Clinically Relevant Pathophysiology of Atopic Dermatitis

Faculty

Melinda Gooderham, MSc, MD, FRCPC
Medical Director of the SKiN Centre for Dermatology
Assistant Professor of Medicine
Queens University
Ontario, Canada

Diamant Thaҫi, MD
Professor & Head of the Comprehensive Center for Inflammation Medicine
University of Luebeck
Luebeck, Germany

Target Audience

The educational design of this activity addresses the needs of international dermatologists, allergists, pediatricians, and other physicians involved in the ongoing management of patients with moderate-to-severe atopic dermatitis.

Program Overview

Atopic dermatitis is a common, chronic inflammatory disease that manifests primarily in the skin.^1,2 The disease-related physical and biopsychosocial burdens of this condition can have a substantial effect on patient and parent/caregiver quality of life.^3,4 Furthermore, people with atopic dermatitis have a higher likelihood of developing atopic comorbidities.⁵ A better understanding of atopic dermatitis disease etiology has resulted in new insights into disease characterization and led to the development of targeted therapies.^6-8 As a result, the first biologic therapy is now FDA-approved to treat both pediatric and adult patients with moderate-to-severe atopic dermatitis, with other novel therapies in late-stage clinical development.^8-12 In this 4-part CME Snapshot^TM series, 2 experts in atopic dermatitis will review the pathophysiologic underpinnings of atopic dermatitis, best practices in patient evaluation, common atopic and nonatopic comorbidities, and recommended management strategies that emphasize shared decision making with patients (and their caregivers) who have more severe disease.^2,5,13-15

References

1. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015:66(suppl 1):8-16.
2. Brunner PM, et al. Increasing comorbidities suggest that atopic dermatitis is a systemic disorder. J Invest Dermatol. 2017;137(1):18-25.
3. Carroll CL, et al. The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol. 2005;22(3):192-199.
4. Drucker AM, et al. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Invest Dermatol. 2017;137(1):26-30.
5. Paller AS, et al. The atopic march and atopic multimorbidity: many trajectories, many pathways. J Allergy Clin Immunol. 2019;143(1):46-55.
6. Mansouri Y, Guttman-Yassky E. Immune pathways in atopic dermatitis, and definition of biomarkers through broad and targeted therapeutics. J Clin Med. 2015;4(5):858-873.
7. Gandhi NA, et al. Targeting key proximal drivers of type 2 inflammation in disease. Nat Rev Drug Discov. 2016;15(1):35-50.
8. Renert-Yuval Y, Guttman-Yassky E. What’s new in atopic dermatitis. Dermatol Clin. 2019;37(2):205-213.
9. Wollenberg A, et al. Treatment of atopic dermatitis with tralokinumab, an anti-IL-13 mAb. J Allergy Clin Immunol. 2019;143(1):135-141.
10. Simpson EL, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335-2348.
11. Simpson EL, et al. Dupilumab efficacy and safety in adolescents with moderate-to-severe atopic dermatitis: results from a multicenter, randomized, placebo-controlled, double-blind, parallel-group, phase 3 study. Presented at the 27th EADV Congress; September 12-16, 2018; Paris, France. Poster 4640.
12. Paller AS, et al. Dupilumab significantly improves atopic dermatitis in children aged ≥6 to <12 years: results from a phase 3 trial (LIBERTY AD PEDS). Presented at the 2020 Revolutionizing Atopic Dermatitis (RAD) Virtual Conference. April 2020.
13. Czarnowicki T, et al. Atopic dermatitis endotypes and implications for targeted therapeutics. J Allergy Clin Immunol. 2019;143(1):1-11.
14. Sandhu JK, et al. Association between atopic dermatitis and suicidality: a systemic review and meta-analysis. JAMA Dermatol. 2019;155(2):178-187.
15. Ariëns LFM, et al. Dupilumab in atopic dermatitis: rationale, latest evidence and place in therapy. Ther Adv Chronic Dis. 2018;9(9):159-170.

