Many systemic drugs effective as off-label options in dermatology

MAUI, HAWAII — Dermatologists who visit the website for Dupixent may be inclined to believe the monoclonal antibody only treats atopic dermatitis, asthma and chronic rhinosinusitis. Similarly, a glance at Stelara’s website may prompt readers to think it only treats Crohn’s disease and ulcerative colitis.

However, James Treat, MD, associate professor of pediatrics and dermatology, Perelman School of Medicine at the University of Pennsylvania, told Maui Derm attendees that those websites only tell part of the medications’ stories.

Treat noted the following potential dermatological uses for prescription drugs.

• Dupixent (dupilumab, Sanofi and Regeneron Pharmaceuticals): contact dermatitis, chronic urticaria, itch, alopecia areata and eosinophilic annular erythema;
• Stelara (ustekinumab, Jannsen Biotech): atopic dermatitis, deficiency of the IL-36R antagonist or DITRA, hidradenitis and acne;
• Xeljanz (tofacitinib, Pfizer): vitiligo;
• Xolair (omalizumab, Genentech and Novartis): mastocytosis;
• Enbrel (etanercept, Amgen): Stevens-Johnson syndrome; and
• Methotrexate: alopecia areata.

Treat noted that off-label use of medications help future patients, as well.

“There are lots of pathways [for different drugs] that have been elucidated, which has led to much better therapy,” he said. “But we can then use that therapy to target other diseases that affect the same pathways. And when they affect the same pathways, the drugs can help to see whether the pathways are actually true or not.” – by Janel Miller

Reference: Treat J. Alternative uses for systemic drugs in pediatric dermatology. Presented at: Maui Derm for Dermatologists; Jan. 25-29, 2020; Maui, Hawaii.

Disclosures: Treat reports writing chapters for UpToDate and being an author for Andrew’s Diseases of the Skin.