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Atopic Dermatitis Learning Zone

Expert Opinion

Read time: 30 mins
Can PDE4 inhibitors address the unmet needs in treating atopic dermatitis? Professor Michael Cork answers difficult questions about our current understanding of PDE4 inhibitors and how they differ to standard treatments for atopic dermatitis.

Meet our expert Michael Cork, a Professor of Dermatology in the Department of Infection, Immunity and Cardiovascular Disease at the University of Sheffield, United Kingdom. With a special interest in the treatment atopic dermatitis, Professor Cork sees a broad spectrum of patients, including some of the most severe cases of atopic dermatitis in the UK and internationally.


In this expert interview, discover the impact of atopic dermatitis on patient quality of life and the unmet needs that remain in treating this disease. Find out how the phosphodiesterase-4 (PDE4) enzyme fits into the pathophysiology of atopic dermatitis and how PDE4 inhibitors compare to topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI). Also glimpse into the future, as Professor Cork describes upcoming clinical trials of comparing PDE4 inhibitors to TCS for the treatment of atopic dermatitis.

What impact can atopic dermatitis have on patients?

As a chronic relapsing inflammatory skin condition, atopic dermatitis can have a huge influence on many aspects of a patient’s life. From interfering with work to negatively affecting sleep and mental health, learn about the profound impact on the lives of patients with atopic dermatitis.

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What are the unmet needs in treating atopic dermatitis?

The majority of patients surveyed with mild, moderate or severe atopic dermatitis have described themselves as being not satisfied or only fairly satisfied with current available treatments1. In this video, Professor Cork shares the significant unmet needs that remain in the treatment of atopic dermatitis.

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How is PDE4 involved in the pathophysiology of atopic dermatitis?

Professor Cork describes the central role of the PDE4 enzyme in regulating the release of a variety of inflammatory cytokines involved in the development of atopic dermatitis.

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Why is PDE4 an attractive therapeutic target?

Limited choices in the range of topical treatments for atopic dermatitis has led to a great interest in developing new non-steroidal anti-inflammatory therapies. Find out why PDE4 inhibitors have become a therapeutic target of interest, with Professor Cork, in this short video.

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What affects treatment compliance in atopic dermatitis?

Fear of topical steroids has been observed in over 80% of patients and parents4,5, leading to an impact on treatment compliance5. Professor Cork discusses the difficulty of using TCS treatment because of steroid phobia and whether these fears are justified.

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How do topical PDE4 inhibitors differ from oral options?

Topical therapies can provide significant advantages over oral forms of the same drug. In this video, Professor Cork describes the differences between topical and oral PDE4 inhibitors and the benefits topical treatments can provide.

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What are the main limitations of topical corticosteroids and calcineurin inhibitors?

Current guidelines recommend TCS and TCI for atopic dermatitis, but their safe and effective use requires adequate potency, sufficient dosage and correct application6. Here, Professor Cork explains the main limitations of using these recommended treatments.

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How is PDE4 currently being evaluated in clinical trials for atopic dermatitis?

Previous phase three clinical trials have provided significant efficacy and safety data that led to the approval of a PDE4 inhibitor for the treatment of mild to moderate atopic dermatitis7. However, more research is needed to understand the effect of PDE4 inhibitors on the skin. In this video, Professor Cork explains the trials that are currently on pause in Europe that will directly compare TCS with PDE4 inhibitors.

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References

  1. Paller AS, Mcalister RO, Doyle JJ, Jackson A. Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr (Phila). 2002;41(5):323–332.
  2. Purushothaman B, Arumugam P, Kulsi G, Song JM. Design, synthesis, and biological evaluation of novel catecholopyrimidine based PDE4 inhibitor for the treatment of atopic dermatitis. Eur J Med Chem. 2018;145:673–690.
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