The new hope for an eczema cure
Wednesday, April 19, 2017
Atopic dermatitis (AD), a chronic inflammatory skin disease, is often referred to as "eczema," which is a general term for several types of skin inflammation. About 31.6 million Americans have symptoms of eczema, including 17.8 million with symptoms of AD.
In one United States survey, a total of 9,752 children had a diagnosis of eczema, which translated to a 10.7 percent national prevalence of eczema in children under 18 years of age, with a trend towards higher disease prevalence in the East Coast states.
Tormenting symptoms of the skin disease include relentless itching that triggers scratching and subsequent skin swelling, cracking, weeping of clear fluid and eventually, thickening skin. Seventy percent of eczema cases start in children younger than 5 years old, and about 60 percent of infants who have eczema continue to have one or more symptoms in adulthood.
A chronic disease, AD significantly impacts all aspects of life. Patients suffer from different psychosocial problems, including frustration, embarrassment, and anger about their appearance.
Caring for a child with moderate or severe AD has a significantly greater negative impact on the family than does caring for a child with diabetes, and the financial costs incurred by the family are greater than those incurred by the family of a child with asthma. The costs of therapy, work loss, and disability from eczema can only be roughly estimated. For example, a study of AD estimated that direct costs alone were $1 billion to $4 billion in the U.S.
Eczema treatments have generally been limited to topical medications, steroid creams, moisturizers and ultraviolet light, plus antihistamines to relieve itching, which provide some relief for eczema but limited relief for AD. Basically, there is no cure for eczema ─ until now.
The U.S. Food and Drug Administration (FDA) recently approved Sanofi and Regeneron's Dupixent (dupilumab) injection (subcutaneously, once every two weeks) to treat adults with uncontrolled moderate-to-severe eczema. The active ingredient is the antibody dupilumab that binds to a protein [interleukin-4 (IL-4) receptor alpha subunit (IL-4Ra)] that causes inflammation.
By binding to this protein, Dupixent is able to inhibit the inflammatory response that plays a role in the development of AD. The most common side effects include injection site reactions, cold sores in the mouth or on the lips, and eye and eyelid inflammation, including redness, swelling and itching.
The approval of Dupixent was based on data from the global LIBERTY AD clinical program, which included three randomized Phase 3 pivotal trials known as SOLO 1, SOLO 2 and CHRONOS. Of the 2,119 participants enrolled, one-third to two-thirds achieved clear or nearly clear skin after 16 weeks of treatment.
About 4 in 10 participants had itching decrease sharply, improving sleep and reducing anxiety and depression, which affect many patients. The studies examined the use of Dupixent either alone (SOLO 1 or SOLO 2, 1,379 adult patients enrolled) or with topical corticosteroids (CHRONOS, 740 adult patients enrolled) in patients with inadequately controlled moderate-to-severe AD.
In all of these studies, Dupixent alone or with topical corticosteroids met the primary and key secondary endpoints. Dupixent MyWay has been developed to help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs.
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