Poon discussed a community health needs survey and how the “model minority” myth can impact care for Asian Americans.

Identifying Unique Health Challenges of AAPI Populations, with Adrienne Poon, MD, MPH

Asian American and Pacific Islander (AAPI) populations are often overlooked in health care due to the model minority myth, which portrays these individuals as uniformly successful and without significant health or socioeconomic disparities and can contribute to gaps in research, policy, and healthcare access. In reality, AAPI communities are diverse and should be looked at in a disaggregated way to better understand and target unique health challenges of these populations.

Adrienne Poon, MD, MPH, associate professor of medicine at George Washington University, presented research investigating community health needs of AAPI populations in the greater Washington, DC, area at the 

American College of Physicians (ACP) Internal Medicine (IM) Meeting 2025

, held April 3-5, in New Orleans, Louisiana.

HCPLive spoke with Poon to learn more about the study and some preliminary findings. Some preliminary findings of note include high rates of hyperlipidemia, diabetes and hypertension in Vietnamese Americans, high rates of depression in Chinese Americans, and high rates of anxiety in Indian Americans, posing an alarming pattern in the field.

Poon gave an overview of how she and her colleagues conducted the survey and shared further research that she would like to do in looking at health disparities in AAPI populations. She also discussed some factors clinicians should keep in mind when treating AAPI patients and stressed the importance of conducting this research.

“[Sharing] ways to promote a healthy lifestyle is really important for the patients, but also in a way that… works for them and their families… I've heard people say in the community [that some of the guidance] is not the most culturally appropriate. So, trying to work with them to find strategies that are tailored towards an individual, I think is important,” Poon told 

Poon has no relevant disclosures to report.

Poon AN. Debunking the Model Minority Myth: Preliminary Findings for a Community Health Needs Assessment for Asian American, Native Hawaiian, and Pacific Islander Health Disparities in Greater Washington DC. Presented at: ACP IM Meeting 2025; April 3-5; New Orleans, Louisiana.

Adrienne Poon, MD, MPH

Afif El-Hasan, MD

Amy Spizuoco, DO, is a dermatologist, dermatopathologist, and Mohs surgeon based in New York City as well as a clinical instructor in the Department of Dermatology at The Icahn School of Medicine at Mount Sinai.

Top Clinical Insights from SDPA 2025: Eczema, Alopecia, Burnout, Vitiligo, JAK Inhibitors

In late June, physician assistants convened at the 

SDPA Annual Summer Dermatology Conference

 in Washington, DC, from June 25 – June 29th, to attend talks from other physician assistants and clinicians.

in people of color. This edition of HCPLive Five spotlights interviews on tips for treating chronic hand eczema, using trichoscopy to differentiate alopecia subtypes, preventing career burnout, breaking down vitiligo misconceptions, and the workup before initiating JAK inhibitors for alopecia.

Tips to Optimize Diagnosis, Management of Chronic Hand Eczema with Adam Friedman, MD

Adam Friedman, MD, professor, chair of dermatology, and director of the Supportive Oncodermatology Program at The George Washington University School of Medicine & Health Sciences, shared clinical insights on diagnosing and managing chronic hand eczema (CHE), emphasizing its diagnostic complexity. CHE has symptoms that overlap with conditions, such as psoriasis, lichen planus, and secondary syphilis. In his interview, Friedman underscored the importance of patient history, especially recurrence, duration, and occupational exposure, and highlighted visual cues to differentiate CHE from other dermatoses.

He also noted that CHE often lacks sharp demarcation, unlike palmoplantar psoriasis, which favors pressure-prone areas. Recognizing patterns like lichenification and confluence helps inform diagnosis.

Trichoscopy Provides Clearer Differentiation of Alopecia Subtypes, With Amy Spizuoco, DO, FAOCD

Amy Spizuoco, DO, FAOCD, a board-certified dermatologist at True Dermatology and a clinical instructor at Mount Sinai, highlighted how trichoscopy enhances diagnostic accuracy in alopecia by revealing key patterns such as black dots, yellow dots, exclamation hairs, and follicular loss. She explained that recognizing these visual cues, like exclamation hairs in alopecia areata or follicular plugging in telogen effluvium, can distinguish scarring from non-scarring forms and guide proper treatment.

