April W. Armstrong, MD, MPH, and other investigators carried out this study, noting that there are known challenges to adherence to topicals. They also highlighted a reported rate of 50% of adherence to these treatments.

“The aim of this study was to determine treatment pattern, patient preferences on medication delivery method (topical, oral, versus injectable medications), patient satisfaction, and perspectives on topical therapies,” Armstrong and colleagues wrote. “This manuscript presents results related to patient treatment preferences and treatment patterns.”

Study Identifies Unreported Adverse Drug Reaction Linked to Tildrakizumab for Psoriasis

Using the US Food and Drug Administration Adverse Event Reporting System (FAERS) repository of pharmacovigilance data, another study suggested that there is a potential signal for new adverse drug reactions (ADRs) among patients that have psoriatic disease and are treated with tildrakizumab.

This conclusion could allow for support of clinical monitoring in addition to improving prediction of disease risk. This research was led by Jinger Lin, from the department of dermatology at Fujian Medical University’s Union Hospital in Fujian, China.

“It greatly facilitates the FDA’s comprehensive assessment of drug safety after a drug is marketed,” Lin et al. wrote. “Our findings have potential to provide physicians and health policymakers with meaningful insights in monitoring (tildrakizumab)-associated ADRs, thereby fostering rational use of clinical medications.”

Study Highlights Guselkumab Effect on Psoriasis Patients with Early Skin Clearance

Another study covered in August found that disease activity among those with moderate to severe psoriasis and early complete skin clearance can be controlled using a guselkumab dosing interval extension. These were the results of the GUIDE randomized clinical trial led by Kilian Eyerich, MD, of the department of dermatology and venereology at the University of Freiburg Medical Center in Germany.

“Herein, we present primary end point data, supported by other clinical and immunologic findings, to evaluate whether de-escalation of guselkumab treatment by dosing interval extension to every 16 weeks is noninferior to dosing every 8 weeks for maintaining clinical response in SRes,” Eyerich et al. wrote.

Dupilumab Maintains Effectiveness in AD for Up to 5 Years, But 1 in 4 Still Discontinue Treatment

In another August study, investigators explored the long-term efficacy and rationale for drug discontinuation among those with atopic dermatitis who implement dupilumab. The research team looked at pooled data drawn from 14 hospitals found in the Netherlands, and they noted that about 70% of patients utilized dupilumab for up to 5 years.

They added that 2 in 3 were shown to be able to taper their dosing interval to every 3 or 4 weeks, though ineffective results or adverse events are occasionally seen and around 23.8% of patients discontinued use of this drug for these reasons most commonly.

“This study highlights the importance of multicenter registries to evaluate long-term treatment effects in large daily practice cohorts,” the investigators noted. “Future studies in patients who discontinued dupilumab due to controlled disease may contribute to the knowledge on the disease course and possible disease modification after treatment discontinuation.”