FDA approves first systemic treatment for alopecia areata
The FDA has approved the Janus kinase (JAK) inhibitor baricitinib (Olumiant®) for the treatment of adult patients with severe alopecia areata (AA). The drug is the first systemic treatment approved for alopecia areata. In February, the FDA granted priority review for baricitinib in adults with severe AA.
[How effective are steroid-sparing agents in treating chronic alopecia areata? Read more in DermWorld Weekly.]
The efficacy and safety of baricitinib in AA was studied in two randomized, double-blind, placebo-controlled trials with patients who had at least 50% scalp hair loss for more than six months. The primary measurement of efficacy for both trials was the proportion of patients who achieved at least 80% scalp hair coverage at week 36.
Patients in these trials received either a placebo, 2 mg of baricitinib, or 4 mg of baricitinib daily. In the first trial (BRAVE AA-1), 22% of the patients who received 2 mg of baricitinib and 35% of those who received 4 mg achieved adequate scalp hair coverage, compared to 5% of those who received a placebo. The second trial (BRAVE-AA-2) had similar results: 17%, 32%, and 3%, respectively.
What has research revealed about the pathogenesis of alopecia areata and other hair disorders as well as new potential therapeutics? Find out inDermWorld.
DermWorld Insights and Inquiries: Aluminum can cause allergic contact dermatitis — Allergen of the Year 2022
Allergen of the year is an eagerly awaited award for those of us excited by allergic contact dermatitis. It has been given each year for over 20 years to highlight allergens of new and emerging significance and sometimes to highlight allergens that are notably not significant such as thimerosal and parabens. This year the honor goes to aluminum. Aluminum is ubiquitous and we are all exposed daily; however, aluminum and aluminum salts such as aluminum sulfate, aluminum acetate, and aluminum chloride hexahydrate infrequently cause allergic contact dermatitis. One study estimates that 0.9% of adults and 5.1% of children are allergic to aluminum. Aluminum is an allergen not commonly tested in most patch test clinics and is not included in the three panels of the FDA-approved allergy patch test series.Keep reading!
DermWorld Young Physician Focus: Academy leadership programs position young physicians for success
After spending at least eight competitive years in medical school and graduate medical education, settling into post-graduate dermatology practice can feel a bit disconcerting. This feeling of uncertainty may also not occur immediately after training, but later in a dermatologist’s career — after all, a physician may find themselves at a professional crossroads at any time. Recent graduates and ‘paleoderms’ alike may be unaware that the American Academy of Dermatology has several programs aimed at providing leadership education and addressing professional ennui. Keep reading!
FDA approves dupilumab for children 6 months to 5 years of age with AD
The U.S. FDA has approved dupilumab for the treatment of children aged 6 months to 5 years with moderate-to-severe atopic dermatitis (AD) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. The approval makes dupilumab, which was granted priority review by the FDA for this indication, the first and only biologic FDA-approved medication for the treatment of moderate-to-severe AD from infancy through adulthood.
[Is there evidence to suggest a true remittive effect of JAK inhibitors for atopic dermatitis? Read more inDermWorld.]
A phase 3 randomized, double-blind, placebo-controlled trial analyzed dupilumab’s efficacy and safety when added to standard-of-care low-potency topical corticosteroids (TCS) every four weeks (200 mg or 300 mg) versus low-potency TCS monotherapy in 162 children aged 6 months to 5 years with uncontrolled moderate-to-severe AD.
[What is the path forward for treating children with severe atopic dermatitis with dupilumab? Find out inDermWorld.]
Dupilumab met the primary and all secondary endpoints of the trial. At 16 weeks, 28% of patients administered dupilumab with TCS achieved clear or almost-clear skin versus 4% with placebo. Further, 53% of patients achieved 75% or greater improvement in overall disease severity from baseline versus 11% in the control group, and 48% achieved clinically meaningful reduction in itch versus 9% in the control group.
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Risk of vitamin D deficiency in Black patients with CCCA
In a JAAD research letter, the authors performed a retrospective chart review of 54 Black patients diagnosed with CCCA at an alopecia clinic. Of the 27 patients included in the study, nearly all had vitamin D deficiency (VDD) or vitamin D insufficiency (VDI) (92.5%).
Compared with Black individuals in the general population, Black patients with CCCA had more than five times increased odds of having vitamin D deficiency or insufficiency and significantly higher prevalence of VDD and VDI (92.6% vs. 69.7%). Additionally, 89% of the patients with VDD or VDI had a CCCA severity score of 3 or higher.
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