Discussing Ways to Help Clinicians Facing Career Burnout, with Hope Cook, PA-C

Hope Cook, PA-C, a physician associate from Georgia Skin Cancer & Aesthetic Dermatology, shared strategies for addressing clinician burnout, emphasizing that burnout is not the end—it can mark a new beginning.

In her session and interview, she introduced her CPR framework: Cocooning (inner reflection and awareness), Planning (evaluating what needs to change), and Revamping or Resigning (deciding whether to reshape or leave one’s role). Using a controlled burn metaphor, Cook illustrated how burnout can clear space for growth and career renewal. Drawing from her book (“Healing Clinician Burnout: How to Revive Your Life and Career”) and podcast, she offered practical, realistic steps clinicians can take to move from feeling stuck to rediscovering purpose in their professional lives.

Breaking Down Vitiligo Misconceptions at SDPA 2025, With Gina Mangin, PA-C

Gina Mangin, MPAS, PA-C, from Sand Lake Dermatology Center, addressed common vitiligo misconceptions, underlining that treatment is possible, even after years of the disease. In an interview, she highlighted the importance of using a Wood’s lamp to confirm diagnosis, especially in patients with skin of color.

Mangin discussed when to escalate to systemic therapy, using markers like rapid progression, confetti depigmentation, and inflammatory borders to assess disease activity. She also said harder-to-treat areas like hands and feet may require both topicals and phototherapy. With new therapies emerging alongside narrowband UVB, Mangin shared her optimism about re-pigmentation and maintaining results through an aggressive, tailored approach.

The Workup Before Initiating a JAK Inhibitor for Alopecia, With David Cotter, MD, PhD

David Cotter, MD, PhD, an assistant clinical professor at the University of Nevada, outlined key steps in evaluating patients with alopecia areata before starting a JAK inhibitor. His recommended workup includes a CMP, fasting lipids, TB and hepatitis B screening, QuantiFERON gold, and often varicella zoster titers—even beyond guideline recommendations—to assess shingles risk. He also considers pregnancy and HIV testing when appropriate.

Cotter stressed that clinicians should feel confident prescribing JAK inhibitors, as long as baseline labs are clear. Follow-up labs are crucial at 12 weeks, with frequency adjusted by patient risk. While many patients see significant regrowth, safety monitoring remains essential throughout treatment.

Check out insights from SDPA 2025 on eczema, alopecia, vitiligo, burnout, and JAK inhibitor workups—key tips to improve dermatology care.

HCPLive Five at SDPA 2025

Amy Spizuoco, DO

Dermatological experts discuss challenges that are associated with the use of standard and emerging treatments in special patient population.

Patient Subgroups and Educational Opportunities in Rare Dermatological Disorders

Benjamin Kaffenberger, MD

Closing Reflection: A Journey of Understanding and Resilience

Video content above is prompted by the following:

How do you think advancements in paroxysmal nocturnal hemoglobinuria care will impact the patient and caregiver experience in the future?

Are there any aspects of your care or communication with your health care team that you feel could be improved?

This program was made possible with support from Novartis Pharmaceuticals.

Panelists discuss how emerging treatments, digital health tools, and enhanced care coordination could streamline disease management and improve quality of life while identifying opportunities to strengthen provider communication and access to resources.

Brandi Lewis

Raffi Tachdjian, MD, MPH, FAAAAI, FACAAI: 

Let’s switch gears to barriers in the use of biologics in clinical practice. Dr White, do you see any trends or utilization differences, with the penetration of therapeutics, into the lives of patients with severe asthma, moderate to severe asthma, eosinophilic asthma, and difficult-to-treat asthma, among primary care providers or physicians vs the specialists?

In terms of thinking about how you titled this section, the barriers, I haven’t seen much of a trend of use in primary care physicians for biologics. There are multiple reasons for that. There’s a lot of what we’ve outlined, how complex it can be to decide what agent you might start a patient on. There’s going to be a barrier there. There’s definitely going to be a barrier in the ability to get insurance approval because these require some specialization in terms of the office staff and nursing staff shepherding it through the approval process. A lot of primary care practices may not have that infrastructure built in. I haven’t seen a big uptake in my area with primary care physicians using respiratory biologics.

