Dermatology

Tralokinumab shows durable efficacy and reassuring safety in AD up to 6 years

In the ECZTEND open-label extension, 1672 patients ≥12 years with moderate-to-severe atopic dermatitis received long-term tralokinumab after prior exposure in parent trials. Median exposure was 2.6 years, and 68.4% completed their intended trial period, with only 7.1% discontinuing for lack of efficacy. Treatment-emergent adverse events occurred at 114.3 per 100 patient-years, were >97% nonserious, mostly mild or moderate, and largely judged unrelated to tralokinumab. Efficacy improved during the first 16 weeks and then stabilized through week 248, with ≥50% maintaining IGA 0/1 and EASI-90 and ≥80% EASI-75 responses. 1

Dupilumab and tralokinumab rank favorably for airway events in systemic AD therapy

This network meta-analysis pooled 26 randomized trials with 13,069 atopic dermatitis patients treated with biologics or JAK inhibitors versus placebo. Compared with nemolizumab 90 mg, dupilumab 300 mg and tralokinumab 150 mg significantly reduced asthma risk based on relative risk estimates. SUCRA rankings suggested tralokinumab 150 mg had the lowest asthma-related adverse event risk among assessed regimens. For allergic rhinitis, dupilumab 200 mg ranked best, whereas abrocitinib 100 mg had the highest combined risk of asthma and allergic rhinitis. 2

Switching oral JAK inhibitors benefits many patients with severe alopecia areata

This multicenter retrospective review included 108 patients with severe alopecia areata who switched oral JAK inhibitors after at least 6 months on a prior agent. On the second JAK inhibitor, 48.8% achieved SALT ≤20 and 32.6% achieved SALT ≤10, indicating substantial regrowth in nearly half. Among 21 patients receiving a third JAK inhibitor, 52.4% reached SALT ≤20 and 38.1% SALT ≤10, suggesting further salvage potential. Response to the first JAK inhibitor predicted response to the second, with an odds ratio of 3.33 for achieving SALT response. 3

Agent Orange exposure linked to higher acral melanoma risk in US veterans

This nested case-control study identified 1292 veterans with acral melanoma and matched them to nonacral melanoma controls and controls without melanoma in the VA system. Agent Orange exposure increased odds of acral melanoma versus cutaneous melanoma and versus non-melanoma controls, with adjusted odds ratios around 1.3. Current smoking was associated with lower acral melanoma odds compared with both control groups, despite known systemic harms. Prior keratinocyte carcinoma and actinic keratoses were associated with higher acral melanoma odds compared with controls without melanoma. 4