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Poll

How do you most often manage patients affected by acne as a result of systemic tx?

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Stop systemic therapy
   
Switch to another systemic therapy
   
Prescribe a topical or systemic therapy for acne
   
Other/A combination of the above
   

Tutorial

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Poll

Which systemic tx do you use most often in paediatric pts with moderate–severe AD?

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Anti-IL-13 monoclonal antibody therapy
   
Anti-IL-4Rα monoclonal antibody therapy
   
Tyrosine kinase inhibitor therapy
   
Off-label systemic therapy/Never use systemic therapy
   

Tutorial

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Poll

Which of these burdens of AD tend to impact your paediatric patients the most?

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Mental health/psychological burden
   
Impact on sleep and activities of daily living
   
Treatment burden
   
Other
   
 
Understanding and assessing disease severity in children and adolescents with AD
Selection of systemic therapy for children and adolescents with moderate–severe AD
Practical management of side effects of systemic treatments for moderate–severe AD
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Atopic Dermatitis, Dermatological Conditions, Paediatric Dermatology CE/CME accredited

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Treating moderate-to-severe atopic dermatitis in children and adolescents: Insights from the experts

  • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Italian, Japanese, Simplified Chinese, Portuguese, Spanish.
  • A practice aid is available for this activity in the Toolkit
  • Downloads including slides are available for this activity in the Toolkit
Learning Objectives

After watching this activity, participants should be better able to:

  • Assess disease burden in paediatric patients with atopic dermatitis, including those affected on the hands and feet
  • Select systemic therapies for individual paediatric patients with moderate-to-severe atopic dermatitis based on the latest efficacy and safety data in the context of patient-specific factors
  • Apply effective strategies for monitoring and managing key side effects associated with systemic therapies for moderate-to-severe atopic dermatitis in paediatric patients
Overview

In this activity, dermatologists with expertise in atopic dermatitis (AD) respond to questions from the dermatology, immunology, paediatrics and primary care communities on managing moderate-to-severe AD in children and adolescents, including assessing the severity of AD, selecting systemic therapy and managing the potential side effects of systemic treatment.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

Allergists, dermatologists, dermatology nurses/nurse practitioners, immunologists, paediatric dermatologists, paediatricians and primary care physicians involved in the management of atopic dermatitis.

Disclosures

USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Prof. Dr. med. Diamant Thaçi discloses: Advisory board/panel fees from AbbVie, Almirall, Boehringer Ingelheim, Bristol Myers Squibb, Leo Pharma, Novartis, Pfizer and UCB. Consultancy fees from AbbVie, Almirall, Boehringer Ingelheim, Bristol Myers Squibb, Leo Pharma, Novartis, Pfizer and UCB. Grants/research support from AbbVie, Leo and Novartis. Speaker’s bureau fees from AbbVie, Almirall, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Leo Pharma, Lilly, Novartis, Pfizer, Roche-Posay, Sanofi and UCB.

Dr Benjamin Ungar discloses: Advisory board/panel fees from Arcutis Biotherapeutics, Bristol Myers Squibb, Castle Biosciences, Fresenius Kabi, Galderma, Janssen, Lilly, Pfizer, Primus Pharmaceuticals, Sanofi and UCB. Grants/research support from Bristol Myers Squibb, Incyte, Pfizer, Rapt Therapeutics and Sanofi.

Content Reviewer

Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Contributor

Sola Neunie has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have questions regarding credit please contact cpdsupport@usf.edu.

Accreditations

Physicians

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Nurses

USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

A maximum of 0.75 contact hour may be earned by learners who successfully complete this continuing nursing education activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

This activity is awarded 0.75 ANCC pharmacotherapeutic contact hour.

Date of original release: 01 October 2024. Date credits expire: 01 October 2025.

If you have any questions regarding credit please contact cpdsupport@usf.edu.

EBAC® Accreditation

touchIME is an EBAC® accredited provider since 2023.

This module is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 0.75 hours of effective education time.

The Accreditation Council for Continuing Medical Education (ACCME®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on mutual recognition on substantive equivalency of accreditation systems with EBAC®.

Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC® CE credits to AMA PRA Category 1 CreditsTM. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other healthcare professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 CreditTM.

Faculty Disclosure Statement / Conflict of Interest Policy

In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities.

