Great results for a serious illness with new therapy

A new treatment option for eczema has been successfully tested

Atopic dermatitis is a chronic skin condition that has become more common in recent decades. Although mild forms of the disease can often be dealt with relatively well with external treatments, there are few hopes for those affected by severe atopic dermatitis. It may soon change due to a new type of therapy.

"The disease affects about eleven percent of all girls and boys at pre-school age and one to two percent of adults in Germany, many diseases are chronic and complex," says Hannover Medical School (MHH). Those who have suffered suffer from dry, flaky and reddened skin, which is itching agonizing and, if the affected areas are clearly visible, is accompanied by social stigma. Effective treatment options are therefore urgently needed, but they were not yet available for severe forms of the disease. However, a new approach has been successfully tested by MHH and the University of Veterinary Medicine Hannover (TiHo). Their findings were published in the Journal of Allergy and Clinical Immunology.

Severe eczema is only partially treatable

"The causes of atopic dermatitis are diverse, including irritants, allergens, and microbiological, hormonal, and psychological effects," experts say. Cortisone compounds and so-called calcineurin inhibitors have played a key role. According to experts, only immunosuppressants with ciclosporin, which have many side effects, and dupilumab antibodies are available for the treatment of particularly severe forms.

Dupilumab is slightly usable

Dupilumab was available for targeted replacement of allergic inflammatory messengers for about a year and "is a big step forward in the treatment of critical patients," said Professor Dr. med. Thomas Werfel of the MHH Dermatology, Allergology and Venereology Clinic. However, this does not help all patients well enough. In addition, drugs should be injected, which is particularly difficult to tolerate children who are particularly affected by eczema. The newly tested drug is now for oral use.

New active ingredient for oral use

The new active substance that can be used as a tablet has significantly improved the appearance of the skin in tests with 98 patients. "Already after eight weeks, the proportion of the affected skin, such as redness, blisters and scratches, fell by half," said MHH. The drug is "histamine-4 receptor blockers". It stops the inflammatory process and relieves itching by preventing the effect of messenger histamine on the cells concerned.

Histamine-4 receptors play a key role

"Laboratory and in vivo results in the mouse model that we have published since 2005 show that the histamine-4 receptor is an interesting target for the treatment of atopic dermatitis," the professor explains. Werfel. Since then, researchers have been intensively researching the use of inflammatory skin diseases. "We assume that the histamine-4 receptor blocker works independently of the cause of atopic dermatitis and is currently studying which patients can benefit the most from new therapies," said Professor Werfel.

No side effects were found

According to scientists, no adverse drug reactions were observed in this study and now, with the participation of the Hanover team, a larger international study with about 400 patients will start to find the optimal dose of this medicine. "We have been working together on this for many years. The project is a very good example of broadcasting research, an interdisciplinary medical research aimed at translating the results into clinical use as soon as possible," said Professor Med. Manfred Kietzmann of TiHo Pharmacology, Toxicology and Pharmacy. Institute (Fp)