touchIMMUNOLOGY touchIMMUNOLOGY
Dr Elaine Siegfried

Cardinal Glennon Children’s Hospital, St. Louis, MO, USA

CHAIR

Panelists:
Assist. Prof. Nives Pustišek, Prof. Andreas Wollenberg
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Paediatric Dermatology, Atopic Dermatitis, Dermatological Conditions, Immunology CE/CME accredited

touchPANEL DISCUSSION
A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

Paediatric atopic dermatitis: Evolving strategies for improved management

  • Downloads including slides are available for this activity in the Toolkit
Learning Objectives

After watching this activity, participants should be better able to:

  • Recognize the burden of atopic dermatitis in children, their families and caregivers and its impact on quality of life, particularly in moderate-to-severe disease
  • Summarize the latest data for systemic treatment options in children and adolescents with moderate-to-severe atopic dermatitis
  • Assess how continuity of care in children and adolescents impacts long-term symptom control
Overview

In this activity, three experts discuss the burden of atopic dermatitis in children and their families, how to assess it in the clinic, and when treatment escalation with systemic therapy should be considered. They also explore how clinicians can support paediatric patients and their families to achieve long-term control of atopic dermatitis and optimize treatment outcomes.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

Dermatologists, allergists and immunologists, nurses, dermatology nurse practitioners, primary care physicians and paediatricians involved in the management of paediatric atopic dermatitis

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Elaine Siegfried discloses: Speaker Bureau fees from: Regeneron, Sanofi Genzyme and Verrica. Consulting fees from: AbbVie, Alphyn, ASLAN Pharmaceuticals, Boehringer Ingelheim, Cara Therapeutics, Incyte, Leo, NobelPharma, Novan, Novartis, Pfizer, Pierre Fabre, Regeneron, Sanofi Genzyme, UCB and Verrica. Contracted research: AI Therapeutics. Clinical trials (all fees to institution): Amgen, Janssen, Lilly, Pierre Fabre, Regeneron, Sanofi and Verrica. Data safety monitoring board: Espere Healthcare, Leo, Novan, Pfizer and UCB. 

Dr Nives Pustišek discloses: Speaker’s Bureau: AbbVie, Bayer, Bioderma, LEO Pharma, L’Oreal Adria, Novartis, Oktal Pharma, Pfizer and Sanofi-Aventis.

Prof. Andreas Wollenberg discloses: Advisory Board or Panel: AbbVie, Aileens, Almirall, Amgen, BMS, Galderma, Glenmark, GSK, Hans Karrer, Kyowa Kirin, Janssen, Leo Pharma, Eli Lilly, L’Oreal, MSD, Mylan, Novartis, Pfizer, Pierre Fabre, Regeneron, Sanofi-Aventis and UCB. Consultancy fees from: AbbVie, Aileens, Almirall, Amgen, Beiersdorf, Bioderma, Bioproject, BMS, Galderma, GSK, Hans Karrer, Kyowa Kirin, Janssen, Leo Pharma, Eli Lilly, L’Oreal, MSD, Mylan, Novartis, Pfizer, Pierre Fabre, Regeneron, Sandoz, Sanofi-Aventis and UCB. Grants/Research Support from: Leo Pharma (relationship terminated) and Pierre Fabre. Salary, Contractual Services from: Pierre Fabre. Speaker’s Bureau: AbbVie, Almirall, Amgen, Beiersdorf, Bioderma, Bioproject, BMS, Galderma, Glenmark, GSK, Hans Karrer, Kyowa Kirin, Janssen, Leo Pharma, Eli Lilly, L’Oreal, Maruho, MedImmune, MSD, Mylan, Novartis, Pfizer, Pierre Fabre, Regeneron, Sanofi-Aventis and UCB.

Content reviewer

Ann Lin, MD, Peer Reviewer has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Adriano Boasso has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu.

Accreditations

Physicians

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 a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 07 December 2023. Date credits expire: 07 December 2024.

If you have any questions regarding credit please contact cpdsupport@usf.edu.

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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Topics covered in this activity

Paediatric Dermatology / Atopic Dermatitis / Dermatological Conditions / Immunology
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touchPANEL DISCUSSION
Paediatric atopic dermatitis: Evolving strategies for improved management
0.75 CE/CME credit

Question 1/5
Which of the following is considered an important indicator of the severity of atopic dermatitis?

