33731 Use of digital resource centers for atopic dermatitis patients, caregivers, and health care professionals to improve shared decision-making and proactive management

Overview: To close gaps in atopic dermatitis (AD) care, we developed and analyzed aligned resource centers for patients/caregivers and health care professionals (HCPs). Methods: The patient resource center was designed to support patients/caregivers in being more proactive in their AD care. The HCP-targeted resource center aimed to increase their awareness of AD patient perspectives and improve communication. Surveys were completed by users of both resource centers. Results: Of the 1014 HCPs, 22% were physicians (30% specialists), 19% were nurse practitioners/physician assistants, 47% were nurses, and 12% were pharmacists. Approximately one-half of 801 patients (98% adults) reported that they only treat their AD when experiencing a flare, and only 30% were very satisfied with their care. Only 56% indicated that they make all decisions with their HCP, and only 22% of HCPs reported that they always involve their AD patients/caregivers in shared decision-making. Only 21% of patients always share preferences, goals, or concerns about AD with their HCP, and only 6% of HCPs rated their ability to ask about and understand the impact of AD on patients’ quality of life as “very good.” Actions that patients planned to take included proactive skin care, asking their HCP about additional treatment options, and telling their HCP about the impact of AD on their quality of life. Nearly 60% of 764 HCPs planned to educate AD patients/caregivers about treatment options and expectations. Conclusions: These results highlight communication gaps between AD patients/caregivers and HCPs. Insights from these data can be used to improve shared decision-making

34039 Maintenance of skin clearance in a long-term open-label study of fixed-combination halobetasol propionate and tazarotene lotion for psoriasis in participants with prior use of topical treatments

Background: Most patients with psoriasis are dissatisfied with their current treatment, primarily because of limited effectiveness. This post hoc subgroup analysis evaluated long-term efficacy and safety of fixed-combination halobetasol propionate (0.01%) and tazarotene (0.045%) lotion (HP/TAZ) in participants with use of topical corticosteroid (TCS; 137/550 [24.9%]) or other antipsoriatic topical medications (51/550 [9.3%]) before entry in an open-label study of HP/TAZ (NCT02462083). Methods: Participants in the open-label study received HP/TAZ once daily. At week 8, participants who achieved treatment success (investigator’s global assessment [IGA] score of 0 or 1) stopped treatment and were reevaluated monthly through 52 weeks; those who did not achieve treatment success continued HP/TAZ. Twenty-four continuous weeks of treatment were allowed if participants achieved ≥1-grade improvement in IGA from baseline at week 12, with monthly reevaluation. If at any point the condition intensified to IGA ≥2, HP/TAZ was resumed, otherwise, HP/TAZ was discontinued. Results: From weeks 8 to 52, similar treatment success rates were achieved by participants with prior use of TCS (range, 20.0%-40.0%) or other topicals (range, 21.1%-53.8%). Mean affected body surface area at baseline was 5.7% and 5.5%, respectively, and decreased to 3.8% and 2.4%, respectively, at week 52. Percentage of participants who maintained disease control for 29 to 85 days after HP/TAZ cessation was comparable. Rates of adverse events were similar between groups. Conclusions: Regardless of the type of previous topical therapy, participants with prior use of topical medications maintained skin clearance with HP/TAZ over 52 weeks

34587 Efficacy of ruxolitinib cream for the treatment of atopic dermatitis by anatomic region: Pooled analysis from two randomized phase 3 studies

