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Pharmacy and Wellness Review

Abstract

Atopic dermatitis is a common chronic inflammatory skin disease that affects millions of children and adults in the United States. Atopic dermatitis is characterized by recurrent pruritus, erythema, and relapsing symptoms that can significantly impair quality of life. The pathophysiology of atopic dermatitis involves epidermal barrier dysfunction, immune dysregulation, and genetic susceptibility. Atopic dermatitis guidelines follow a stepwise approach that begins with a severity assessment, trigger avoidance, and nonpharmacologic and pharmacologic treatments. First-line therapies include topical corticosteroids (TCSs), topical calcineurin inhibitors (TCIs), and emollients. Crisaborole and topical ruxolitinib are used for mild-to-moderate disease when prior therapy has been inadequate. Monoclonal antibodies and other systemic agents are reserved for patients with moderate-to-severe atopic dermatitis. Rocatinlimab is a new injectable monoclonal antibody that inhibits T-cells by targeting the OX40 receptor, thereby reducing the autoimmune response in moderate-to-severe atopic dermatitis. The safety, efficacy, and tolerability of subcutaneous rocatinlimab in patients with moderate-to-severe atopic dermatitis have been evaluated in two pivotal trials: ROCKET-IGNITE and ROCKET-HORIZON. The ROCKET-IGNITE and ROCKET-HORIZON trials demonstrate that rocatinlimab yields statistically significant, clinically meaningful improvements in patients with atopic dermatitis compared with placebo.

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