Therapeutic areas in focus
SKIN DISEASE TREATMENTS
Dermatologically speaking: Finding new treatments for women
Pharmafile sat down with the team at Organon to unearth the different ways that women’s dermatological conditions can be successfully supported and managed
What is the future plan for expanding the range of treatments available to women with dermatological conditions?
Simon Nicholson, Managing Director UK&ENI Cluster:
Essentially, we are a women’s health company built on three pillars: women’s health, biosimilars and established medications. We have a strong foundation of more than 60 medicines across a range of areas including contraception, reproductive health, menopause, cardiovascular disease, dermatology, allergy and asthma, to name a few.
Our mission is to deliver impactful medicines and solutions every day for every woman. Our focus for the future is not limited, but our commitment remains to listen to women and identify areas of unmet need. This will drive our investment and our future portfolio.
How does dermatitis and other skin conditions affect those suffering from them?
Manjit Aujla, Lead Established Brands & Biosimilars UK-ENI:
Dermatitis and other skin inflammatory conditions can have a real impact on self-esteem and confidence, and in extreme cases the psychological impact can be far reaching with some people experiencing depression and anxiety.
A person’s long-term well-being can be impaired by skin conditions. These can have a profound effect on all aspects of people’s lives, including personal relationships and social engagement. Improvements in awareness of skin conditions, and access to specialist services including psychological interventions, can be helpful in both treating and coping with many skin conditions.
What would you say is the greatest challenge faced by women suffering from skin conditions?
Faye Sheen, Brand and Customer Manager UK and Ireland:
It is very difficult to talk about one single challenge that women with skin conditions face as every part of their life can be affected – including relationships, careers, self-confidence, mental health, and in some cases, this could have an indirect impact on wider family members quality of life.
Depression and anxiety are probably the greatest challenge for women suffering from skin conditions as this can affect women’s ability to work and study, and can have a major impact on family and social life. Women with skin conditions may want to cover up or shy away from social interactions.
What are the priorities in this area?
It is now five months since we launched Organon, and we launched with a commitment to identify the unmet needs in the women’s health space, by really listening to women and all our key stakeholders. We have continually sought the views of women through many channels, and it is clear there are a number of significant areas of unmet need in both the provision of solutions to treat conditions which specifically affect women, but also those which have a disproportionate effect on women. The biggest challenge for us moving forward will be to prioritise our efforts and ensure we are supporting women in the areas of greatest need, at the right time and in the right way. An example
of this is the impact of COVID-19 on sexual health services, which in turn impacted access to contraception and resulted in a substantial increase in unplanned pregnancies across the world.
The biggest challenge for us moving forward will be to prioritise our efforts and ensure we are supporting women in the areas of greatest need, at the right time and in the right way
On World Contraception Day, we partnered with The Faculty of Sexual and Reproductive Health to shine a light on the challenges that women have faced through this disruption, and as part of a major initiative to improve access to LARCs, we have been pioneering the development of a new treatment pathway in Liverpool. By igniting the conversation around contraception, we hope to empower women with the knowledge that they need to understand the contraceptive options that are available to them.
More recently, on World Menopause Day, we listened to women between the ages of 40-60 – undoubtedly a time in a woman’s life that can be really challenging. Our survey results confirmed that although there is still need for further education, when women feel supported, it can also be a time of real empowerment and a milestone that positively opens the door to the next chapter of their lives.
Our next major milestone is International Women’s Day on March 8. We will be continuing to give women a voice, and continuing to listen so that we can make a material difference and create a better, and healthier, every day for every woman. This is just the beginning for us as a women’s health company. There is much more to come.
is the Managing Director of the UK & ENI Cluster at Organon, with over 14 years of experience in the pharmaceutical industry. Simon is committed to making life better for each and every woman.
is the Brand and Customer Manager UK and Ireland at Organon. Faye has a strong focus on supporting women, ensuring that women’s voices are heard, and is keen to make sure that Organon reflects what women want.
is the Lead of Established Brands and Biosimilars UK & ENI at Organon, with over 13 years of experience in the pharmaceutical industry. Manjit has a particular interest in multi-channel marketing and integration.
VIRTUAL DERMATOLOGICAL ENGAGEMENT
Insight and oversight: Making the most of virtual platforms in dermatology
FIDE is an independent expert-led consultancy, specialising in providing insight into inflammatory skin conditions. Dr Bruce E Strober, Executive Director, takes a look at virtual communication with HCPs and patients, and offers insight into how to make the most out of virtual communications with dermatologists, HCPs, and patients
What has the impact of restricted one-to-one healthcare professional (HCP) access engagement been on dermatological patient care?
Dr Bruce Stober:
We have observed minimal effect – our practice has functioned mostly normally (with appropriate COVID-19 precautions in place) for the past 18 months.
Some restrictions have been placed on the number of pharma reps to keep density down. We’re actually busier than ever with patient care, and allow in-person interaction with pharmaceutical representatives. Truth be told, some restriction on pharmaceutical interaction is positive, as it can be overwhelming to a busy HCP trying to conduct patient care.
COVID-19 restrictions have also limited knowledge transfer – what effect has this had on dermatological R&D and patient care?
