Letter from the Editor

Dear Reader,

AAD 2020 Virtual Meeting is a revolutionary experience. The dermatological community regrets that the AAD Meeting in Denver could not take place. Yet, it is a remarkable achievement of the AAD to provide in the first half of 2020 innovations in dermatology in this virtual environment.

In this AAD 2020 Medicom Conference Report, innovations are reported in several areas of dermatology and in several dimensions of medical progress. Important areas with revolutionary innovations are inflammatory dermatoses and oncology. Important dimensions of medical progress are: development of new pathogenesis-based treatments with an improved efficacy/safety ratio, insights from real-world evidence, personalised care, reconciling individualised clinical data, and potential biomarkers.

In psoriasis, the promise to realise clear skin has advanced further. Bimekizumab, targeting IL-17 A and F proved to realise a 90% improvement of the PASI in 85% of the patients after 16 weeks treatment. Comparative studies between biologics help us to better position these drugs in the treatment of psoriasis. Risankizumab was shown to be superior to secukinumab after 16 weeks and after 1 year. A new topical PDE4 inhibitor, roflumilast, proved to result in clear skin in a third of the patients.

Cardiovascular disease as comorbidity is being investigated in many centres. In a study on CV background in psoriasis, biologics could not be shown to be protective for cardiovascular disease. A remarkable statement by Prof. Gelfand, a leading scientist in dermato-epidemiology: “There are currently no therapies used for psoriasis that have proven to lower CV events in
RCTs.

In special psoriasis populations, therapeutic possibilities have been improved. In pregnancies, new data suggest safety of certolizumab. In patients >65 years, a post-hoc analysis of the reSURFACE 1 and 2 trials showed that tildrakizumab, a selective IL-23 inhibitor, is well tolerated in this population.

In atopic dermatitis, innovative treatments are small molecules and biologics. The JAK1 inhibitor abrocitinib proved to be effective and shows a remarkable effect  on itch. Its effect was noticed already after 2 weeks. Also, the biologic tralokinumab (anti IL-13) proved to be more effective than placebo. In children with atopic dermatitis, dupilumab proved to be effective and safe.

Both in atopic dermatitis and psoriasis, personalised care using biomarkers is the mainstay in research. Personalised medicine strives to find the best solution in the individual patient based on factors relevant to the course of the disease. To retrieve materials for measurement of RNA of multiple cytokines, a non-invasive way to collect materials was presented: tape stripping. This offers a promising approach to get a fingerprint of the complex immunity of psoriasis and atopic dermatitis in the individual patient.

Other important highlights presented and discussed in this report include:

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    • Treatment of intractable itch: intranasal kappa-opioid agonist effective for intractable pruritus
    • Cannabinoids in itch, lupus erythematosus, and dermatomyositis
    • What you need to know about systemic therapies
    • Cutaneous side effects of immune checkpoint inhibitors

The virtual AAD provided a wealth of new data. I hope you enjoy reading this report.

Best regards,

 

Prof. Peter C.M. van de Kerkhof

 

Biography:

Peter C.M. van de Kerkhof is emeritus Professor of Dermatology and immediate past chairman of the Department of Dermatology of Radboud University Nijmegen. He is currently the coordinating Medical Officer of the International Psoriasis Council and chair of the scientific advisory board of the Dutch burn association. He has been working for many years on the pathogenesis and treatment of psoriasis. He has published more than 700 publications in peer-reviewed journals and has given many presentations on invitation at international conferences. He has served as president of the ESDR, EDF, and the International Psoriasis Council, and was board member of various international societies. Current interests are pathogenesis and development of biomarkers for psoriasis; real clinical practice research; and personalised medicine.

Conflict of Interest Statement:Consultancy services for: Celgene, Almirall, Amgen, Pfizer, Philips, AbbVie, Eli Lilly, Galderma, Novartis, Janssen Biotech, Janssen-Cilag, LEO Pharma,Sandoz, Mitsubishi Tanabe, Sandoz, Bristol Meyer Squibb, UCB, Dermavant.Speaker services for: Celgene, Almirall, Eli Lilly, Novartis, Jansen-Cilag, LEO Pharma, Sandoz, Bristol Meyer Squibb.

 



Posted on 28 August, 20205 January, 2021