Journal of the European Academy of Dermatology and Venereology最新文献

{"title":"OX40/OX40L modulation: A target for regulating T cells in cutaneous inflammatory disorders","authors":"Aditya K. Gupta,&nbsp;Julia Steriopoulos,&nbsp;Vasiliki Economopoulos,&nbsp;Paradi Mirmirani,&nbsp;Vincent Piguet","doi":"10.1111/jdv.70443","DOIUrl":"10.1111/jdv.70443","url":null,"abstract":"<p>The aetiology of many inflammatory cutaneous diseases is T cell-driven and involves dysregulation of the immune response. The complex nature of the immune system's involvement in these diseases has made the development of effective, safe, and durable treatments challenging, resulting in a continued demand for the development of novel therapeutics. OX40 and its ligand OX40L have been previously identified as a crucial axis in T cell differentiation and function, and are promising targets for the treatment of T cell-driven disease. Development of OX40/OX40L agonists and inhibitors has potential uses in atopic dermatitis, alopecia areata, psoriasis, and more. While trials of these drugs have mainly been conducted in atopic dermatitis, they show promise in treating other dermatological conditions. Studies of amlitelimab and rocatinlimab have shown some efficacy but have demonstrated increased durability of response. Current concerns with the class are the potential for broad immune suppression with antagonists and the potential for worsening disease with agonists. Additional studies will enable us to determine their benefit–risk ratio in the real-world setting.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1318-1331"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term efficacy of abrocitinib in patients with moderate-to-severe atopic dermatitis to 2 years","authors":"Melinda J. Gooderham,&nbsp;Jonathan I. Silverberg,&nbsp;Marjolein De Bruin-Weller,&nbsp;Leon Kircik,&nbsp;Diamant Thaçi,&nbsp;Zuotao Zhao,&nbsp;Fernando Valenzuela,&nbsp;Toshifumi Nomura,&nbsp;Andrew Selfridge,&nbsp;Dorothy Fan,&nbsp;Daniela E. Myers,&nbsp;Pinaki Biswas,&nbsp;Saleem A. Farooqui,&nbsp;Melissa Watkins,&nbsp;Herwig Koppensteiner","doi":"10.1111/jdv.70439","DOIUrl":"10.1111/jdv.70439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Abrocitinib treatment previously showed clinically meaningful improvements in skin signs and symptoms in patients with moderate-to-severe atopic dermatitis (AD) up to 48 weeks, with a manageable safety profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To further evaluate long-term efficacy and patient-reported outcomes (PROs) with abrocitinib in patients with moderate-to-severe AD up to 112 weeks of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>JADE EXTEND (NCT03422822), an ongoing, phase 3, long-term extension study of previous abrocitinib trials, includes patients from qualifying trials MOA (NCT03915496), MONO-1 (NCT03349060), MONO-2 (NCT03575871), COMPARE (NCT03720470), TEEN (NCT03796676) and DARE (NCT04345367). Efficacy assessments include the proportion of patients achieving IGA score of 0 or 1 (IGA 0/1); absolute Eczema Area and Severity Index ≤7 (EASI ≤ 7), ≥75%/≥90%/100% improvement in EASI (EASI-75/-90/-100); ≥4-point improvement in Peak Pruritus Numerical Rating Scale (PP-NRS4); PP-NRS score of 0 or 1 (PP-NRS 0/1); EASI-90 + PP-NRS 0/1. PROs include Dermatology Life Quality Index score of 0 or 1 (DLQI 0/1), Children's Dermatology Life Quality Index score of 0 or 1 (CDLQI 0/1), Patient Global Assessment score of 0 or 1 (PtGA 0/1), and ≥4-point improvement in Patient-Oriented Eczema Measure (POEM ≥ 4). Data cut-off: 5 September 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At data cut-off, 403 (42%) and 425 (56%) patients received abrocitinib 200 mg and abrocitinib 100 mg, respectively, for ≥112 weeks. Week 112 efficacy responses were IGA 0/1 57% and 52%; EASI ≤7 81% and 77%; EASI-75 84% and 78%; EASI-90 61% and 54%; EASI-100 26% and 21%; PP-NRS4 70% and 58%; PP-NRS 0/1 43% and 33%; EASI-90 + PP-NRS 0/1 37% and 30%. Week 112 PROs were DLQI 0/1 43% and 41%; CDLQI 0/1 59% and 39%; PtGA 0/1 75% and 72%; POEM ≥4 88% and 81%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Abrocitinib treatment resulted in clinically meaningful outcomes and improvements in PROs, including high-threshold endpoints, in substantial proportions of patients with moderate-to-severe AD up to 2 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1372-1381"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Janus kinase inhibitors with reduced depression in alopecia areata","authors":"Chih-Yi Ho,&nbsp;Hsiang-Ling Wu,&nbsp;Ying-Xiu Dai,&nbsp;Yi-Hsien Shih,&nbsp;Ying-Hsuan Tai","doi":"10.1111/jdv.70184","DOIUrl":"10.1111/jdv.