Atopic dermatitis (AD) is a highly pruritic inflammatory skin disease. Two phase 3 studies (TRuE-AD1/TRuE-AD2) enrolled patients aged ≥12 years with AD for ≥2 years, an Investigator’s Global Assessment (IGA) score of 2/3, and 3%–20% affected body surface area. Patients (total N = 1249; median age, 32 years) were randomized (2:2:1) to twice-daily 0.75% ruxolitinib (Janus kinase [JAK] 1/JAK2 inhibitor) cream, 1.5% ruxolitinib cream, or vehicle cream for 8 weeks of double-blind treatment, and thereafter continued in a long-term, 44-week period of the studies. In this pooled analysis, mean percentage change from baseline in Eczema Area and Severity Index (EASI) anatomic region subscores is reported up to Week 8 (n = 1208). For the head and neck region, patients applying 0.75%/1.5% ruxolitinib cream (vs vehicle) achieved mean improvements of 59.3%/55.8% (vs 13.4%), 70.4%/71.3% (vs 22.4%), and 70.0%/78.7% (vs 45.0%) at Weeks 2, 4, and 8, respectively (all P \u3c.0001). Results were similar for the upper limbs region (48.5%/54.7% [vs 13.3%], 66.6%/70.3% [vs 25.0%], and 73.5%/74.9% [vs 35.1%] all P \u3c.0001). For the trunk region, patients achieved mean improvements of 49.8%/60.0% (vs 12.1%), 67.3%/73.8% (vs 15.0%), and 72.7%/81.0% (vs 15.6%) at Weeks 2, 4, and 8, respectively (all P \u3c.0001). Similar results were observed for the lower limbs region (46.0%/48.2% [vs 16.3%], 65.9%/66.2% [vs 13.9%], and 76.3%/74.9% [vs 39.8%]; all P \u3c.0001). Ruxolitinib cream was well tolerated, with an adverse event profile similar to vehicle. In summary, ruxolitinib cream demonstrated significant improvements vs vehicle in patients with AD across anatomic regions as early as Week 2

367 Googling acne: Analyzing ingredients and price of over the counter acne products

Introduction: Given the convenience of the over-the-counter (OTC) market, many individuals trial OTC products as a means to combat their acne. Within the OTC acne market, there is great heterogeneity in ingredients and price. Herein, we analyze the distribution of ingredients and price among OTC acne products in top Google searches, which the public may encounter when performing an online search. Methods: Google searches for key terms “acne”, “acne treatment”, “top acne treatment”, and “best acne regimen” were performed. Unique acne products for the first 100 websites for each term were collected. Summary statistics for median, range, mean, and standard deviation for price per topical therapy were analyzed. A factorial ANOVA was performed assessing effect of ingredient on price. Results: A total of 272 unique products were collected out of the 400 websites analyzed. The mean price per ounce of all products was $24.79 (standard deviation of$31.84) and median[range] was $10.40 [ Conclusion: Providers play an important role in educating and helping patients to navigate the OTC market. Based on efficacy and affordability, benzoyl peroxide and adapalene should remain the active ingredient of choice when turning to the OTC market. Given the heterogeneity of the OTC market, patients should carefully evaluate OTC products and be aware that not all products will have ingredients containing a grade A strength of recommendation and know that products with the same topical therapy can vary dramatically in price

Short Term and Long-Term Efficacy of Calcipotriene/ Betamethasone Dipropionate Foam Combination

Psoriasis is a well-known chronic disease characterized by the development of erythematous, indurated, scaly, pruritic plaques on the skin with cycles of remission and symptom flare-ups. The management of patients with chronic plaque psoriasis has been more challenging since the Covid-19 pandemic as health care professionals have had to adapt to remote consultations for some patients, and patients have had to adapt to the changing health landscape. The rapid resolution of psoriasis symptoms especially those with a substantial impact on quality of life can improve patient satisfaction and adherence, making it an important factor in successful treatment. Cal/BD foam contributes to improved patient adherence and treatment outcome through its rapid action and superior efficacy versus Cal or BD monotherapy, Cal/BD ointment and gel and clobetasol cream in the short-term flare treatment of psoriasis. Moreover, the benefits of proactive long-term management of psoriasis compared to reactive management and its favourable safety profile are higher efficacy and a better health-related quality of life. Cal/BD foam should be considered an effective topical treatment for short-term flare treatment and long-term control of adult psoriatic patients

Proactive Management with Cal/BD Foam in Patients with Plaque Psoriasis prolongs Time with improved health-related Quality of Life when compared with reactive Management

