Abby L. Allen, RN, NP: Update on Biologics for Atopic Dermatitis

The use of biologics is a hot topic during the American College of Allergy, Asthma and Immunology (ACAAI) 2023 Annual Scientific Meeting in Anaheim, California, and is featured in many sessions, including an update within the advanced practice health care providers track.

Abby L. Allen, RN, NP, spoke during the session about the use of biologics in atopic dermatitis. Following the session, she spoke with Dermatology Times andshared her insights on biologics, current challenges in treating atopic dermatitis, and the importance of the allergist-dermatologist collaboration. Allen is a nurse practitioner in Delaware and Chairperson of the Allied Health Committee for ACAAI.

“Atopic dermatitis is a very terrible inflammatory condition that affects many children and adults in the United States ,so it's exciting to have so many tools to help in the management of this condition. In the presentation, we highlighted some of the newer options that have been released, including the JAKs, which are really helpful, as well as dupilumab, which has been proven to be a great tool in the management of the atopic dermatitis and the biologic therapies.

“There are a lot of challenges in treating these patients; this is a chronic condition, so that's very difficult to deal with. A lot of these patients are sleep deprived, and they are up all night itching. We have these wonderful therapies, but sometimes it takes a while to get approval, and that can be really difficult for the patients. Sometimes we have lapses in therapy, because we’re waiting for renewal from the insurance company. So, that's a bit of a struggle.

“[When supporting youth patients,] we want parents to come away feeling comfortable with whatever treatment option we choose. I do think that, for the most part, the safety profile that we can get for patients 6 months and up is amazing. And yes, there are some things to watch out for, but I think just making them be aware it; saying, ‘Hey, these are some things that we have seen’ makes them feel a lot more comfortable. We don't want them going home and just reading the brochure and saying, ‘Oh my gosh, they didn't tell me this.’

“I think it is important to be aware of mental health issues and patients saying they are feeling that way. It is common, and I also think that a lot of people don't want to talk about it. So kind of letting them know, ‘Hey, people with your condition a lot of times have trouble sleeping and feel a little bit more anxious and maybe a little bit more depressed.’ And then asking them if they're feeling that way. And I think once they realize like, ‘Hey, it's not just me,’ that makes them feel a little bit better about it as well.

“There's a lot of misconceptions and how to take care of atopic dermatitis. So one of the first things that I'll ask is how often are they bathing? What moisturizer are they using? And a lot of times you uncover a lot of problems that way. Patients are really thankful that you're really digging deep into their regimen and then go through treatment options. If they're well aware of everything, I think they feel more comfortable and how to proceed.

“I think we dermatologists and allergists collaborate really well. For the most part, in my area, a lot of our dermatologists just prefer that we take care of atopic dermatitis. I think a lot of times they identify this patients and they say there's a lot more going on here, because that is part of the atopic condition, and they refer them to allergy. And then sometimes we’ll see a patient and realize it isn't atopic dermatitis, and then we send them to our derm colleagues. So it's a good working relationship.”

Transcript has been edited for style and space.