Children with atopic dermatitis suffer from sleep disturbance that worsens with increased disease severity.1 It is mainly caused by nocturnal itching and scratching behaviour, skin-related pain and skin-related fearful thoughts,2 influencing other aspects of daily life that leads to a negative impact on the quality of life.

References

  1. Fishbein AB, et al. J Am Acad Dermatol. 2023;88:348–56.
  2. Cameron S, et al. Allergy. 2023; doi: 10.1111/all.15818.
Question 2/5
Which of the following conditions would you exclude before recommending targeted systemic therapy for your 6-year-old patient with suspected atopic dermatitis that is refractory to topical treatment?

Primary immunodeficiencies can mimic refractory atopic dermatitis.1 Systemic therapy for atopic dermatitis includes immunosuppressive drugs, biologics and Janus kinase inhibitors targeting the immune system that can worsen primary immunodeficiencies.2,3

References

  1. Izadi N, Leung DYM. Ann Allergy Asthma Immunol. 2018;120:23–33.
  2. Wollenberg A, et al. J Eur Acad Dermatol Venereol. 2022;36:1409–31.
  3. Tsuji G, et al. Biomedicines. 2023;11:1303.
Question 3/5
Based on regulatory agency approvals (as of November 2023), which of the following systemic treatments would you consider for your patients with atopic dermatitis who are ≤6 years old?

Dupilumab is approved by the FDA and EMA for the treatment of severe atopic dermatitis in patients 6 months or older who are candidates for systemic therapy.1,2 Lebrikizumab3, tralokinumab1,2 and upadacitinib1,2 are indicated for the treatment of moderate-to-severe atopic dermatitis in adults and adolescents ≥12 years who are candidates for systemic therapy.

Abbreviations

EMA, European Medicines Agency; FDA, US Food and Drug Administration.

References

  1. EMA. Available at: www.ema.europa.eu/en/medicines; SmPCs searchable by drug name (accessed 3 November 2023).
  2. FDA. Available at: www.accessdata.fda.gov/scripts/cder/daf/index.cfm; PIs searchable by drug name (accessed 3 November 2023).
  3. EMA. Lebrikizumab: Summary of opinion. Available at: www.ema.europa.eu/en/documents/smop-initial/chmp-summary-positive-opinion-ebglyss_en.pdf (accessed 3 November 2023).
Question 4/5
Your 17-year-old female patient with atopic dermatitis reports increasingly worse itch, particularly at night, despite daily use of a high-potency topical corticosteroid. She has concerns about using an injectable medication and the need for blood tests. How do you advise her about the requirements for JAK inhibitors (abrocitinib, baricitinib and upadacitinib) and targeted biologics (dupilumab, lebrikizumab and tralokinumab)?

JAK, Janus kinase.

Biologics are available as injections for the treatment of atopic dermatitis, typically dosed every 2–4 weeks. They do not require regular laboratory monitoring.1 JAK inhibitors are available as oral formulations and can be useful for short-term, episodic treatment but have safety concerns, especially in paediatric patients with long-term treatment needs.1 The European guideline (EuroGuiDerm) on atopic eczema recommends baseline screening (full blood count, renal, liver and lipid profile, creatinine phosphokinase levels, and hepatitis and TB tests) prior to treatment initiation with JAK inhibitors, and regular monitoring while on therapy.2

Abbreviations

JAK, Janus kinase; TB, tuberculosis.

References

  1. Butala S, Paller AS. J Allergy Clin Immunol. 2023;151:681–5.
  2. Wollenberg A, et al. J Eur Acad Dermatol Venereol. 2022;36:1409–31.

 

Question 5/5
Your 14-year-old male patient with severe atopic dermatitis achieved control of his skin disease 6 months after starting tralokinumab therapy. His parents are currently administering the injections but he would like to self-inject. What do you recommend?

Tralokinumab can be self-injected by the patient or their caregiver, as determined appropriate by a healthcare professional.1 Proper training should be provided to patients or caregivers on the administration of tralokinumab prior to use.1 Self-management should be encouraged as it can improve adherence to the treatment plan, thereby improving health-related outcomes in chronic conditions.2

References

  1. EMA. Tralokinumab SmPC. 30 October 2023. Available at: www.ema.europa.eu/en/medicines (accessed 3 November 2023).
  2. Lozano P, Houtrow A. Paediatrics. 2018;141:e20171284.
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