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alopecia areata (AA) is associated with a significant psychological burden, particularly an increased risk of major depressive disorder (MDD). Janus kinase (JAK) inhibitors are emerging as an effective treatment for AA, yet their impact on MDD risk remains unclear. Understanding this association could inform treatment decisions and improve patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to determine if treatment with JAK inhibitors is associated with a reduced incidence of MDD in AA patients compared to those receiving other treatments or no treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilized the TriNetX international healthcare database, including patients diagnosed with AA between 1 January 2011 and 30 June 2024. Patients were categorized into two groups based on JAK inhibitor use within 6 months after AA diagnosis. Propensity score matching ensured balanced groups across observed covariates. The primary outcome was MDD diagnosis between 6 months and 5 years after AA diagnosis. Secondary outcomes included new antidepressant prescriptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, 1838 patients in each group (conventional treatments with or without JAK inhibitors) were analysed. Treatment with JAK inhibitors was significantly associated with a lower risk of MDD [aHR: 0.42, 95% confidence interval (CI): 0.22–0.82, <i>p</i> = 0.009] and antidepressant prescriptions (aHR: 0.46, 95% CI: 0.32–0.67, <i>p</i> &lt; 0.001). These findings were consistent across 1-year, 3-year, 5-year and 10-year periods. Subgroup analyses revealed stronger associations in younger patients (18–29 years), those of White ethnicity, and those treated at academic medical centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows that JAK inhibitor treatment in AA patients is associated with a significantly lower incidence of MDD and reduced antidepressant use. These findings suggest a potential role for JAK inhibitor in improving mental health in AA. Randomized controlled trials are warranted to confirm these findings and explore the long-term safety and benefits of JAK inhibitors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1382-1391"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year abrocitinib in atopic dermatitis: Are we reaching the new targets?","authors":"Axel De Greef,&nbsp;Marie Baeck","doi":"10.1111/jdv.70534","DOIUrl":"10.1111/jdv.70534","url":null,"abstract":"&lt;p&gt;The article by Gooderham et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; provides long-term data on abrocitinib (JAK1 inhibitor) in moderate-to-severe atopic dermatitis (AD), extending experience from multiple qualifying trials into JADE EXTEND up to 112 weeks.&lt;/p&gt;&lt;p&gt;In this study, abrocitinib achieved rapid and sustained improvements in both clinician-reported and patient-reported outcomes. At week 112, EASI-75 was achieved by 84% and 78% of patients receiving abrocitinib 200 and 100 mg, respectively; EASI-90 by 61% and 54%; and EASI-100 by 26% and 21%. Importantly, itch responses were also improved, with PP-NRS 0/1 reached by 43% and 33% of patients. The composite endpoint of EASI-90 plus PP-NRS 0/1 was achieved by 37% and 30%, respectively, suggesting that a substantial proportion of patients reached the state of minimal disease activity (MDA) under continuous treatment.&lt;/p&gt;&lt;p&gt;These findings should be interpreted in light of the evolution of AD treatment goals. The Aiming High in Eczema/Atopic Dermatitis (AHEAD) recommendations proposed a more ambitious treat-to-target strategy, integrating shared decision-making and defining MDA through optimal targets combining clinician and patient-reported outcomes.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In this framework, EASI-90 or EASI ≤ 3 and PP-NRS ≤ 1 represent clinically meaningful ‘optimal’ targets. The abrocitinib data therefore support the feasibility of these higher targets in a substantial subgroup of patients.&lt;/p&gt;&lt;p&gt;The recently published International Eczema Council consensus further refines this landscape by defining low disease activity, very low disease activity, on-drug complete control and off-drug remission.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Low disease activity is defined as vIGA-AD 2 or EASI ≤ 7 plus PP-NRS ≤ 4, whereas very low disease activity requires vIGA-AD 0/1 or EASI ≤ 3 plus PP-NRS 0/1. On-drug complete control requires complete clinical clearance and PP-NRS 0/1 for at least 6 months, ++while off-drug remission requires maintained remission for at least 12 months after treatment discontinuation. From this perspective, JADE EXTEND demonstrates robust on-drug disease control but does not address true remission or disease modification.&lt;/p&gt;&lt;p&gt;This distinction is essential. Bieber et al. emphasized that disease modification in AD should not be confused with high clinical response during drug exposure.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Their ‘&lt;i&gt;AD Disease Activity Index&lt;/i&gt;’ incorporates clinician-reported outcomes, patient-reported outcomes and biomarkers to identify deep remission and, ultimately, off-therapy sustained control. JADE EXTEND showed that abrocitinib can maintain clinical control over 2 years, but whether such control suppresses subclinical inflammatory memory or modifies the natural course of AD remains unknown.