Hintergrund: Die Phase-III-Studie PSO-LONG (NCT02899962) zeigte, dass ein proaktives Management (PM) mit Cal/BD-Schaum (Calcipotriol 0,005 %/Betamethason Dipropionat 0,064 %) gegenüber einem reaktiven (RM) über bis zu 52 Wochen bei Erwachsenen mit Psoriasis zu einer überlegenen Wirksamkeit führt. [1] Der von Patienten angegebene DLQI [2] bewertet deren Wahrnehmung der Psoriasis hinsichtlich der gesundheitsbezogenen Lebensqualität (HRQoL). Diese Post-hoc-Analyse von PSO-LONG untersucht, ob das initiale DLQI-Ansprechen nach Cal/BD-Schaumbehandlung in der Open-Label-Phase besser durch anschließendes PM oder RM gehalten werden konnte. Ziele: 1) Hervorheben, dass eine 1x tgl. offene Behandlung mit Cal/BD-Schaum über 4 Wo. die HRQoL von Plaque-Psoriasis-Patienten verbessert 2) Zeigen, dass ein PM mit Cal/BD-Schaum über bis zu 52 Wo. die anfängliche HRQoL-Response, die nach einer 4-wöch. offenen Cal/BD-Schaum-Behandlung erreicht wurde, im Vergleich zum RM bei Plaque-Psoriasis-Patienten signifikant verlängert Methoden: PSO-LONG beinhaltete eine initiale 4-wöchige Open-Label-Phase (OLP) (1x tgl. Cal/BD-Schaum) und eine 52-wöchige doppelblinde Erhaltungsphase (EP), in der Patienten randomisiert zweimal wöchentlich Cal/BD- oder Vehikel-Schaum (PM bzw. RM) anwendeten. Bei Rezidiven (Physician’s Global Assessment [PGA] ≥2) wurde über 4 Wo. 1x tgl. Cal/BD-Schaum gegeben. Der Anteil der Patienten mit einem DLQI = 0/1 nach der OLP wurde während der EP weiter beobachtet, um festzustellen, wie lange anfänglich erzielte Ergebnisse anhielten. Pro Gruppe wurden Kaplan-Meier-Kurven und Hazard Ratios (HR) für die Zeit mit Ansprechen ausgewertet. Ergebnisse: Die Analyse umfasste 521 Patienten mit überwiegend PGA-moderater Psoriasis (85,2 %). Während der OLP erreichten 49 % der Patienten einen DLQI = 0/1. Während der EP war das RM versus PM mit fast doppelt so hohem Risiko assoziiert, den DLQI = 0/1 zu verlieren (HR: 1,92; p\u3c0,001), und die mediane Zeit bis zum Ansprechverlust war fast 3,5x kürzer (57 bzw. 197 Tage). Fazit: Bei einer Untergruppe von Patienten, die nach initialer Behandlung mit Cal/BD-Sprühschaum ein DLQI = 0/1 HRQoL-Ansprechen erreichten, verlängerte das anschließende PM mit Cal/BD-Schaum die Zeit mit DLQI-Ansprechen signifikant gegenüber RM

Tapinarof in the treatment of psoriasis: A review of the unique mechanism of action of a novel therapeutic AhR modulating agent (TAMA)

Tapinarof, a novel, first-in-class small-molecule topical therapeutic aryl hydrocarbon receptor (AhR) modulating agent (TAMA), is in clinical development for the treatment of psoriasis and atopic dermatitis. The efficacy of tapinarof in psoriasis is attributed to its specific binding and activation of AhR, a ligand-dependent transcription factor, leading to the downregulation of pro-inflammatory cytokines, including interleukin-17, and regulation of skin barrier protein expression to promote skin barrier normalization. AhR signaling regulates gene expression in immune cells and skin cells, and has critical roles in the regulation of skin homeostasis. Tapinarof-mediated AhR signaling underlies the mechanistic basis for the significant efficacy and acceptable tolerability observed in early phase clinical trials of tapinarof cream in the treatment of psoriasis