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Today, an estimated 17% of Canadians will experience atopic dermatitis (AD) at some point in their lives.[i] November marks Eczema Awareness Month, a timely opportunity to shed light on a chronic inflammatory condition known as atopic dermatitis or better known as eczema. Atopic dermatitis (AD) is often characterized as itchy and inflamed skin and is the most common form of eczema.[ii] AD is associated with atopic comorbidities, such as asthma, food allergies, atopic eye disease, and allergic contact dermatitis. People living with AD may experience as many as nine flare-ups per year, each lasting up to 15 days. [iii] [iv] [v]
Leading dermatologist Dr. Irina Turchin discusses the impact of atopic dermatitis and the significance of new advancements in treatments to support AD disease management in Canada.
What impact can atopic dermatitis have on quality of life?
Atopic dermatitis is more than itchy skin. There are various ways that AD can have an impact on patients. Due to the significant itch that patients experience, it can result in a disruption of regular sleep, recurrent eczema flare-ups and a lack of disease control in moderate to severe AD. As AD is a visible skin condition, patients often experience anxiety, depression, low self esteem, and psychosocial issues which can impact overall quality of life. Many patients will bring their treatments with them while traveling, as the eczema flare-ups can happen at any given time.
Have there been recent research innovations?
We’ve had several clinical developments investigating topical, systemic and biologic therapies. Today, there are trials taking place to target different therapeutic pathways and indications, such as hand dermatitis that is commonly seen in atopic dermatitis patients. We’re fortunate to have many new effective treatments on the horizon to support better disease management. Particularly, what will be significant in the next year is the introduction of Janus kinase (JAK) inhibitors for the treatment of moderate to severe AD. JAK inhibitors turn off JAK-STAT signalling pathways important in AD pathogenesis limiting the transcription of cytokines that cause immune activation, inflammation, and itch. There are also other molecules targeting different disease mechanisms that are still in clinical trials. Research and innovation continue to take place so that we can continue to find effective solutions for managing AD. I believe that in the next two to five years, AD will be a completely different disease in terms of management.
What are the differentiating factors of JAK inhibitors for patients?
JAK inhibitors have been shown to have high efficacy, rapid treatment responses and rapid and substantial improvement in pruritus that we haven’t seen with traditional systemic and biologic agents. Due to their efficacy, JAK inhibitors have been shown to improve patients’ quality of life and well-being. Traditionally, we’ve used off-label systemic therapies to manage AD, most of which are associated with significant adverse events, health risks and tolerability issues. JAK inhibitors are usually well tolerated and promise to have better risk benefit profile compared with traditional systemic therapies that are now used off label.
How can JAK inhibitors contribute to AD disease management?
JAK inhibitors can be provided as an oral therapy which can offer convenience and ease of use for patients. With JAK inhibitors, patients will see a rapid and significant improvement in pruritus which in turn will improve their sleep. It will be interesting to see what happens once we diminish AD disease burden and observe how this impacts family life, social function and work productivity. I am looking forward to seeing the real-world experience of these impacts on patients in a positive way.
What message would you like to share?
As a dermatologist, it’s exciting to see the continued advancements in AD disease management. I have had the privilege of being involved in clinical trials and have seen first-hand, the impact of JAK inhibitors on disease management and quality of life for my patients. I’m looking forward to offering these treatments outside of clinical trials and essentially contributing to the broader impacts in the AD patient population. Awareness and understanding of AD remains crucial for both healthcare professionals and patients. With new advances in treatment, continued research and innovation, we aim for optimal AD management for every AD patient for years to come.
About Dr. Irina Turchin MD, FRCPC, DABD, FAAD
Dr. Irina Turchin is a dermatologist at Brunswick Dermatology Center in Fredericton, New Brunswick. Dr. Turchin has a Bachelor of Science degree from the University of Alberta. She did her medical training at the University of Calgary and completed Dermatology residency at McGill University. Dr. Turchin is board certified in Dermatology in both, Canada and United States and holds memberships with Canadian Dermatology Association, American Academy of Dermatology and European Academy of Dermatology. Dr. Turchin is interested in medical innovation and is involved in clinical trials.
Sponsored by an IMC-member research-based pharmaceutical company.
[i] Canadian Dermatology Association. About Eczema. Retrieved from https://dermatology.ca/public-patients/skin/eczema/ Accessed October 18, 2021.
[ii] Canadian Dermatology Association. About Eczema. Retrieved from https://dermatology.ca/public-patients/skin/eczema/ Accessed October 18, 2021.
[iii] Zuberbier T, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol 2006;118(1):226–232.
[iv] Kaufman BP, et al. Atopic dermatitis in diverse racial and ethnic groups – variations in epidemiology, genetics, clinical presentation, and treatment. Exp Dermatol 2018;27:340-57.
[v] National Eczema Association. Eczema Causes and Triggers. nationaleczema.org/eczema/causes-and-triggers-of-eczema/. Accessed Sept 23, 2020.