Skin therapy letter最新文献

Biologics have emerged in recent years as relatively safe and effective options for managing plaque psoriasis, however, a subset of patients remain reluctant to initiate biologic therapy. Icotrokinra is a novel, first-in-class oral peptide that targets the interleukin-23 receptor and has demonstrated a favorable safety and efficacy profile comparable to that of injectable biologics in individuals aged 12 years and older. This review summarizes the clinical trial data regarding the safety and efficacy of icotrokinra.

Alopecia areata (AA), an autoimmune condition characterized by non-scarring hair loss, affects 2% of the United States population. AA is a CD8 T-cell driven autoimmune disease in which the cytokines interferon-gamma and interleukin-15 play a central role in disease progression. These pathways depend on Janus kinase (JAK) signaling, making JAK inhibitors an ideal therapeutic option in treating AA. Deuruxolitinib, an oral JAK inhibitor, was approved by the US Food and Drug Administration in July 2024, for the treatment of severe AA in adults. Deuruxolitinib is the third oral JAK inhibitor approved for the treatment of severe AA, the others being baricitinib and ritlecitinib. Deuruxolitinib's mechanism of action, clinical efficacy, and safety profile in the treatment of AA are reviewed.

Atopic dermatitis (AD) is a common, chronic immune-mediated inflammatory skin disease. The OX40-OX40 ligand (OX40L) pathway has emerged as a novel therapeutic target. On this basis, three phase II clinical trials have been conducted to evaluate the efficacy and safety of three different OX40-OX40L inhibitors (amlitelimab, rocatinlimab, and telazorlimab) in moderate-to-severe AD. Herein, we review the published data from these studies.

Immunotherapy has shown promise in treating locally advanced, recurrent, and metastatic cutaneous squamous cell carcinoma. More recently, studies have shown the role of immunotherapy as neoadjuvant treatment in advanced disease for which surgery may not be curative or would be expected to result in functional or cosmetic morbidity. This paper reviews data showing the safety and efficacy of cemiplimab as neoadjuvant treatment in cutaneous squamous cell carcinoma. Early findings suggest that neoadjuvant immunotherapy may help improve surgical outcomes by reducing tumor burden before resection.

Neurofibromatosis type 1 (NF1) is a genetic condition inherited in an autosomal dominant pattern, but with 50% of cases caused by de novo mutations. Neurofibromin, the gene product in NF1, regulates the RAS/MAPK pathway, and mutation can lead to cell proliferation and the development of tumours. NF1 often presents in childhood with cafe-au-lait macules, skinfold freckling, nervous system tumours, and phenotypically variable findings. Plexiform neurofibromas (PN), a type of peripheral nerve sheath tumour seen in NF1, are typically histologically benign. However, PN can cause significant physical disfigurement, pain, and decreased quality of life, and have historically been difficult to treat. Selumetinib, a MEK inhibitor inhibiting the RAS/MAPK pathway, was Health Canada approved in 2022 for the treatment of symptomatic, inoperable PN in individuals with NF1 aged 2 years and older. Phase 1 and 2 trials have demonstrated reduced tumour size, decreased disfigurement and pain, and increased quality of life.

Atopic dermatitis (AD) is a common inflammatory skin condition characterized by erythema and intense pruritus. A key pathway implicated in its pathogenesis is the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signaling pathway. Upadacitinib, a JAK inhibitor, has been approved for the treatment of moderate-to-severe AD. This review evaluates the long-term safety and efficacy of upadacitinib in AD, incorporating findings from the Measure Up 1 and Measure Up 2 phase 3 studies.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disease that impacts approximately 10-15% of the population in the United States and Canada. Lebrikizumab is a novel systemic human monoclonal immunoglobulin G4 antibody that inhibits the activity of interleukin-13. In June 2024, lebrikizumab was approved by Health Canada for the treatment of moderate-to-severe AD in adults and adolescents who are 12 years of age and older, followed by US Food and Drug Administration approval in September 2024. This review provides an overview of data from clinical trials on the efficacy and safety of lebrikizumab in adult patients.

Nanodermatology has been an emerging area of research and drug development in the last two decades. Nanodermatology lies at the intersection of nanotechnology, chemical engineering, biophysics, and pharmacology. Increasing research has yielded potential benefits of nanotechnology in the treatment of various skin conditions via enhanced transdermal drug delivery. Nanoparticles, defined as particles ranging from 1 to 1000 nanometers, have been more frequently explored for their potential role in targeted drug delivery systems. Nanocarriers, which include liposomes, ethosomes, and vesicle carriers, have been increasingly investigated to improve efficacy of various drugs via enhanced delivery to the target site. Many dermatologic conditions are preferentially treated with topical formulations to locally target the affected area and reduce systemic absorption, but these formulations are limited in their penetration. The ability of topical formulations to effectively deliver active ingredients to the target site is uncertain, therefore nanoparticles have been increasingly investigated as an approach to boost drug delivery to the deeper layers of the skin, improve absorption, and decrease adverse effects. Enhanced drug delivery utilizing nanoparticles has been successfully trialed for treatment of psoriasis, vitiligo, acne vulgaris, and atopic dermatitis in many research studies, however more investigation is needed prior to utilization in humans.

Prurigo nodularis and atopic dermatitis are chronic, inflammatory skin conditions characterized by significant pruritus that disrupts daily life. They also involve dysfunction of the T-helper 2 immune response, leading to the over secretion of interleukin-31 (IL-13) in the dermis and serum. Nemolizumab is a new IL-31 receptor antagonist that has shown high efficacy in the treatment of prurigo nodularis (PN) and atopic dermatitis (AD) in multiple phase 3 trials, with a good safety profile. A brief overview of PN and AD including highlights of the findings from three trials of nemolizumab in treating these disorders will be presented herein.

Clindamycin phosphate 1.2%/benzoyl peroxide 3.1%/adapalene 0.15% (IDP-126) is a novel fixed-dose triad gel combination approved by the US FDA October 2023 and by Health Canada August 2024 for the treatment of acne vulgaris in patients aged 12 years and older. IDP-126 was efficacious in moderate to severe acne compared to vehicle and component topical dyads in phase 2 and to vehicle in phase 3 randomized controlled studies. Efficacy outcomes were inflammatory and noninflammatory lesion counts and Evaluator's Global Severity Score. IDP-126 also had a favorable tolerability and safety profile.