Good morning, I'm Kathy Schwartzenberger. I'm Professor of Dermatology at Oregon Health and Science University. I serve as the Chair of the Scientific Assembly Committee for the American Academy of Dermatology's Annual 2025 Meeting.
I think kind of one of the most interesting areas of new knowledge is what we call Oncodermatology. It's advancing the care of our patients with complex skin cancers.
We're learning, for example, that if you come in with a melanoma, particularly a later stage melanoma, it may be advantageous to give what we call neoadjuvant therapy. You may get your immunotherapy prior to actually removing the cancer. And that's kind of new thinking for dermatologists because we usually see a skin cancer, we cut it out. So, now we're having to stop and think is it more appropriate to interface with the oncologist before we do the surgery to actually provide the immunotherapy in a neoadjuvant fashion. And I think that that's been kind of a frame shift for dermatology, and it's really gotten us really in the front lines of treating serious cancers.
We're really on the cusp of seeing just a strong integration of technology, particularly with artificial intelligence being brought in and used in just incredibly innovative ways to provide and enhance not only our understanding of basic science, but the way we actually will be able to deliver care to our patients.
In full disclosure, one of my areas of interest and expertise is allergic contact dermatitis where people develop allergies to chemicals or other things that might get on their skin. And there's quite a few challenges in addressing those patients. One is figuring out what they're actually allergic to since many of us get exposed to a lot of different things and then doing the appropriate testing to figure that out.
So one of our members is actually doing and reported a study using artificial intelligence in various points of that to help narrow down the potential allergens that they might be exposed to and then they're doing it in a patient -directed way to then have the patient actually do the patch testing themselves instead of waiting a year to get in to see few people in the country who can do that patch testing. So being able to really harness a technology like artificial intelligence to work with the patient is just amazing.
Tapinarof Cream 1% Once Daily: Maintenance of Low Disease Activity Including Pruritus Through End of the Treatment-free Interval in a Long-term Extension Trial in Patients Down to 2 Years of Age with Atopic Dermatitis
Hello, I am Dr. Linda Stein Gold. I'm the Director of Dermatology Clinical Research at Henry Ford Health System in Detroit, Michigan, and I'm a medical dermatologist.
Tapinarof cream is actually a topical non -steroidal treatment. It was first FDA approved for psoriasis in adults and more recently was FDA approved for atopic dermatitis all the way down to age two.
The Adoring 3 study was a long -term safety and efficacy study that came after the first phase 3 clinical trials. And after those studies, patients were then allowed to go into an open label, meaning everybody got the drug.
But we also had other patients come into this study, as well. Some came from the maximum use study, so they had more extensive body surface area. And some came directly into the long -term study. And this was especially a lot of children. So, in these studies, we had a very high percentage of pediatric patients, over 80%, which is nice, especially if we're studying atopic dermatitis.
The way this long -term study was designed was similar to how we designed the psoriasis long -term study.
Patients came into the study and they treated once a day with Tapinarof 1% cream, and they treated until their skin got completely clear. So not clear or almost clear, but it had to be completely clear. Once their skin was clear, they actually went off medication and we waited to see how long it took for the disease to come back. So, if they got mild disease or worse, we put them back on medication again until they were clear.
So, patients could go on or off medication over the course of the rest of the year, really kind of in a realistic way, seeing what happens when we go off medication, is it possible to have a durable effect or a treatment -free period? And if you do get a treatment -free period, how rapidly does that disease come back? Does it come back really suddenly? What happens to the itch over the course of that treatment -free period?
We had over 700 patients who came into this long -term study. About 58 of them were actually clear when they started, so they stayed off drug. And the rest of them, 670 of them had mild disease, or actually almost clear or worse, so they continued on the medication.
And what we found was really interesting. We found that if you get to completely clear skin and you go off of medication, patients on average had 80 consecutive days of a treatment -free period. And what we were interested in was finding out, well, what happens at the end of those 80 consecutive days? What was the disease like?
And we found that at the end of that treatment-free period, the majority of patients had mild disease, about 84 % of them. So, it seems like when the disease is coming back, it's coming back slowly. So, it's mild. The mean easy score was a 3 .4, so that also indicates mild disease. And when we look at the itch, they've been off drug for an average of 80 days, consecutively, the itch score was under a three. So again, that indicates very mild disease.
So that's good news. It turns out that it's possible to give our patients a drug holiday and that's kind of a new novel concept.
