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Disease modification in inflammatory skin disorders: opportunities and challenges

Nature Reviews Drug Discovery volume 22, pages 662–680 (2023)Cite this article

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An Author Correction to this article was published on 21 August 2023

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Abstract

Progress in understanding of the mechanisms underlying chronic inflammatory skin disorders, such as atopic dermatitis and psoriasis vulgaris, has led to new treatment options with the primary goal of alleviating symptoms. In addition, this knowledge has the potential to inform on new strategies aimed at inducing deep and therapy-free remission, that is, disease modification, potentially impacting on associated comorbidities. However, to reach this goal, key areas require further exploration, including the definitions of disease modification and disease activity index, further understanding of disease mechanisms and systemic spillover effects, potential windows of opportunity, biomarkers for patient stratification and successful intervention, as well as appropriate study design. This Perspective article assesses the opportunities and challenges in the discovery and development of disease-modifying therapies for chronic inflammatory skin disorders.

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Fig. 1: Developmental stages of atopic dermatitis and psoriasis vulgaris and candidate pharmacological targets for disease-modifying interventions.
Fig. 2: Typical trajectories of atopic dermatitis and psoriasis vulgaris with their respective comorbidities and the expected outcomes on successful disease-modifying interventions.

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Acknowledgements

This work was supported by the Christine Kühne-Center for Allergy Research and Education (CK-CARE).

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  1. Department of Dermatology and Allergy, University Hospital, Bonn, Germany

    Thomas Bieber

  2. Christine Kühne — Center for Allergy Research and Education, Davos, Switzerland

    Thomas Bieber

  3. Davos Biosciences, Davos, Switzerland

    Thomas Bieber

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T.B. was speaker and/or consultant and/or investigator for AbbVie, Affibody, Almirall, Amagma, AnaptysBio, AOBiom, Arena, Aristea, Asana Biosciences, ASLAN Pharma, Bayer Health, BioVerSys, Böhringer-Ingelheim, Bristol-Myers Squibb, Connect Pharma, Daichi-Sanyko, Dermavant, DIECE Therapeutics, Domain Therapeutics, DS Pharma, EQRx, Evelo, Galderma, Galapagos, Glenmark, GSK, Incyte, Innovaderm, Janssen, Kirin, Kymab, LEO, LG Chem, Lilly, L’Oréal, MSD, Medac, Micreos, Nektar, Novartis, Numab, OM-Pharma, Overtone, Pfizer, Pierre Fabre, Q32bio, RAPT, Sanofi/Regeneron, UCB and Union Therapeutics. He is the founder and chairman of the board of the non-profit biotech ‘Davos Biosciences’ within the International Kühne-Foundation.

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FDA, Guidance for Industry, ‘Submitting Documents Using Real-World Data and Real-World Evidence to FDA for Drug and Biological Products’, September 2022: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/submitting-documents-using-real-world-data-and-real-world-evidence-fda-drug-and-biological-products

Framework for FDA’s real-world evidence program: https://www.fda.gov/media/120060/download

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Press release from dermatology experts on skin diseases: https://newsroom.submitmypressrelease.com/2022/01/05/top-dermatology-experts-from-across-the-world-unite-to-call-for-comprehensive-action-to-elevating-skin-disease_123684.html

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Press release from Sanofi: New, late-breaking data at EADV highlights emerging clinical profile of amlitelimab (formerly KY1005) in adults with inadequately controlled moderate-to-severe atopic dermatitis: https://www.sanofi.com/en/media-room/press-releases/2021/2021-09-30-12-30-00-2306183

Tralokinumab SmPC: https://www.ema.europa.eu/en/documents/product-information/adtralza-epar-product-information_en.pdf

WHO report on Psoriasis: https://apps.who.int/iris/handle/10665/204417

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Bieber, T. Disease modification in inflammatory skin disorders: opportunities and challenges. Nat Rev Drug Discov 22, 662–680 (2023). https://doi.org/10.1038/s41573-023-00735-0

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