&lt;/p&gt;&lt;p&gt;Another important limitation is that conventional long-term extension endpoints only partially capture the dynamic nature of AD. The authors report an overall stabilization of disease severity, w","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1294-1295"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease-dependent and independent factors determine the burden of illness among family members","authors":"Vishal Gupta,&nbsp;Francesca Sampogna","doi":"10.1111/jdv.70538","DOIUrl":"10.1111/jdv.70538","url":null,"abstract":"&lt;p&gt;The article by Abdalla et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; highlights an important aspect of the burden of chronic dermatological diseases: its impact on the lives of family members and caregivers. While the impact on quality of life in chronic skin conditions, such as chronic urticaria, psoriasis, atopic dermatitis and vitiligo, has been widely explored, the effect on the so-called ‘greater patient’ remains less well studied. The concept of the Greater Patient, introduced by Basra and Finlay,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; provides a valuable framework for understanding the true burden of dermatological disease. Skin conditions rarely affect only the individual diagnosed; instead, their impact extends to partners, parents, children and caregivers whose daily lives are reshaped by treatment routines, emotional stress, financial costs and social stigma. Recognizing this broader sphere of burden shifts dermatology from a strictly patient-centred model towards a family-centred perspective, with important implications for clinical care, health-economic evaluation and outcome measurement, and highlights the need to consider family quality of life alongside patient-reported outcomes.&lt;/p&gt;&lt;p&gt;In this issue of the &lt;i&gt;JEADV&lt;/i&gt;, Abdalla et al. report a large multinational study, including nearly 1200 family members to assess the impact of chronic spontaneous urticaria (CSU) on relatives of affected patients.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; They used the Family Dermatology Life Quality Index (FDLQI),&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; one of the most widely used instruments in dermatology, developed by Finlay's group. The mean FDLQI score in this study was 9.6. For context, this burden is comparable to that reported among family members of patients with hidradenitis suppurativa and vitiligo, and higher than that observed in families of patients with melanoma, alopecia areata and psoriasis.&lt;/p&gt;&lt;p&gt;The main finding was a clear inverse association between CSU control and family quality of life across all FDLQI dimensions, suggesting that better disease control could substantially reduce family burden. Similar associations between disease severity and family quality of life have been reported in several dermatological conditions, particularly atopic dermatitis and psoriasis, where increasing severity is consistently linked to greater caregiver burden and psychosocial impact. However, disease severity is only one of several determinants of family quality of life. Indeed, family members' well-being is closely related to patients' quality of life. Basra et al. previously demonstrated a strong correlation between FDLQI and DLQI scores across a range of skin diseases (&lt;i&gt;r&lt;/i&gt; = 0.69). Notably, the association between FDLQI and patient-reported quality of life was stronger than that with disease severity (&lt;i&gt;r&lt;/i&gt; = 0.49),&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; and similar findings have been reported in families of patients with psoriasis and atopic dermatitis. Evidence from alopecia areata further sugges","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1298-1299"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological treatment in atopic dermatitis—Lessons from the BioDay registry","authors":"Weronika Zysk,&nbsp;Magdalena Trzeciak","doi":"10.1111/jdv.70548","DOIUrl":"10.1111/jdv.70548","url":null,"abstract":"&lt;p&gt;The BioDay registry study by van der Gang et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; comparing dupilumab and tralokinumab adds important real-world evidence on Biological treatment in atopic dermatitis (AD). The main clinical finding of this study is the more favourable efficacy profile of dupilumab.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although the differences in mean EASI and NRS-pruritus scores between the two treatments did not reach the threshold for minimal clinically important difference, patients treated with dupilumab more often achieved the treatment targets EASI ≤7 and NRS-pruritus ≤4. They discontinued treatment less frequently because of lack of efficacy. In addition, dupilumab showed higher drug survival after 52 weeks.