2020 IDEOM Annual Meeting: Actinic Keratosis Stakeholders Survey Identifies Gaps in Research and Care
February 2022 | Volume 21 | Issue 2 | Original Article | 128 | Copyright © February 2022
Published online January 28, 2022
Folawiyo Babalola BSA,a Cameron Moattari BS,b Brian Berman MD PhD,c Neal Bhatia MD,d Leonard H. Goldberg MD,e Alice Gottlieb MD PhD,f Ayman Grada MD MS,g C. William Hanke MD MPH,h Jared Jagdeo MD MS,B,i Xochitl Jimenez MD,j Nellie Konnikov MD,k George Martin MD,l Edward Maytin MD PhD,m Michael Milane MD MBA,n Mark S. Nestor MD PhD,o Aliene Noda MD,p Ted Rosen MD,q Sana Shah PharmD,r Andrea Willey MD,s Jane Yoo MD MPP,t Nathalie C. Zeitouni MD,u Daniel M. Siegel MDb,v
aJoe R. & Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX;
bSUNY Downstate Health Sciences University College of Medicine, Brooklyn, NY;
cUniversity of Miami Miller School of Medicine, Miami, FL; Center for Clinical and Cosmetic Research, Aventura, FL;
dClinical Dermatology Therapeutics Clinical Research, San Diego, CA;
eDerm Surgery Associates, Houston, TX; Houston Methodist Hospital, Houston, TX;
fIcahn School of Medicine at Mount Sinai, New York, NY;
gR&D and Medical Affairs, Almirall US, Malvern, PA;
hAscension St. Vincent Health, Indianapolis, IN;
iBrooklyn Campus of the NY Harbor VA Healthcare System, Brooklyn, NY;
jAlmirall, LLC, Los Angeles, CA;
kBoston VA Healthcare System, Boston, MA;
lDr. George Martin Dermatology Associates Kihei, Maui, HI;
mCleveland Clinic, Cleveland, OH;
nPrivate R&D;
oUniversity of Miami Miller School of Medicine, Miami, FL;
pGalderma SA, Lausanne, Switzerland;
qBaylor College of Medicine, Houston, TX;
rScientis, Trinity, FL;
sSurgical & Aesthetic Dermatology, Sacramento, CA;
tIcahn School of Medicine at Mount Sinai, New York, NY;
uMedical Dermatology Specialists, Phoenix, AZ; University of Arizona College of Medicine, Phoenix, AZ;
vBrooklyn Campus of the NY Harbor VA Healthcare System, Brooklyn, NY
Abstract
This is a report of the survey results from the International Dermatology Outcome Measures (IDEOM) actinic keratosis (AK) workgroup. The purpose of the survey was to compile a list of gaps within AK care and management that require refinement. The results were discussed at the IDEOM annual meeting held virtually on October 23–24, 2020. This built a framework with which the AK workgroup, which consisted of physicians, patients, and pharmaceutical scientists, discussed at length in their breakout session at the meeting. The electronic survey was distributed to patients, pharmaceutical scientists, and leading physician experts in the field via email on September 22, 2020, with a deadline of October 2, 2020. The survey consisted of three open-ended prompts concerning key gaps and/or unmet needs in (1) the care of AKs, (2) outcome measurement of AKs in clinical trials and, (3) the measurement of AKs in clinical practice. The results were qualitative, with a response rate of 47%. Responses included reform of outcome measures for clinical trials, a methodology for evaluating the efficacy of preventative measures, and a comparison of treatments to establish a treatment protocol, among other efforts. This paper will also provide a brief overview of the current state of the AK outcome measures, emphasizing the heterogeneity of the measures and detailing the AK workgroup's future efforts to create a reliable and applicable core outcome measure set.
J Drugs Dermatol. 2022;21(2):128-134. doi:10.36849/JDD.6360
INTRODUCTION
Actinic keratoses (AKs) are chronic recurrent lesions that develop most commonly in fair complected patients. Other risk factors include male gender, extensive sun exposure, immunosuppression and advanced age.1,2 Although the likelihood of progression of an individual AK to cutaneous squamous cell carcinoma (cSCC) ranges between 0.25–20%, the difficulty in accurately predicting which lesions will progress to cSCC substantiates the common practice of eliminating these lesions.3,4 There are various treatments for AKs, ranging from lesion-directed therapy targeting individual clinically visible lesions, to field-directed therapies, which target a larger surface area and are advantageous in treating areas with field cancerization. Areas of field cancerization contain subclinical lesions due to clonal expansion of a single mutated cell that creates a field of premalignant cells.5 These therapies have been studied and compared through countless