But what I have seen is a lot more willingness to use these biologics at the point where it’s determined that they’re necessary. Because previously, 5 or 6 years ago, there was this sense that you’d start 1 or 2 of your worst patients on this and see how things would go for them, if these made a big change. In the allergy and immunology space, I definitely think we’ve seen a lot of comfort, recognizing that once a patient is poorly controlled, we need to think about these biologics. We have a lot of comfort using them now. They’re very safe. They’re very effective.

The other group I’ve seen a lot of uptick in is with our pulmonary colleagues, who also see a lot of asthma. Before these newer biologic agents, they may not have been using omalizumab in their practices for a variety of reasons, but now they’re much more willing and comfortable using these. It’s the same idea, reserving it for not just the very worst of the worst or the steroid-dependent asthmatics but also starting to more routinely consider this. At my institution, Scripps Health, it’s been great. We have a lot of sharing patients. Patients may have some confusion about what might be the best biologic, so they consult with us and still have a lot of their care directed by pulmonary. Those are the trends. I’ll bet it’s different in different parts of the country. Dr Chase and Dr Siri, I’m curious if you’ve noticed anything or any trends in your own practices.

 Overall we’ve seen similar trends with primary care providers. There’s a better awareness among primary care providers, who know that patients are coming and asking about these medications. Some have been talking with family members or friends who may have exposure to them. Others have been seeing television commercials of individuals breathing better, and wondering how they can be in that same category. The uptake has been higher with pulmonary colleagues over time. I hope they’ve learned that everyone in allergy is very friendly. A call to inquire about whether this patient is a good candidate for a biologic is much more common than ever before.

 There’s increased recognition from allergists that we’re allergy, asthma, and immunology experts. We’ve seen a lot of good collaboration with our pulmonary colleagues as well as our primary care doctors. Primary care has so many challenges, such as limited time. It’s helpful that there has been an increased movement toward biologics. There’s more understanding and education into what’s considered uncontrolled, what we accept as a number of exacerbation rates and corticosteroid systemic burdens over time. It’s been really helpful.

Raffi Tachdjian, MD, MPH, FAAAAI, FACAAI:

 A couple of weeks ago, I had a patient come in on a follow-up with his wife and son. I thought, “They must be on their way to go shopping or to a restaurant.” It was the son who said, “Thank you for giving me my father back, because now I can play sports with him. He can breathe.” My patient was nodding; he’s a man of a few words. Those scenarios validate why we’re doing this and pushing the science to get better outcomes. Better outcomes, but not at the risk of worse adverse effects.

Dr Chase, earlier you described that give and take, the benefits and risks with the corticosteroids. With that in mind, what can be done to increase the availability of biologics in scenarios where patients need them and suffer from the deleterious effect?

That’s a great question. This is on all of us to educate our patients right off the bat. I love to tell patients, “Don’t worry.” I always have a couple of backup plans if we think they’re going toward the point of needing more assertive therapies in terms of biologics. That education is great. With settings like this, we all get to talk together, engage one another, learn from one another, and think more about how we can better educate our colleagues on the fact that these biologics exist. They’re there for us to use, and we wield them all the time. Let us be helpful to you if we can.

Access has always been an issue. For many individuals, access can be getting to a provider in an area that’s within a reasonable distance. We’ve seen some uptake with telemedicine with the pandemic, and that’s been lovely. But for an issue like asthma, we sometimes need to see patients in the office. However, all these biologics now, with the exception of reslizumab, can be self-administered. That’s huge. That’s what patients want: to take medication in the comfort of their own home, on their own time, knowing that there aren’t safety concerns about it.

With this group here, we’ve gotten very quickly comfortable with biologics being another step in the armamentarium we use to treat patients. We look at someone as they walk in the door and think, “I’ll bet they’re going to need a biologic at some point.” We’ve all done that. Now we have lots of years of safety and efficacy data. Hearing stories from patients validate that this was the right decision to make the right approach.

Finally, there’s the overall thinking about being part of the conversation. We need to let others know that this isn’t a field that’s stagnant. We’re getting new breakthroughs all the time. We need to encourage research further on asthma as a main issue for individuals in the United States and worldwide. There are even more to come. There are barriers, but there are lots of reasons to be excited about the future of asthma.