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; However, these results should be interpreted with caution, as the dupilumab group was substantially larger than the tralokinumab group and the study had an observational design. Another important finding is the speed of treatment response.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The advantage of dupilumab was most visible early in treatment, particularly in EASI and itch reduction already after 4 weeks.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This may be especially relevant for patients requiring rapid disease control, particularly those with severe pruritus and high symptom burden. At the same time, these findings suggest that dupilumab and tralokinumab may have different roles in the management of AD. They highlight the growing need for patient phenotyping and individualized Biological treatment in AD. Selective IL-13 inhibition may still be beneficial in selected patients, particularly those with a more skin-limited disease phenotype. In contrast, broader IL-4/IL-13 blockade may be particularly relevant in patients with concomitant asthma, which was more common in the dupilumab-treated group in the present study.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The authors correctly highlight that mean EASI or NRS scores may not fully reflect treatment success in clinical practice.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In clinical practice, both patients and physicians assess treatment not only by improvements in scores but mainly by the ability to maintain long-term disease control, reduce the need for additional therapy and avoid treatment discontinuation or switching. Therefore, including treatment discontinuation in the definition of treatment failure may better reflect everyday clinical decision-making. Although the authors did not observe significant differences in Biological-associated ocular surface disease between treatments,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; some real-world reports suggest that selected patients may benefit from switching from dupilumab to tralokinumab.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; However, interpretation is limited by the lack of systematic ophthalmologic assessment in most AD registries. Moreover, although not addressed in this study, dupilumab-associated head and neck dermatitis remains an important challenge in AD. Emerging data suggest that selective","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 8","pages":"1292-1293"},"PeriodicalIF":9.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70548","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab for infants with atopic dermatitis: Friendly administration tips to enhance adherence","authors":"Emanuele Scala,&nbsp;Filomena Russo","doi":"10.1111/jdv.70347","DOIUrl":"https://doi.org/10.1111/jdv.70347","url":null,"abstract":"&lt;p&gt;Atopic dermatitis (AD) is a chronic inflammatory skin disease driven by type 2 immune responses involving cytokines such as IL-4 and IL-13. It is characterized by persistent pruritus and widespread skin lesions that significantly impact the quality of life (QoL) of both affected children and their caregivers. Disease onset typically occurs in childhood, with approximately 60% of cases presenting within the first year and nearly 80% before age six.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Early prevention and effective management are therefore crucial, especially considering the limitations of systemic therapies in young children.&lt;/p&gt;&lt;p&gt;In a recent real-world study published in the JEADV, Lasek et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; report outcomes from the French Early Access Program (EAP) involving 198 children aged 6 months to 5 years with moderate-to-severe AD. Dupilumab, a monoclonal antibody targeting IL-4 and IL-13, was injected every 4 weeks at a dose of 200 mg for children weighing 5–15 kg and 300 mg for those weighing 15–30 kg. Children who reached 15 kg during treatment continued receiving the 200-mg dose.&lt;/p&gt;&lt;p&gt;By 6 months, approximately 84% of patients achieved an Investigator's Global Assessment (IGA) score of 0/1, indicating clear or almost clear skin. Additionally, 94.4%, 75.0% and 44.4% of patients achieved at least 50%, 75% and 90% improvement, respectively, on the Eczema Area and Severity Index (EASI 50/75/90). Meaningful reductions in pruritus were also noted, with about 67.6% of patients reporting a ≥4-point improvement in the Pruritus-Numerical Rating Scale (P-NRS) scores, highlighting the substantial benefit of dupilumab. These clinical improvements were accompanied by gains in QoL, as reflected by reductions in paediatric-specific measures, including the Infants' Dermatitis QoL Index (IDQOL; for children &lt;4 years) and the Children's Dermatology Life Quality Index (CDLQI, for children ≥4 years). Mean score decreases of −6.9 and −8.8, respectively, indicate a substantial reduction in disease-related discomfort and psychosocial burden in this patient group.