Lawrence Eichenfield, MD

Chief of Pediatric and Adolescent Dermatology
Rady Children's Hospital-San Diego
Vice Chair, Department of Dermatology
Professor of Dermatology and Pediatrics
UC San Diego School of Medicine

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What is the prevalence of AD in various age groups and what is the range of clinical phenotypes in the pediatric and adolescent age groups? What is the impact on the individual patient, and how do co-morbidities make management challenging?

Lawrence Eichenfield, MD

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What is the rationale and evidence that supports prompt, intensive, severity-of-disease-appropriate management of moderate-to-severe AD in the pediatric and adolescent age group?

Lawrence Eichenfield, MD

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Can you align the heterogeneous range of clinical phenotypes seen in children and adolescents with AD to the appropriate severity-of-disease metrics that would trigger specific therapies?

Lawrence Eichenfield, MD

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What are the triggers and phenotypes in the pediatric age group that consensus, guidelines, and evidence suggest should be treated with topical therapies, and what symptomatic, historical, or skin-based findings suggest a need to intensify therapy?

Lawrence Eichenfield, MD

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How do you select among systemic agents for moderate-to-severe AD, including systemic immunotherapy with dupilumab? Where does this IL-4/IL-13 inhibitor fit into sequencing of therapy in pediatric and adolescent patients?

Lawrence Eichenfield, MD

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What is the rationale for deploying a biologic such as dupilumab that inhibits type 2 cytokine signaling? What symptoms—itch, redness, and systemic burden—in pediatric and adolescent patients are ameliorated by targeted inhibition of IL-4 and IL-13?

Lawrence Eichenfield, MD

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In light of the recent approval (May 2020) of dupilumab for AD in pediatric patients between the ages of 6 and 11 years of age, can you review the evidentiary basis for this approval based on clinical trials, and the practical implications?

Lawrence Eichenfield, MD

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Can you share a case of a pediatric patient with severe AD, in whom you intensified therapy with dupilumab, and what the outcome was? How did the discussion evolve with the family and what end points were affected after how many months of therapy?

Lawrence Eichenfield, MD

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Since systemic immunotherapy targeting type 2 cytokine signaling will likely be started in younger pediatric populations, for what duration of therapy do you recommend with cytokine-inhibiting biologics such as dupilumab?

Lawrence Eichenfield, MD

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Can you describe a patient with AD who has more moderate but persistent disease, who is doing fairly well, with topical treatments, but in whom you felt intensification with a systemic type 2 cytokine-signaling inhibitor was appropriate?

Lawrence Eichenfield, MD

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How would you summarize the status of the current arsenal for AD and, in particular, the degree to which new systemic therapies are addressing the unmet for long-term disease management in the pediatric and adolescent population?

Lawrence Eichenfield, MD