Raj Chovatiya, MD, PhD: Long-Term Control of Atopic Dermatitis with Current Therapies

Raj Chovatiya, MD, PhD, Assistant Professor of Dermatology and Director at the Center for Eczema and Itch at the Feinberg School of Medicine at Northwestern University, discussed current atopic dermatitis (AD) therapies and long-term control data with HCPLive.

Chovatiya’s interview covered the data he had discussed in his presentation conducted at the Revolutionizing Atopic Dermatitis (RAD) 2023 Annual Meeting in Washington, DC.

Chovatiya began by stating “it's great that we're starting to get new therapeutic options for atopic dermatitis, but what do things look like in the long run and, essentially, do people keep improvement of signs and symptoms of the disease? Can they be off of therapy? Can they use less therapy, or do they have to continue with the same amount?”

The focus of Chovatiya’s presentation was just trying to take a look at some of the longer term data from the handful of topical and systemic targeted therapies that have been approved in the last several years.

“I touched on crisaborole ointment and ruxolitinib cream,” he said. “In the case of crisaborale, there's some newer data suggesting that for folks that have a pretty good response to initial therapy, proactive treatment may be a way to sort of prevent flares in the long run. And in this case, the way that the trials were designed suggested that once-daily proactive use was actually able to stave off flares compared to individuals we're not treating in that sense.”

Chovatiya noted that this is one plus of this AD therapy that dermatologists have had for 2 years.

“In the case of ruxolitinib cream, our topical JAK inhibitor, what we covered was some of the longer term data going up to a year,” he said. “And what it suggested was that when folks were kind of treating when they had active disease, stopping when their skin was clear, and going to this approach, by and large, people were able to generally maintain good clearance.”

He added that clearance seemed to even increase over time with topical ruxolitnib cream.

“Additionally, in the long term treatment period where people were using the medication on and off, people were really using the medication about half the time, suggesting that you may not necessarily need to use the cream all the time to keep long term control,” he stated.

Chovatiya also covered the biologic therapies category, specifically tralokinumab and dupilumab.

“We went into a little detail about some of the longer term data here, both in terms of the open label extensions,” he said. “And this is data that's extending out to multiple years that suggests that people that stay on therapy pretty continuously at approved dosing, they do a pretty good job.”

He noted that the caveat to these results was that it is difficult to keep patients on something in the long run, adding that numbers are often lost in long term extension arms over time.
“But they both sort of mirrored each other in that way, in the case of tralokinumab, potentially a little bit more time required to get there, but they do seem to sort of catch up for people that do respond well,” he said.

Chovatiya also discussed the 2 oral JAK inhibitors covered in his presentations, specifically abrocitinib and upadacitinib.

“In the case of both therapies, we did actually review individuals who maintained or even got better responses in the long run, something that people don't necessarily think about JAK inhibitors (considering them to be) sort of very quick on off medications,” he explained. “And in fact, for individuals that don't necessarily get to where you want to within the first few months of therapy, there are later responders who can then achieve reasonable control.”

For more information about Chovatiya’s conference presentation, view the full interview segment above.

The quotes contained in this interview were edited for clarity.