&lt;/p&gt;&lt;p&gt;The safety profile remained consistent with previous clinical trials,&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; with low rates of adverse events—primarily mild or moderate—and no new safety concerns identified. Notably, these findings extend beyond the typical 16-week duration of randomized trials, further supporting dupilumab as an effective and well-tolerated treatment for moderate-to-severe AD in very young children. However, caregivers should take special considerations into account.&lt;/p&gt;&lt;p&gt;To optimize adherence and ease the administration process, several strategies can help reduce the stress of injections for children.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; These include removing the syringe or prefilled pen from the refrigerator 30–45 minutes before injection to reduce discomfort caused by cold, applying a topical anaesthetic to reduce pain and using distraction techniques such as audiovisual media, toys o","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 7","pages":"1118-1119"},"PeriodicalIF":9.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70347","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Denifanstat in acne therapy: A promising step forward","authors":"Stefania Guida,&nbsp;Evgenia Makrantonaki","doi":"10.1111/jdv.70120","DOIUrl":"https://doi.org/10.1111/jdv.70120","url":null,"abstract":"&lt;p&gt;Acne vulgaris, affecting up to 85% of individuals worldwide, is among the most common dermatological diseases.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Despite its widespread impact and the emotional and physical burden of affected patients, treatment options still remain limited in moderate-to-severe cases and far from optimal. The study by Chen et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; reported the intriguing results of a phase 2 randomized controlled trial evaluating Denifanstat, a first-in-class fatty acid synthase (FASN) inhibitor,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; for moderate-to-severe acne vulgaris. The trial enrolled 180 participants across 13 centres in China, comparing three oral doses of Denifanstat (25, 50 and 75 mg) against placebo over 12 weeks. The primary endpoints included percent change in total lesion counts and ≥2-grade reduction in Investigator's Global Assessment (IGA).&lt;/p&gt;&lt;p&gt;One of the key strengths of this study lies in its mechanistic innovation. Denifanstat targets de novo lipogenesis,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; a pathway increasingly recognized in acne pathophysiology.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; By inhibiting FASN, Denifanstat potentially modulates sebum composition and inflammatory signalling, offering a non-antibiotic systemic alternative.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The trial design is robust since it is randomized, double-blind, placebo-controlled and dose-escalating. The inclusion of multiple efficacy endpoints and safety assessments, along with pharmacokinetic data, provides a comprehensive evaluation. Notably, the 50 mg dose showed the most favourable balance between efficacy and tolerability, with significant reductions in lesion counts and no study withdrawals due to adverse events.&lt;/p&gt;&lt;p&gt;Despite promising results, several limitations should be addressed. First of all, the study was not powered to detect differences in IGA scores, which are critical for clinical decision-making. The lack of significant improvement in IGA ≥2-grade reduction across groups (&lt;i&gt;p&lt;/i&gt; = 0.336) may reflect either insufficient sample size or limitations in the semi-quantitative nature of the IGA scale. Furthermore, the absence of a dose–response relationship—particularly the plateau effect observed at 50 mg—raises questions about optimal dosing. Pharmacokinetic data suggest saturation of biological response at this dose, but further exploration in larger cohorts is warranted. The duration of the study (12 weeks) may also be insufficient to capture long-term efficacy and safety, especially for a systemic agent. Additionally, the trial lacked standardized photographic documentation, which could affect lesion assessment consistency across sites.&lt;/p&gt;&lt;p&gt;Taken together, the study by Chen et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; showed that Denifanstat represents a novel therapeutic class with potential to reshape systemic acne treatment. Its non-antibiotic mechanism is particularly relevant in the context of rising antimicrobial resistance. The favourable safety profile—especia","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 7","pages":"1122-1123"},"PeriodicalIF":9.