The lack of in-person meetings has necessitated virtual learning, which isn’t vastly inferior. However, in-person learning likely fosters more Q&A and discussion that is somewhat blunted by the virtual medium. Patient care likely hasn’t been impacted significantly. The real issue is how COVID-19 has delayed the FDA review process, inhibiting the approval of important new medications for patients in need.
Dermatology is an area with significant unmet patient needs. What is needed to provide access to expert insight, and how do you work to ensure it?
To really get to the bottom of unmet patient needs efficiently, it is vital for biopharmaceutical companies to develop relationships with a variety of HCPs who can provide unbiased insights on the market
landscape. These insights are crucial for uncovering real challenges across the patient and healthcare professional journey. It is only by truly listening that organisations can develop solutions that can improve the lives of patients.
As a consultant I regularly interact with pharmaceutical companies of all types and sizes to help ensure more sensible product development and commercialisation. I also participate in numerous virtual continuous medical education (CME) and promotional activities that foster education and discussion.
Which areas of dermatology are neglected in terms of research and development, and patient care?
Some rare skin conditions, such as lichen planus, scarring alopecia, granuloma annulare, and hypersenstivity dermatitis (that primarily affects older individuals), are overlooked. These conditions are often tough to treat and require a lot of trial and error approaches. They also often face treatment failure. Further, medications that might be effective, without FDA approval for these uses, are hard to deliver to patients.
What have the most interesting developments in dermatology been over this time period, and what changes do you anticipate in the next ten years?
Without a doubt, the advancement of psoriasis therapeutics, which are now very effective and safe, and the incipient development of effective therapies for atopic dermatitis. The next 10 years will see further advancements in atopic dermatitis, hidradenitis suppurativa, alopecia areata, and vitiligo. Further, there appears to be a revolution brewing in the development of novel topical drugs with safe and effective mechanisms of action and can treat inflammatory dermatitis.
What are some of the ways dermatologists can adjust to the challenges presented to them in patient care through the COVID-19 pandemic?
In the US, COVID-19 has not recently impacted dermatology, with many practices quite busy. It appears that business has returned to normal. In essence, we are learning to live with COVID-19, instituting the correct precautions along the way.
What difficulties have arisen in educating HCPs in managing skin conditions over the past few years?
While allowing learning in the comfort of one’s own home or office, the movement to virtual media, due to lack of good engagement, is an inferior approach to in-person conferences and symposia. It is a mixed bag, as the lack of travel is, on balance, easier on lifestyle and happiness. HCPs who are disciplined and engaged can still learn a lot from the current virtual educational offerings.
What is your number one piece of advice for biopharmaceutical companies looking to enhance their relationship with dermatologists today?
Keep the interaction data driven, with honest presentations of your drug/agent – no tricks and over-commercialised approaches that don’t jibe well with reality. Also, focus on patients who have comorbidities – work with registries and other repositories of realworld data to get an idea of how the drug really works when used in clinical practice.
Dr Bruce E Strober
Executive Director at FIDE, is Clinical Professor of Dermatology at Yale University School of Medicine, and practices at Central Connecticut Dermatology. He is also co-Scientific Director of the CorEvitas psoriasis registry, Treasurer of the International Psoriasis Council, and Editor in chief of the Journal of Psoriasis and Psoriatic Arthritis. Dr Strober earned both his medical degree and his doctorate from Columbia University College of Physicians and Surgeons in New York. He completed his residency in dermatology at the Department of Dermatology, New York University School of Medicine. He is certified by the American Board of Dermatology and is a Fellow of the American Academy of Dermatology.
To find out more about FIDE, contact:
INFLAMMATORY SKIN DISEASES
“The pain keeps me awake at night. I can’t cope with this anymore”
The therapeutic agents of the past decade have revolutionised dermatological treatments, improving the quality of life of patients with psoriasis. Dr Susanne Farwer at UCB shares her extensive clinical experience in the area
What have been the most significant advancements in dermatology and psoriasis management over the past decade?
Dr Susanne Farwer:
The past decade of dermatology has seen the development and launch of novel therapeutic agents with differentiated modes of action, enabling more targeted treatment approaches with a range of effective and well-tolerated therapies. The introduction of these therapies revolutionised dermatology and I have been very privileged to witness first-hand how these drugs have transformed the lives of patients living with chronic inflammatory dermatoses, such as psoriasis or atopic dermatitis.
Despite these scientific advancements, psoriasis remains a challenge to treat, with a substantial proportion of patients not
achieving optimal disease control with the current therapeutic options.
My clinical years exposed me to countless patients desperately seeking that ‘magic pill’, with hopes and expectations for a treatment that will relieve them of the disease burden they have been carrying both mentally and physically. It is these experiences which inspire my passion for improving patient outcomes, and I am excited to be working at the forefront of these advancements.
What challenges and barriers still exist and prevent patients from reaching their treatment goals and living their lives to the fullest?
More than 50% of the UK population are affected by skin disease at some point in their lifetime, with over 13 million people (24%) visiting their GP with a skin condition.
