With so many treatment options available for atopic dermatitis (AD) and more in the pipeline, one common question Raj Chovatiya, MD, PhD, hears from his fellow dermatologists is: How do I choose the right therapy for my patients?
“There isn’t going to be a one-size-fits-all approach, and it may be impossible to differentiate, given that these agents are not likely to be studied head-to-head,” Dr. Chovatiya, assistant professor in the department of dermatology at Northwestern University, Chicago, said during the Revolutionizing Atopic Dermatitis (RAD) Virtual Conference.
Dr. Chovatiya
Dr. Raj Chovatiya
He shared . These include:
- Severity of disease (mild vs moderate vs severe).
- Extent of disease (low vs high body surface area).
- Rapidity of drug onset (hours vs days vs weeks).
- Depth of response based on different endpoints such as itch and number of lesions.
- Long-term efficacy (durability on treatment vs off treatment).
- Adverse events (cutaneous vs systemic).
- Black box warnings (present vs absent).
- Tolerance (selective areas vs the entire skin).
- Vehicle (ointment vs cream).
- Patient preference. “This may be the biggest driver; what do patients want?” Dr. Chovatiya said.
- Access to the drug. Is it easily obtainable for the patient?
He concluded his remarks by posing a question to attendees: “Are we closer to living in a topical steroid–free world for AD? Is that what we want?” he asked. “I wholeheartedly say that’s what we’ve been working toward all these years, and we should keep up the good fight. We have more data for targeted therapy to treat very specific disease with very specific outcomes and endpoints, because I think that’s [what] we all dream about in dermatology.”
Dr. Chovatiya disclosed that he is speaker for and/or a consultant and advisory board member to many pharmaceutical companies.