Requirements for Successful Completion

Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

Time to complete: 48 minutes

If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

This activity is CE/CME accredited

To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

Claim Credit
  • Select in the video player controls bar to choose subtitle language. Subtitles available in English, French, German, Italian, Japanese, Simplified Chinese, Portuguese, Spanish.
  • A practice aid is available for this activity in the Toolkit
  • Downloads including slides are available for this activity in the Toolkit

Topics covered in this activity

Atopic Dermatitis / Dermatological Conditions / Paediatric Dermatology
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touchIN CONVERSATION
Treating moderate-to-severe atopic dermatitis in children and adolescents: Insights from the experts
0.75 CE/CME credit

Question 1/4
In a recent real-world study of the impact of atopic dermatitis on quality of life, what proportion of paediatric patients (age 0–11 years) reported a moderate or extreme impact of a flare on playing with or meeting friends?

Recent patient/caregiver survey data on the impact of flares on quality of life in paediatric (0–11 years, n=221) and adolescent (12–17 years, n=228) patients with moderate-to-severe atopic dermatitis, showed that 67% of paediatric patients and 80% of adolescents reported a moderate or extreme impact of flares on ‘playing with or meeting friends’.

Reference

Eichenfield L, et al. J Am Acad Dermatol. 2024;91(Suppl.):AB91.

Question 2/4
When considering tools to assess atopic dermatitis, which of these outcomes will you consider most important to define the severity of disease?

Clinical measures are important to define the severity of atopic dermatitis. Measures can be objective (physician-assessed disease severity) or subjective (patient-reported symptoms and quality of life outcomes). Both are important to assess, alongside clinical signs and characteristics, including location of the affected areas, in the overall judgement of disease severity. Tools commonly used for assessing atopic dermatitis severity include body surface area (BSA); Dermatology Life Quality Index (DLQI); Eczema Area and Severity Index (EASI); Patient Oriented Eczema Measure (POEM); pruritus Numerical Rating Scale (NRS); and SCORing Atopic Dermatitis (SCORAD). 

Reference

Gooderham MJ, et al. J Cutan Med Surg. 2018;22(Suppl.1):10S–16S.

Question 3/4
Your patient is a 16-year-old with moderate atopic dermatitis historically managed with topical therapies. Your patient explains that in recent months they’ve been experiencing more severe flare ups, with increasingly dry and itchy skin that is prone to cracking. They ask you if there are any other treatments available, as they are worried about the discomfort, and potential scarring. Based on updates reported at AAD 2024, which of the following might you consider next in the management of this patient?

AAD, American Academy of Dermatology.

Data presented at the American Academy of Dermatology 2024 congress showed that dupilumab improved skin barrier function and PROs. In the phase IV PELISTAD study, patients aged 6–11 yrs with moderate-to-severe atopic dermatitis treated with dupilumab (N=23) achieved improved median transepidermal water loss after 16 weeks vs baseline (28.1 g/m2/h; p<0.0001), that persisted to week 28 in both lesional (20.9 g/m2/h) and non-lesional (16.0 g/m2/h) skin (both p<0.01 vs baseline). Improvements in mean PRO scores at week 28 vs baseline were achieved, as measured by both the EASI (6.5 vs 34.8) and WI-NRS (2.0 vs 7.6), where a decrease in score indicates improvement.1,2

Abbreviations

EASI, Eczema Area and Severity Index; PRO, patient-reported outcome; WI-NRS, Worst Itch Numerical Rating Scale.

References

  1. Cork MJ, et al. J Am Acad Dermatol. 2024;91(Suppl.):AB34.
  2. Cork MJ, et al. Presented at: 2024 AAD Annual Meeting, San Diego, CA, USA. 8–12 March 2024. Poster #53081.
Question 4/4
Your patient is a 14-year-old with severe atopic dermatitis. Following discussions with the child and their parents, you are about to initiate treatment with a systemic biologic therapy, as current topical therapies are not achieving adequate disease control. Which of the following would you consider including as part of the patient’s management plan?

Conjunctivitis is a known side effect of systemic biologic therapies, alongside injection-site reactions.1,2 Nasopharyngitis and infections are associated with systemic Janus kinase inhibitor therapies.1

Patients with conjunctivitis may experience dry and itchy red eyes, tearing and foreign body sensation, and an eczematous rash around the eyes. Previous history of conjunctivitis and more severe atopic dermatitis prior to initiation of systemic biologic therapy may be risk factors for conjunctivitis on treatment.2 According to American2 and European guidelines,3 some clinical protocols suggest a baseline ophthalmology examination and the use of lubricant eye drops when biologic therapy is initiated; however, it should be noted that practices may vary.2,3

References

  1. Butala S, Paller AS. J Allergy Clin Immunol. 2023;151:681–5.
  2. Chu DK, et al. Ann Allergy Asthma Immunol. 2024;132:274−312.
  3. Wollenberg A, et al. J Eur Acad Dermatol Venereol. 2022;36:1409–31.
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