In comparison to other chronic conditions such as diabetes, chronic obstructive pulmonary disease (COPD) or cardiovascular disease, dermatological conditions still rank low on the government and health policy makers’ agenda.
The high disease burden and wide-ranging impact of psoriasis on people’s daily lives is still underestimated. Furthermore, the high prevalence of co-morbidities affecting joints, psychosocial well-being, and the metabolic system, are often not well understood or acknowledged across the various stakeholders in the healthcare system. Reports show that nearly 60% of people with psoriasis say the disease causes problems in their everyday lives.
What vividly remains in my memory are the many patient struggles I heard during my clinical years.
Patients consistently report a lack of understanding and awareness of the treatment options available to them, and so they fail to
understand what they can and should expect from their treatment. This therefore limits their influence in shared decision making about their treatment pathway, in partnership with their dermatologist.
My skin looks like a mess and people are staring at me; I am itching all over, and the pain keeps me awake at night. I can’t cope with this anymore, I don’t think anyone will ever find me attractive being covered in all these red patches from top to toe. I’ve not worn a sleeveless top in years and have lost all my confidence showing off my skin
anonymous patient, aged 35, from South Yorkshire.
Currently, the system isn’t working well enough for people with psoriasis, so we are dedicated to working with healthcare professionals and the NHS to find new ways to overcome the systemic challenges that stand between people with skin diseases and access to innovative treatments, and holistic, integrated patient care.
How is UCB Pharma challenging the status quo and how do you hope to impact the space going forward?
Collaboration is fundamental to delivering transformative solutions to those who need it. While those involved in dermatology – patients, clinicians, payors, patient groups, or the scientists working to unlock the treatments of the future – face different challenges, ultimately, we are all working towards the same goal.
This goal is to ensure better lives for those living with skin disease, and faster access to innovative treatments. By working together as partners, we believe we can significantly reduce the time from diagnosis to effective treatment and ultimately, find ways for everyone to feel comfortable in their own skin and live fulfilled lives, free of physical and emotional burden.
We aim to not just listen to stakeholders and gather their insights, but to also involve them in the co-creation of insightdriven solutions. The recent pan-European EPICENSUS Project showcases our collaborative approach to improving outcomes for people living with psoriasis.
Initiated in December 2020 by UCB, this integrated consensus programme involves key stakeholders (clinicians, payors and patient advocacy groups representatives) from across eight European countries, and focuses on generating engagement, gathering insights and enabling a multidisciplinary conversation. It will critically evaluate the current standard of care with regards to diagnosis, monitoring, access, and patient-reported outcomes in psoriasis, with results due to be published later this year. We hope that EPICENSUS will ultimately deliver a paradigm shift in outcomes for people with psoriasis, reducing the significant burden on the health care system and enhancing the delivery of future psoriasis care.
How will new technology such as machine learning and AI influence the dermatology space in the coming years?
New technologies such as machine learning have been successful in predicting the trajectory of patients’ health in various fields such as cancer, diabetic complications, and cardiovascular mortality. Recent studies have shown that although ample data exists on the efficacy of biologics in psoriasis, decision making on treatments is still often based on a trial-and-error approach. In a real-world setting, over 50% of patients required dose adjustment during therapy and 20-50% of patients experienced a relapse, resulting in a switch to another medication.
The application of such modelling algorithm methods for psoriasis treatment could help to predict long-term responses to biologics. Combining patient variables such as demographic data with disease and therapy specifics has shown promising results in this space.
To make the use of these impressive technologies a common practice, further studies and analyses on a larger and more diverse dataset are needed to identify universally applicable criteria.
What further advancements are needed in the dermatology space to achieve better health outcomes for patients, and enable an improved patient experience?
The introduction of integrated care systems (ICSs) provides an opportunity to acknowledge the impact of skin conditions on wider society and the healthcare system. It is important that these ICSs are gathering these insights and using them to implement decisions that strive towards integrated approaches to care.
It is also important that we are leveraging the range of data and the latest innovations in digital technologies to accelerate the identification of genetic, tissue and serum markers, to better predict treatment response and drug survival. This will help to optimise datadriven decision-making to personalise treatment and ultimately improve patient outcomes.
Above all, we won’t stop searching for the best solutions so that everyone has the opportunity to feel completely comfortable in their own skin, to leave the burden of skin disease behind, and to lead a healthy and happy life free of embarrassment, stigma, and judgement.
Emam S et al, Predicting the long-term outcomes of biologics in patients with psoriasis using machine learning, Br J Dermatol 182(5): pp1,305-1,307, 2019
Dr Susanne Farwer
joined UCB in August 2020 as the Medical Solutions Lead for Dermatology in the UK and Ireland. Prior to this move, she spent over 20 years as a healthcare professional including time as a GP and a Specialty and Associate Specialist (SAS) doctor in dermatology for the NHS.
Susanne’s extensive clinical experience combined with her deep passion for advancing and implementing solutions that reduce the disease burden and improve patients’ quality of life, makes her an asset to UCB whose own philosophies include bringing innovative therapies to those with severe chronic diseases.
On a personal level, Susanne prides herself on being adaptable, determined, and inspiring those around her, all while having a great sense of humour.