Dermatology researchers at the University of Oregon recently published two Phase 3 trials of Dupilumab in eczema. Phase 3 trials are the ones that can lead to FDA approval of a new drug. These trials were very successful.
Dupilumab is a human monoclonal antibody against interleukin-4 receptor alpha. Interleukin-4 is a cytokine (inflammatory molecule) that is an important cause of allergic eczema. The studies were done on 1,500 patients with moderate-to-severe eczema that was not responding to topical medications. In one of the trials, patients received injections of Dupilumab weekly, and in the other trial the injections were every two weeks. Both groups showed more than a 75% improvement in their rash compared to placebo. Not only did the rash improve, but there also was great reduction in itching and anxiety/ depression. Finally, quality of life assessments showed marked improvement. In people with moderate-to severe eczema skin rash can cover large parts of the body’s surface. This rash is accompanied by intense, persistent itching which leads to sleep deprivation and symptoms of anxiety and depression. For many people with this measure of eczema, topical therapies just don’t work. The available systemic treatments are often associated with significant toxicity or side effects. Hence, there is a great need for a safe and effective long-term therapy. Dupilumab seems to fit this need. The two main side effects were injection site swelling (8 to 19%) and conjunctivitis (2 to 5%).
Although it’s been suspected that hard water contributes to the development of eczema in infants, the premise had never been scientifically researched until investigators at St. George’s University in Canada have now proven it is so.
Hard water (water with high calcium content) and water with higher chlorine content were both found to increase the likelihood of eczema in infants by 46%.
The investigators also found the installation of a water softener removed this increased risk.
Just-published research of eczema in children – and the accompanying sleep interruption it causes the kids and their parents – has led to a recommended treatment.
University of Nevada researchers compared the benefit of antihistamines versus topical steroids to control the itch/scratching in children with eczema.
They found that both forms of therapy were effective. In fact, they were equally good in preventing sleep disturbance from nocturnal itch – a particularly vexing symptom for families because it causes significant loss of sleep.
And, because the children are unattended in bed, their scratching often causes significant trauma to their skin. All but five percent of the Nevada study group responded positively to the use of antihistamines.
This led the researchers to recommend their use in all children with eczema
Eczema affects up to 20 percent of the population and its incidence is steadily increasing. Eczema is often difficult to treat because it is a multi-factorial disease with numerous causes and triggers.
One therapy that has gone in and out of favor is the use of antihistamines. Proponents argue about their benefit based on positive responses in many patients. Detractors argue that they don’t help everyone, and that all they are capable of doing is controlling the itch, not really healing the cause.
New research from the Medical University of Vienna is putting antihistamines back in the spotlight. Scientists there have discovered that persistent histamine levels in the skin tissue speed the growth of skin cells, thus contributing to the scaling and itching that are hallmarks of eczema.
Keeping the histamine receptors focused on skin cells blocked with a maintenance dose of antihistamine can prevent the cell growth stimulation.