Experts discuss the use of biologic treatment in asthma by primary care physicians vs pulmonology specialists as well as overcoming barriers to biologic use through patient and physician education.

Trends in Biologic Treatment of Asthma

Dareen Siri, MD, FAAAAI, FACAAI

University of Cincinnati College of Medicine

What I want to do is go around to each of you and let you speak directly to the audience for 30 seconds to a minute and leave them with some pithy thought that you’ve had over the past hour and a half from the past decade or 2. I want to leave time for that before we go. Let’s start with you, Henry.

My closing remarks are as follows: I wish that we, in psychiatry, adopt evidence-based practices for the sake of the patient. We have to stop doing the traditional same old, same old, which is often done in patients with schizophrenia, and start thinking of it as an acute emergency—a brain disorder that needs to be treated just as seriously as a stroke or a heart attack—and the only way to stabilize patients with schizophrenia on an ongoing basis, at least the majority. It’s a heterogeneous disorder, I admit to you. We estimate there are at least 800 types of schizophrenia, genetic and nongenetic. Fortunately, 70% of them respond to dopamine antagonist, which is what the long-acting injectables [LAIs] available are. 

We can manage the patient, keep them well. We need to change the habit of giving them pills when they’re discharged from the hospital only to see them come back again and again, and to think this is the way it is with schizophrenia and accept that disability as a fact of life. This is the worst thing you can do for a patient, to expect negative outcomes. I tell my colleagues in psychiatry, how would you treat your own son or daughter if they develop an acute psychotic episode with schizophrenia? How would you treat them based on the best evidence we know these days? Would you treat them differently from the patients? 

Shouldn’t you treat everybody the same, which is to protect them from the hazards of relapse as early as possible, not dillydally and wait for the patient to have multiple relapses and then use long-acting? By then they are disabled, they’re homeless, they’re incarcerated, they may have committed several suicide attempts, and they’re treatment resistant. All those negative things that can happen, most important the disability. They are written off. They have no life anymore. Wouldn’t you want to treat your son or daughter in a different way from how you’re treating your patient? I would ask them that question, knowing what they know about LAIs.

First of all, great panel. Thank you to the moderator and both of my copanelists. I’ll end with some pithy statement that I started with. This stigma has raised its head throughout my career, and that in many regards is at the foundation of today’s discussion. Stigma very often refers to fear; it’s unrealistic. It’s not based on fact, but it’s perpetuated in an ongoing fashion, and that’s a reasonable consideration for today’s discussion of why it’s so difficult to make the argument, to clinicians, patients, and families, why we should use an empirically based approach and do what’s best for the patient clinically short term and long term.

There’s more. There’s also this idea that, as physicians, there’s stigma within our own profession. This last comment that Henry makes is timely. Much of my career…. You go away and stop all your medications as if the other clinicians and physicians in health care think our medicines don’t matter or that they’re doing something to actually prevent mortality in human beings whose lives are as important to me as they should be to them if that patient has heart disease, diabetes, asthma, cancer, or something that’s a component there as well. It’s likely that other individuals, including other physicians and clinicians, are also sending the same message that one shouldn’t take the medication—you shouldn’t take the injections; you shouldn’t need medication. They’re noncompliant; you don’t really need this. Nothing is wrong with you. We’ve got to make that argument much more effectively.

I’ll end with my comment of my mother. To be a doctor you have a good therapeutic alliance. The bedside manner was always what she talked to me about. I have a daughter who’s a doctor, but I always say the smartest doctor in our family was the one who was a schoolteacher: my mother. It made so much sense. At this time in my career, I’ve appreciated that if patients believe in me in many regards and what I represent, if they trust and believe in the doctor, then they’ll trust and believe in our message. Then they’d arguably be more likely to be compliant. Compliance can also occur with LAIs, and they just happen to be with oral treatment. Today’s discussion was remarkably timely for my patient population and 1 that we all should take to heart. We had a very good session. Thank you for having me.

Joe, this is either very good or very bad. You’ve got the last word. Did they take all the good stuff, or do you have something pithy to say?