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The SWITCH algorithm: An expert consensus on treat-to-target criteria for chronic prurigo","authors":"Lea S. Stahl,&nbsp;Claudia Zeidler,&nbsp;Joyce Loewenthal,&nbsp;Svenja Royeck,&nbsp;Matthias Augustin,&nbsp;Robert Bissonnette,&nbsp;Sarina Elmariah,&nbsp;Brian S. Kim,&nbsp;Laurent Misery,&nbsp;Hiroyuki Murota,&nbsp;Hong Liang Tey,&nbsp;Elke Weisshaar,&nbsp;Gil Yosipovitch,&nbsp;Franz J. Legat,&nbsp;Adam Reich,&nbsp;Martin Metz,&nbsp;Sonja Ständer","doi":"10.1111/jdv.70171","DOIUrl":"10.1111/jdv.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To date, the management of chronic prurigo (CPG; prurigo nodularis) relies on expert consensus and guidelines without providing detailed recommendations on long-term treatment management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study was initiated by an expert committee to define, validate and reach consensus on treat-to-target (T2T) criteria and a decision-supporting treatment algorithm for CPG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, single-centre, non-interventional study was conducted in adult CPG patients at a moderate-to-severe disease stage, experiencing intense itch (NRS ≥7; Group A), and in patients who considered themselves successfully treated (Group B). The patients answered questions about their most severe symptoms and essential therapy goals. A committee of 14 field experts evaluated the study results, identified outcome tools from clinical trials and defined and weighted T2T criteria. Based on this, a treatment algorithm was developed through an iterative consensus-building method and anonymous voting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>171 patients (Group A, <i>n</i> = 96; Group B, <i>n</i> = 75) were interviewed. Itch (99.4%), the need to scratch (48%), and pruriginous lesions (45.6%) were the most frequently reported severe symptoms. Pruritus relief (over complete pruritus resolution) and healing of lesions were the key therapeutic goals. In clinical trials, the most frequently used instruments were assessments of worst/peak itch intensity, disease severity via IGA, DLQI and sleep quality. According to the results, the experts defined initial itch control as NRS ≤3, lesion healing with IGA-S 0/1, and burden, along with their respective clinically measurable parameters, as T2T criteria. These criteria, with predefined cut-off values, serve as the decision-tree keys that constitute the treatment algorithm presented here, facilitating a decision to maintain or switch the treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The T2T criteria and the SWITCH treatment algorithm offer a valid and systematic method for evaluating and refining CPG treatment based on patient-reported and expert-validated data. This will help to improve the treatment of patients with CPG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 7","pages":"1185-1194"},"PeriodicalIF":9.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update of the EuroGuiDerm evidence-based guideline for the treatment of acne—Short version","authors":"Alexander Nast,&nbsp;Bassel H. Al Wattar,&nbsp;Marie Beylot Barry,&nbsp;Holger Brüggemann,&nbsp;Zrinka Bukvić Mokos,&nbsp;Dawn M. Caruana,&nbsp;Klaus Degitz,&nbsp;Clio Dessinioti,&nbsp;Brigitte Dréno,&nbsp;Rieke J. B. Driessen,&nbsp;Harald Gollnick,&nbsp;Merete Hædersdal,&nbsp;Alexander Katoulis,&nbsp;Severin Läuchli,&nbsp;Julien Lambert,&nbsp;Alison M. Layton,&nbsp;Giuseppe Micali,&nbsp;Falk R. Ochsendorf,&nbsp;Thozhukat Sathyapalan,&nbsp;Katarina Zak Stangeland,&nbsp;Simon Francis Thomsen,&nbsp;Daniel Töröcsik,&nbsp;Antonia Pennitz","doi":"10.1111/jdv.70331","DOIUrl":"10.1111/jdv.70331","url":null,"abstract":"<p>This evidence- and consensus-based guideline for the treatment of acne was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. This guideline is an update of the 2016 version. This is a short summary of the full version of the EuroGuiDerm Evidence-based Guideline for the Treatment of Acne. For the complete guideline text, detailed methods report, and comprehensive evidence report, please refer to the online full version. In this targeted update, the guideline group prioritized three key clinical questions considered most relevant for current practice:\u0000\u0000 </p><p>Additionally, the updated guideline provides revised recommendations regarding: safety of benzoyl peroxide (BPO), selection of systemic antibiotic therapy, treatment considerations during pregnancy, isotretinoin dosing strategies, and the use of hormonal antiandrogenic contraceptives or other combined hormonal contraceptives, as well as spironolactone. All other aspects remain unchanged from the 2016 guideline.</p>","PeriodicalId":17351,"journal":{"name":"Journal of the European Academy of Dermatology and Venereology","volume":"40 7","pages":"1162-1172"},"PeriodicalIF":9.2,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdv.70331","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147477700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}