ATOPIC dermatitis (AD) is a chronic inflammatory skin condition with diverse manifestations across different body regions, complicating its diagnosis and management. The Eczema Area and Severity Index (EASI) is widely used to assess AD severity, measuring signs like erythema, excoriation, oedema, and lichenification across regions such as the head and neck, trunk, and extremities. Despite extensive treatment guidelines, managing AD remains challenging, especially in sensitive areas like the face and neck, where thin skin and environmental exposure exacerbate the condition.
Recent therapeutic advances focus on targeting the underlying immune dysregulation in AD. The chronic nature of AD is linked to pathogenic T cells, which drive inflammation through multiple pathways. New treatments include Janus kinase (JAK) inhibitors and biologics targeting interleukin (IL)-4 and IL-13. However, these therapies may not fully address symptoms in harder-to-treat areas, such as the head and neck, where patients often experience more severe impacts on quality of life.
Rocatinlimab, a monoclonal antibody targeting the OX40 receptor on T cells, offers a novel approach. By reducing pathogenic T cells and modulating inflammatory pathways, rocatinlimab addresses both acute and chronic aspects of AD. In a phase 2b trial, patients with moderate-to-severe AD treated with rocatinlimab demonstrated significant and sustained improvements in EASI scores across all anatomic regions, including the challenging head and neck area. These benefits were maintained even 20 weeks after discontinuing treatment, suggesting a potential for long-term remission.
Improvements in EASI scores were seen as early as two weeks, with notable gains in erythema and lichenification, which are common in the head and neck. Notably, fewer patients experienced relapse in this region compared to others. These findings highlight rocatinlimab’s potential to address unmet needs in AD management, offering both rapid symptom relief and durable improvement.
Future research will focus on its efficacy in specific subregions and its impact on patient-reported outcomes, paving the way for a more targeted approach to managing moderate-to-severe AD.
Reference
Guttman-Yassky E et al. Durable improvements in atopic dermatitis in the head and neck and across other anatomic regions with rocatinlimab. Arch Dermatol Res. 2024;316(10):747.