Actually, I’m going to begin with LAIs and close with LAIs. This surge of people experiencing psychiatric problems has the potential to impact the health care system for years to come. What I’m talking about is the pandemic has not only interrupted the treatment of people managing mental or substance abuse disorders but has also placed broader segments of the population at risk for developing conditions, such as depression, anxiety, alcohol use disorder, and as Henry alluded to earlier, post-traumatic stress disorder, PTSD. After 25 years in the military, the challenges with PTSD are still forthcoming.

But let me close with this, because we started with LAIs: As our distinguished panelists Rahn and Henry alluded to and you facilitated, Peter, LAI is our hope for the future. We take it for granted, and it’s underutilized. Better education of LAIs for our psychiatric population is certainly a sign of hope.

 I want to thank all of you. This has been a tremendous discussion. Because I’m not a psychiatrist, there was a lot of new information, all of which was hopeful. I didn’t expect it to be. This was great stuff. I want to thank all of you at home, of course, or wherever you’re watching this HCPLive® Peer Exchange broadcast. If you enjoyed the content, we invite you to subscribe for our e-newsletters to receive upcoming Peer Exchanges and other great content right in your inbox. I’m Dr Peter Salgo. Thank you, and I’ll see you next time.

A panel of experts in schizophrenic psychiatric care share their thoughts on the practice, patients, and treatment based on their years of experience.  

Schizophrenia: Practice, Patients, and Treatment 

Henry Nasrallah, MD, University of Cincinnati College of Medicine

Kris Kowdley, MD, FACP, FACG, AGAF, FAASLD: 

We’re comingto the end of this discussion, but I want to talk about unmet needs in PBC [primary biliary cholangitis]. What are some unmet needs? I’m going to have everyone comment, but I’m going to start with you, David.

This was a lead-in to say that transplantation for patients with PBC is an unmet need. They’re not well served by our current allocation system, and I’ve implored some of our UNOS [United Network for Organ Sharing] colleagues to consider itching in the malignant, life-altering aspect of pruritis to be something that we incentivize for transplant. Transplant is supposed to make your life longer and better, and many of these patients with recalcitrant pruritus from PBC deserve quality therapy. That’s where I see the biggest unmet need. I don’t think we do great in our transplant world. That’s a bigger question to answer. I’m hopeful that these new therapies and some of the emerging therapies may be able to treat some of our patients who aren’t candidates for obeticholic acid or second-line therapy as we try to prevent them from progressing to such a stage.

That’s a good point. There’s concern about patients who have decompensated liver disease. Obviously, they can’t receive obeticholic acid. With fibrates, there are some concerns and warnings about liver or kidney toxicity. Clearly, that’s the population where there’s a big need. I’ve had 3 patients in my career who I was able to get either prior to MELD [model for end-stage liver disease] and requiring exception points or during MELD with exception points for refractory life-threatening pruritis, 2 of whom were considering suicide. Those patients would not be eligible for exception points in this era. It’s uncommon, but it’s a huge unmet need. Ed, what do you think are the unmet needs in this disease?

Something we looked at in our clinic is ethnic disparities in PBC. We found that our Latino population who had PBC came at a much later stage of disease. Most of them have cirrhosis. David, you mentioned patients with PBC languishing in clinics. Increasing awareness of PBC and screening using the antimitochondrial antibody in certain ethnic groups or communities would be of value.

Like many things in liver disease, Kris, they’re all out of unmet needs. First, there’s an unmet need regarding the education of practitioners in how to diagnose this early. There’s an unmet need in terms of having more effective primary therapy in the first place for patients with PBC. There’s an unmet need for the treatment of the profound fatigue that some patients have with this disease. Even if they don’t have cirrhosis, it’s a major quality-of-life issue for them. There’s an unmet medical need for the pruritis. The pruritis doesn’t always correlate with the advance, with the stage of the disease. That’s also a misunderstanding. Patients can have moderate pruritis, which does affect their quality of life, but it’s not enough to need a transplant, and their liver disease isn’t so advanced. We know we could do better with therapy. So, there are a lot of unmet needs in PBC.

