Dr James Q. Del Rosso Explores the Latest Advancements in Dermatology

James Q. Del Rosso, DO, research director and principal investigator at JDR Dermatology Research, highlights a number of monoclonal antibodies, Janus kinase inhibitors, and nonsteroidal treatments that have advanced the treatment of dermatologic conditions like atopic dermatitis and alopecia areata.

Del Rosso is a frequent presenter at the Fall Clinical Dermatology conference, and is presenting again this year.

Transcript

What have been some major developments or approvals in dermatology in the past year?

One of the things that I've been tasked with every year at the Fall Clinical Dermatology meeting is "What's New in the Medicine Chest?" and also discussions on "The Newest in Dermatology" that I do with Joshua Zeichner, MD, and Mark Lebwohl, MD, and I do myself the "What's New in the Medicine Chest?" I don't have time to go through all of it, but I cover a variety of different areas.

I'm going to be covering many of the monoclonal antibodies, like dupilumab, tralokinumab, lebrikizumab. I'm going to be discussing Janus kinase inhibitors, like upadacitinib and abrocitinib for atopic dermatitis, and even baricitinib, which is approved for alopecia areata. Remarkable drugs with excellent responses for their given diseases, but the concern has been safety because Janus kinase inhibitors can have some systemic effects like major cardiovascular events, venous thromboembolism, serious infections, and maybe increased potential for malignancy, but it really depends on the comorbidities and other things that are going on with those patients.

There's been a lot of drill down in patients with diseases like atopic dermatitis and alopecia areata—especially younger patients who have fewer comorbidities—to really look at, over time, a large number of patients over time, and it really shows that the risk is very low of these potential problems, but they are possible, so they are monitoring recommendations. But it's not like the house is falling down, so that's very important.

The monoclonal antibodies have excellent safety profiles; they don't require any of the laboratory monitoring or repeated blood testing, but they are truly very effective. For atopic dermatitis, we have tralokinumab, also FDA approved as an anti–IL [interleukin]-13, and of course dupilumab for years now as an anti–IL-4 anti IL-13, and more data accumulating on these. And lebrikizumab [is] not approved yet, but [has] some really good data, including looking at children, so very exciting. Just to wrap up, we're going to talk about the pharmaceutical-grade drug device cantharidin, which is approved for molluscum contagiosum, the first therapy for molluscum.

We're also going to be talking about excellent nonsteroidal treatments, with some new data on topical roflumilast and also topical tapinarof. Tapinarof now has data on intertriginous psoriasis; roflumilast has always had that. We have roflumilast data now on atopic dermatitis, which it's not yet approved for, and we have topical tapinarof data on atopic dermatitis—roflumilast in a foam as opposed to a cream—also seborrheic dermatitis. Some really impressive data.

There are other things we're going to talk about, but I'm going to be drilling down on a lot of new information, and my goal is always to make it clinically relevant for the attendees because the audience is primarily people in the trenches every day just trying to get their patients better, so I'm trying to help them.