New therapy option against eczema successfully tested
Atopic dermatitis is a chronic skin disease that has become more prevalent in recent decades. Although mild forms of the disease can often be dealt with relatively well with external treatments, there is still little hope for those affected by severe atopic dermatitis. This could change soon, thanks to a new form of therapy.
"The disease affects about eleven percent of all girls and boys in preschool age and one to two percent of adults in Germany, many of the disease is chronic and difficult," reports the Hannover Medical School (MHH). Those affected suffer from dry, flaky and reddened skin that itches agonizing and if the affected areas are clearly visible, a social stigma is added. Efficient treatment options are therefore urgently needed – but these were not yet available for the severe forms of the disease. However, researchers at the MHH and the University of Veterinary Medicine Hannover (TiHo) have successfully tested a new approach. Their findings were published in the journal "Journal of Allergy and Clinical Immunology".
Severe eczema only partially treatable
"Atopic dermatitis has different causes, including irritants, allergens and microbial, hormonal and psychological influences," explain the experts. In the treatment of cortisone compounds and so-called calcineurin inhibitors to be applied externally have been of central importance. According to the experts, only the immunosuppressant cyclosporin, which has many side effects, and the antibody dupilumab are available for the treatment of particularly severe forms.
Dupilumab slightly difficult in use
Dupilumab has been available for the targeted inhibition of messengers of allergic inflammation for about a year and "represents a huge step forward in the treatment of critically ill patients," said Professor Dr. med. Thomas Werfel from the MHH Clinic for Dermatology, Allergology and Venereology. However, it does not help all patients well enough. In addition, the drug must be injected, which is particularly difficult to tolerate children who are particularly likely to suffer from eczema. The now tested, new drug is, however, intended for oral use.
New active substance for oral use
The new active substance, which can be taken as a tablet, had significantly improved the skin appearance in the tests on 98 patients. "Already after eight weeks, the proportion of diseased skin such as the redness, blisters and scratch marks reduced by half," said the MHH. The drug is a "histamine-4 receptor blocker". This interrupt the process of inflammation and relieve itching by preventing the messenger histamine from acting on the corresponding cells.
Histamine-4 receptor with a key role
"Laboratory and in vivo results in the mouse model, which we have been continuously publishing since 2005, suggested that the histamine-4 receptor is an interesting target for the treatment of atopic dermatitis," explains Professor. Werfel. Since then, researchers have intensively researched the use of inflammatory skin diseases. "We assume that the histamine-4 receptor blocker works independently of the cause of atopic dermatitis and are currently investigating which patients can benefit most from the new therapy," said Professor Werfel.
No side effects detected
According to the scientists, no side effects were observed in the current study, which were due to the administration of the drug and now, with the participation of the team from Hanover, a larger international study with about 400 patients will start to find the optimal dosage of this drug. "We have been working together on this topic for many years. The project is a very good example of translational research, ie of interdisciplinary medical research with the aim of translating results as quickly as possible into clinical application, "said Professor Dr. med. Manfred Kietzmann of the Institute of Pharmacology, Toxicology and Pharmacy of TiHo. (Fp)