I agree, and your point about pruritis and symptoms not being correlated with disease severity is important to recognize. Some patients, as they start having more symptoms, are petrified, and their fatigue is getting worse. They think they need to get on a liver transplant list.

For patients with PBC, 1 of the extrahepatic manifestations is they can have very profound and aggressive osteoporosis. The guidance documents are clear that patients should have periodic bone densitometry when they have PBC. This, too, doesn’t correlate necessarily with the stage of their liver disease, and you can’t wait until patients are having spontaneous pathological fractures to identify this. The audience should also know in a patient with PBC that they are or should be recommending periodic bone densitometry to look for osteoporosis or even osteopenia.

At a minimum, your patient with PBC who comes into the office every 6 months or 1 year should have a vitamin D test with their standard labs. That’s a guidance, but it’s often not done. We added it to our standard order set for patients with cholestatic liver disease, so other providers would do it. That’s the best and easiest screening tool to identify higher-risk patients.

That’s an excellent point. Fractal vitamin deficiency isn’t necessarily seen only in patients with jaundice, so we do that routinely when we first see the patient. Sonal, you get the last word on unmet needs for education and for patients or clinicians.

I’ll piggyback on what Steve said. As physicians, we focus on normalization of the alkalis or goals of preventing and disease prevention, which are understandable and obviously important. But from a patient perspective, what affects their day to day is their quality of life. If we can improve that, in combination with these new therapies, that will prevent disease progression. That will be huge.

That’s great. That hour and a half went by fast. I appreciate the chance to share thoughts and clinical experience. Thanks to all of you for this rich and informative discussion. Before we conclude, I’d like to get some final thoughts. Everybody gets 30 seconds. Let’s start with you, Steve.

The practitioners in the audience should understand that although this is an uncommon disease, it’s not so uncommon that you won’t see it. You will, and you need to know how to diagnose it and be comfortable about the diagnosis. Be aggressive in your therapy, even in patients who are asymptomatic. Follow their fibrosis scores, and don’t forget these extrahepatic manifestations, which are more prominent than any of the others in liver disease: osteoporosis, hyperlipidemia, pruritis. Become comfortable with it, understand it, and follow the patients aggressively because you’ll help them.

Steve summed it up well. Disease awareness is a big deal in PBC. Although this is a rare disease, it’s not something you’ll see once in your lifetime or never see. It’s important for practitioners to be aware that this disease exists and recognize that it’s an exciting time for patients with PBC. We have good therapies already in existence but even more exciting therapies in development.

I agree with what everyone said. But let’s not let these patients languish in our clinics. Let’s follow that alkaline phosphatase, and let’s get that alkaline phosphatase to normal.

Having the last name Victor puts me at the end of this. Our panelists have hit on all the issues. To the providers and practitioners watching this, go through your clinic and make sure you’ve optimized the patients you have to make sure they don’t see me for transplant.

That’s very well summed up. Thank you again. To our viewing audience, I hope this 

 discussion was useful and informative. If you enjoyed the content, please subscribe to our e-newsletters to receive 

Experts in hepatology review the unmet needs in primary biliary cholangitis, commenting on liver transplant, ethnic disparities, management of pruritis, as well as other symptoms.

Unmet Needs in the Treatment of PBC

Kris Kowdley, MD, FACP, FACG, AGAF, FAASLD

Sidonio discussed how fitusiran may improve the treatment landscape and reduce treatment burden for people with hemophilia A or B with or without inhibitors.

Anticipating Fitusiran’s Approval for Factor-Agnostic Hemophilia A, B, with Robert F. Sidonio Jr., MD, MSc

The FDA is nearing a decision on fitusiran prophylaxis in adults and adolescents over the age of 12 years with hemophilia A or B, with or without inhibitors, as we approach the therapy’s Prescription Drug User Fee Act (PDUFA) date of March 28. The agency previously accepted Sanofi’s biologics license application (BLA) in June 2024.

spoke with Robert F. Sidonio Jr., MD, MSc, who is a Pediatric Hematologist/Oncologist, Medical Director of Hemophilia, and Medical Director of the Clinical Research Office at Aflac Cancer & Blood Disorders Center and Children's Healthcare of Atlanta, as well as an Associate Professor of Pediatrics at Emory University School of Medicine, to learn more about fitusiran and its potential to add to the treatment landscape of both hemophilia A and B.