Educational Objectives

After completing this activity, the participant should be better able to:

• Describe key pathophysiologic mechanisms underlying atopic dermatitis, including the roles of type 2 cytokines and relationships with atopic comorbidities

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

EACCME

The UEMS-EACCME^® and the AMA have recognized each other’s CME credits since 2000. In 2002 the UEMS-EACCME^® and the AMA signed an agreement of mutual recognition of CME credits between Europe and the USA whereby European physicians attending an event in the USA have their credits recognized in Europe and American physicians attending an event in Europe have their credits recognized in the USA.

Royal College of Physicians and Surgeons of Canada

Activities held outside of Canada developed by a university, academy, specialty society, or other physician organization can be recorded as accredited group learning activities under Section 1 of the Royal College of Physician and Surgeons of Canada’s Maintenance of Certification (MOC) Program.

Term of Offering

This activity was released on October 30, 2020, and is valid for one year. Requests for credit must be made no later than October 30, 2021.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must score 100% or better on the posttest and complete the program evaluation.

System Requirements

PC
Microsoft Windows 2000 SE or above.
Flash Player Plugin (v7.0.1.9 or greater)
Internet Explorer (v5.5 or greater), or Firefox
Adobe Acrobat Reader*

MAC
MAC OS 10.2.8
Flash Player Plugin (v7.0.1.9 or greater)
Safari
Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Melinda Gooderham, MSc, MD, FRCPC: Consultant/Independent Contractor: AbbVie, Akros, Amgen, Bausch, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, Kyowa, Novartis, Sanofi, Sun Pharmaceutical Industries, UCB Grant/Research Support: AbbVie, Akros, Amgen, Arcutis, Bausch, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermira, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Janssen, Kyowa, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Sun Pharmaceutical Industries, Takeda, UCB Honoraria: AbbVie, Actelion, Akros, Amgen, Arcutis, Arena, Bausch, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Coherus, Dermira, Eli Lilly, Galderma, GlaxoSmithKline, Glenmark, Janssen, Kyowa, LEO Pharma, MedImmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi, Sun Pharmaceutical Industries, Takeda, UCB Speakers Bureau: AbbVie, Actelion, Amgen, Bausch, Boehringer Ingelheim, Celgene, Eli Lilly, Galderma, Glenmark, Janssen, Leo Pharma, Novartis, Pfizer, Regeneron, Sanofi, Sun Pharmaceuticals, Takeda, UCB.

Diamant Thaҫi, MD: Advisory Board: AbbVie, Almirall, Biogen-Idec, Boehringer Ingelheim, Celgene, Dermira, Dignity, Eli Lilly, Galapagos, GlaxoSmithKline, Leo Pharma, Janssen-Cilag, Maruho, MSD, Mitsubishi Pharma, Mundipharma, Novartis, Pfizer, Regeneron-Sanofi, Roche-Posay, Sandoz, UCB, XenoPort Speaker's Bureau: Abbvie, Almirall, Celgene, Dignity, Eli Lilly, Galapagos, GlaxoSmithKline, Leo Pharma, Janssen-Cilag, Maruho, MSD, Mundipharma, Novartis, Pfizer, Regeneron-Sanofi, Roche-Posay, Sandoz, UCB Grant/Research Support (Investigator): AbbVie, Almirall, Biogen-Idec, Boehringer Ingelheim, Celgene, Dermira, Dignity, Eli Lilly, Galapagos, GlaxoSmithKline, Leo Pharma, Janssen-Cilag, Maruho, MSD, Mitsubishi Pharma, Novartis, Pfizer, Regeneron-Sanofi, Sandoz, UCB

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Lindsay Borvansky: Nothing to disclose
Andrea Funk: Nothing to disclose
Liddy Knight: Nothing to disclose
Ashley Cann: Nothing to disclose
Stacey Ullman: Nothing to disclose
Rose O’Connor, PhD, CHCP: Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.