Most Exciting New Therapies in Atopic Dermatitis, with Matthew Zirwas, MD

During this interview at the Maui Derm NP+PA Fall 2024 conference in Nashville, Matthew Zirwas, MD, the director of the clinical trials and dermatitis center at Dermatologists of Greater Columbus, touched on highlights from his talk ‘Atopic Dermatitis and Itch Update 2024.’

Specifically, Zirwas highlighted what he describes as some of the most exciting therapies which have become recently available for the eczema treatment armamentarium. He highlighted the recent approval of lebrikizumab-lbkz (EBGLYSS) for adults and children 12 years of age or older with moderate-to-severe eczema that has not been adequately treated with topicals.

“The most exciting new thing in atopic dermatitis, I'd say this year, is a new drug from Lilly which just got approved last week,” Zirwas explained. “It's a drug that we've been watching for 10 years, and the generic name is lebrikizumab. The data started coming out in 2013 and it finally got its approval last week. There are a couple things that are unique and really worth knowing about this drug.”

Zirwas pointed to the drug’s blocking of interleukin (IL)-13 and lack of impact on IL-4, suggesting that it would not work for asthma or other conditions as a result.

“It sounds like that would be a thing that worked against it,” Zirwas said. “But on the other hand, because it's more targeted and only hits IL-13, some of the side effects that we see with dupilumab like red face, arthralgia, new onset psoriasis, we don’t see with it. So it has probably got a better adverse event profile.”

Zirwas later noted that nemolizumab is another option for treating atopic dermatitis, given its unique efficacy for itch.

“What's exciting about it is that it's a totally new mechanism of action for us in dermatology,” Zirwas explained. “So it's an IL-31 inhibitor. People often refer to IL-31 as the ‘itch cytokine,’ and that is not an intelligent way to think about it. In reality, IL-31 isn't just an itch cytokine. Yes, it has a unique efficacy for itch, but it also directly affects keratinocytes, fibroblasts, and immune cells, so it is also an anti-inflammatory and a pro-barrier drug.”

He added that the drug is known to provide faster relief from itch among patients compared to the results of dupilumab.

View the full interview segment above to learn more about new therapies for eczema.

The quotes contained in this summary were edited for the purposes of clarity.

Zirwas reported being a consultant and investigator for Arcutis Biotherapeutics, and has received grants from Amgen and UCB and personal fees from AbbVie, Dermavant, EPI Health, Galderma, Genentech/Novartis, Incyte, L’Oréal, Lilly, Pfizer, Regeneron, and Sanofi.

References

1. ^{Smith T. FDA Approves Lebrikizumab Treatment of Eczema Among Patients Aged 12 and Older. HCPLive. September 13, 2024. https://www.hcplive.com/view/fda-approves-lebrikizumab-treatment-eczema-among-patients-aged-12-and-older. Date accessed: September 18, 2024.}