“Fitusiran being once every 2 months, likely in most patients, that's about as low administrative burden as you can get, short of gene therapy or a definitive cure. So, we're happy about having another option for patients. This could be a really good option for patients that have poor intravenous access, or if they may have not responded to other non-factor therapies… Certainly there'll be some products maybe better for others, but this one is an appealing one,” Sidonio told 

Sidonio stressed that compared to other therapies facing approval, fitusiran benefits from a very large pre-approval study series, the ATLAS series of trials, that has generated years of long-term safety and efficacy data. He anticipates the therapy’s approval, and past barriers of insurance and Medicaid coverage, expects uptake to be enthusiastic.

The ATLAS-PPX trial previously met its primary end point of reducing annualized bleeding rate (ABR), with fitusitan reducing ABR 79.7% (

 = .0021) from baseline compared to a reduction of 46.4% (

= .0598) with bypassing agent /clotting factor concentrate prophylaxis.

Sidonio's relevant disclosures include Biomarin.

1. Press Release: ISTH: Sanofi advances leadership in hemophilia with new data for ALTUVIIIO and fitusiran. News release. Sanofi. June 21, 2024. 

https://www.sanofi.com/en/media-room/press-releases/2024/2024-06-21-05-00-00-2902104

2. Kenet G, Nolan B, Zulfikar B, et al. Fitusiran prophylaxis in people with hemophilia A or B who switched from prior BPA/CFC prophylaxis: the ATLAS-PPX trial. 

. 2024;143(22):2256-2269. doi:10.1182/blood.2023021864

Robert F. Sidonio, Jr., MD, MSc

Atopic Disease Hypersensitivity Reactions Vary by Biologic Type with Valerie Jaroenpuntaruk, MD

A study found reslizumab had the greatest rate of hypersensitivity reactions among patients with 

2025 American Academy of Allergy, Asthma, & Immunology (AAAAI)

 annual meeting in San Diego from February 28 – March 3, reported the severity and prevalence of hypersensitivity reactions to specific biologics for atopic diseases.

Investigators reviewed Mayo Clinic Health System records from January 2009 and August 2024, identifying 65 patients (mean age: 45.2 years; 60 females) with hypersensitivity reactions to biologics. The team examined the reactions of patients taking the following biologics: benralizumab, dupilumab, mepolizumab, omalizumab, reslizumab, and tezepelumab. 2 patients reacted to multiple biologics.

Most patients (74%) had ≥ 1 atopic condition, such as asthma, chronic urticaria, atopic dermatitis, idiopathic anaphylaxis, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, and mast cell disorders. The mean documentation of allergies per person was 16.7.

spoke with investigator Valerie Jaroenpuntaruk, MD, from the Mayo Clinic, on what these findings mean for clinicians.

“I would say the big takeaway for this study's finding is that we found that while hypersensitive reactions to biologics are generally uncommon, the prevalence varies by agent overall,” Jaroenpuntaruk said.

Jaroenpuntaruk and colleagues found 2.2% of patients on biologic therapy for atopic diseases experience hypersensitivity reactions, with reslizumab having the greatest reaction rate, followed by omalizumab. Most reactions occurred within the first 2 doses; the most common manifestations were cutaneous, respiratory, and other symptoms, in that order. The study also demonstrated that reactions were more common in females, in which 83% had a history of drug allergies.

The findings also highlight the feasibility of switching between biologic therapies, with a 97.2% success rate for the 81.8% of participants who switched a biologic. Moreover, 75% of participants successfully switched to the same biologic.

“Biologics have changed so many lives, and it could make so much a big difference in patients’ atopic or underlying atopic conditions,” Jaroenpuntaruk said. “In general, just be aware that while these [reactions] are low, it can happen, but essentially it comes down to [a] risk-benefit discussion with the patient to guide kind of more at the final decision on the therapy.”

A relevant disclosure for Jaroenpuntaruk includes GlaxoSmithKline, LLC.

Ahead of AAAAI 2025, HCPLive spoke with Jaroenpuntaruk about varying hypersensitivity reactions in patients with atopic diseases on biologics.

Authors