Additional Advances in Atopic Dermatitis Research and Clinical Trials With Peter A. Lio, MD
Treatment of atopic dermatitis in children and adolescents is progressing rapidly, making educational opportunities crucial in understanding the evolving therapeutic landscape. Dr. Peter A. Lio, Clinical Assistant Professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine, is currently serving as co-chair, along with Dr. Linda F. Stein Gold, of i3 Health’s CME/NCPD/AAPA activity titled “Best Practices and Emerging Evidence in Treatment of Atopic Dermatitis in Children and Adolescents.” In this interview, Dr. Lio shares additional insights into recent innovations in atopic dermatitis treatment and the importance of keeping up to date in this advancing field.
Click the links below to view the full CME/NCPD/AAPA activity!
i3 Health: Since recording this activity, what updates and advances have there been in the treatment landscape of atopic dermatitis (AD)?
Peter A. Lio, MD: This is arguably the most exciting time in the history of atopic dermatitis! There is an incredible stream of innovation, new ideas, and deeper understanding. I often refer to this as the virtuous cycle of drug development: as we get new medications, it's not only that we have a new tool in our toolbox, so to speak, but we also get a new understanding of the condition it's treating, and this leads to even more understanding!
We now have four biologics on the market, two JAK inhibitors, and three major new topicals for atopic dermatitis, all in the past few years. As we learn more about each and how best to use them, there have also been breakthroughs in some of the environmental causes of eczema, the role of Staphylococcus bacteria in eczema, and new insights into the neuroimmunology of the disease. There is renewed interest in the concepts of remission and disease modification as well, along with newer, higher standards of treatment goals that I think are really important.
i3 Health: What do you think are the most pressing unanswered questions in AD research that should be explored?
Dr. Lio: I have two answers here. The first is from a patient perspective, and that would be: "What causes AD?!" That is super interesting to me and other clinicians, of course, but my most pressing unanswered question is "Can we prevent it or permanently improve AD?" I
think the answer is a decided "perhaps," and I truly want to understand how we could do this for patients.
i3 Health: Are there any ongoing trials or future trials you are keeping an eye on that you would like to share?
Dr. Lio: There are some exciting trials right now! One of them is a new botanical agent that has powerful antibacterial effects, as well as being both anti-itch and anti-inflammatory. As someone who likes alternative medicines and more natural approaches, I am waiting with bated breath to see how the studies go, and I can't wait to have it available for my patients.
On the other end are some incredibly exciting technologies surrounding biologic agents. The first is a way to make them last many times longer in the body without breaking down, meaning that once- or twice-yearly injections could be possible for some patients. That would be an incredible game-changer, to be sure! The second is what are called bispecific or polyspecific antibodies, meaning we could potentially target multiple cytokines with a single agent. It is simultaneously obvious, because we are used to lots of great combinations in dermatology, but also genius and innovative. I can't wait to see how these will perform!
i3 Health: In your opinion, what is the most significant benefit of participating in educational opportunities like this activity, for individual practitioners and for improving patient care in AD?
Dr. Lio: We are sort of drowning in information these days, and that is largely a good thing, I think. However, at the same time, it can be extremely difficult to digest all of the new information and to separate what's important from the noise. Educational opportunities like this allow for people who are really focused on a given area, who deeply understand the questions and problems, and who have experience thinking through these difficult decisions, to help guide us. I'm not so foolish as to believe that experts have all the answers—they don't—but someone who is very experienced in an area can most certainly be a guide, and that is absolutely worth something. It makes me think of the old Latin aphorism: Experientia stultorum magistra, prudentia sapientum ("Experience is the teacher of fools, while foresight is the teacher of wise men.")
i3 Health: Looking ahead to the next year or two, what development or advancement in the treatment of atopic dermatitis are you most excited about or hopeful to see come to fruition?
Dr. Lio: I'm hopeful to see more widespread adoption of new treatment goals, getting patients who are suffering better than ever before. I'm hopeful to see better understanding
of how to use these new medications and for which patients. Lastly, I'm hopeful that we will move the needle on understanding prevention and remission of AD.
About Dr. Lio
Peter A. Lio, MD, is a Clinical Assistant Professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine. He specializes in the treatment of atopic dermatitis and connective tissue diseases. Dr. Lio is the Founding Director of the Chicago Integrative Eczema Center. He has particular interest in integrating alternative and complementary medicines into dermatology care, and he has authored over 200 publications and 3 textbooks.