Dermatology

JAK inhibitors increase acne risk versus Th2 biologics in adult atopic dermatitis

This cohort study compared incident acne in adults with atopic dermatitis starting a Janus kinase (JAK) inhibitor versus a Th2 cytokine inhibitor. The outcome was new-onset acne after treatment initiation, not baseline disease. JAK inhibitor use was associated with a higher risk of developing acne than Th2 cytokine inhibitor therapy. These findings support anticipatory counseling, early acne management plans, and factoring baseline or scarring acne into advanced therapy selection. 1

0.2% thiamidol cream modestly improves facial hyperpigmentation versus vehicle

In this 12-week randomized, double-blind, vehicle-controlled trial, 200 participants with facial hyperpigmentation used 0.2% thiamidol or vehicle cream. Thiamidol achieved significantly greater mMASI reductions than vehicle at weeks 4, 8, and 12, with roughly double the relative improvement by week 12. Physician global assessments favored thiamidol, but patient global assessments and digital color analysis showed no significant between-group differences. Freckles and solar lentigines did not improve versus vehicle, and no significant adverse events occurred, supporting good tolerability for cosmetic use. 2

Nemolizumab efficacy and safety comparable to other anti-IL biologics in moderate-to-severe AD

This Bayesian network meta-analysis synthesized 22 randomized trials of nemolizumab and other advanced systemic therapies combined with topicals for moderate-to-severe atopic dermatitis. Across CsA-experienced adults and CsA-naïve adolescents, nemolizumab showed no significant differences in EASI-75 or IGA success versus other anti-IL monoclonal antibodies. In CsA-naïve adults, lebrikizumab demonstrated statistically superior efficacy to nemolizumab for some endpoints. Safety profiles were comparable, positioning nemolizumab as an efficacy-similar option where itch reduction and tolerability are prioritized. 3

Lebrikizumab benefits dupilumab-experienced atopic dermatitis patients, including prior inadequate responders

The open-label ADapt study evaluated lebrikizumab in 86 adolescents and adults with moderate-to-severe atopic dermatitis who had discontinued dupilumab. Most discontinued dupilumab for inadequate response, with others stopping for adverse events, intolerance, or miscellaneous reasons. By week 16, 57.4% achieved EASI-75, with durable responses and sustained pruritus and quality-of-life improvements through week 24. Adverse events were mainly mild or moderate; serious events and discontinuations were infrequent. Notably, none of the patients who stopped dupilumab for eye events, facial dermatitis, or inflammatory arthritis experienced similar problems on lebrikizumab. 4