Managing Itch Among Patients with Atopic Dermatitis, with Gil Yosipovitch, MD

Gil Yosipovitch, MD, presented a talk titled ‘Managing Itch’ at the Revolutionizing Atopic Dermatitis (RAD) Conference in Nashville, Tennessee.

Yosipovitch is known for his work as a professor of dermatology at the Miller School of Medicine at the University of Miami and Director of the Miami Itch Center. In a recent Q&A interview by HCPLive, Yosipovitch’s responses to various questions related to the management of pruritus, or itch, in atopic dermatitis were highlighted:

HCPLive: Would you provide us with some specifics that you presented in your session on managing itch in atopic dermatitis?

Yosipovitch: We discussed different mechanisms of targeting itch, targeting the narrow immune pathways, first targeting with type 2 cytokines, with the new drugs that target IL-4, IL-13, IL-31, and their pruritic effect. Beyond just atopic dermatitis and prurigo nodularis, we also discussed drugs that target narrow sensitization phenomena in the nerves, GABAergic drugs, and their doses, kappa opioids, as well as understanding the skin and brain mechanisms of itch.

HCPLive: What were some examples of the therapeutics you touched on during your presentation?

Yosipovitch: Specifically, we discussed in the biologic arena; Dupilumab, nemolizumab, and lebrikizumab as the major drugs, as well as a bit on drugs that are targeting the JAK-STAT pathway, abrocitinib and upadacitinib. We also discussed pregabalin and gabapentin, as well as the kappa opioids, [such as] butorphanol.

HCPLive: We’ve spoken before about chronic pruritus of unknown origin and your research related to this. Are there any updates that you'd want to share with colleagues?

Yosipovitch: This is an entity that we see in our clinics, mainly in the elderly who have itch without a rash, or the rash is secondary to the scratching. It’s very common, and I would say that a lot of it was related to immunosenescence of type 2 cytokines overexpression, and therefore, drugs such as dupilumab and nemolizumab could work for these patients. With dupilumab, an ongoing study is being conducted, and hopefully, the phase 3 trials will be published this year or next year. Nemolizumab is also starting this type of drug trial, and I can tell you from my own clinical observation and off-label use, these drugs seem to be very promising for this condition.

HCPLive: Outside of atopic dermatitis and itch, are there any developments in dermatology you're looking forward to recently?

Yosipovitch: I think any chronic itchy condition is of interest to me in my research. I strongly believe that we need to better understand neuropathic itch and how to treat it. I've mentioned in my talk about the GABAergic drugs, but there are possibly other drugs that could target some of the narrow transmission of it. Whether these are Nav1.7, 1.8 inhibitors, or other drugs, and it could really target the nerve itself, rather than just the immune system, because in the neuropathic itch, the immune system has a minor role.

HCPLive: What do you see as the value of disease-specific conferences such as RAD?

Yosipovitch: I like RAD, because I think that it emphasizes a lot of components of inflammation in the skin. Atopic dermatitis is a great hallmark condition where the inflammatory immune system works with nerves. Therefore, we can learn a lot from RAD to treat other conditions that involve inflammation of the skin.

For any additional information related to Yosipovitch’s presentation or related topics covered at RAD 2025, view our latest conference coverage.

The quotes used in this Q&A interview were edited for the purposes of clarity.