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Avoiding Polypharmacy & Topical Confusion with Roflumilast · The Science of Skin

• 0:00
  SPEAKER_00: Thank you to our sponsor, Arcutus Biotherapeutics, for their support of the Science of Skin podcast and furthering Derm Education.
• 0:07
  SPEAKER_00: Arcutus is a medical dermatology company that champions meaningful innovation to address the urgent needs of individuals living with immune-mediated dermatological diseases and conditions.
• 0:18
  SPEAKER_00: With a commitment to solving the most persistent patient challenges in dermatology, Arcutis has a growing portfolio of advanced targeted topicals.
• 0:27
  SPEAKER_00: Arcutus's unique dermatology development platform, coupled with their dermatology expertise, allows them to develop differentiated therapies against biologically validated targets for a range of inflammatory dermatological conditions.
• 0:41
  SPEAKER_00: Arcutis strives to simplify disease management and optimize drug efficacy, safety, and tolerability.
• 0:48
  SPEAKER_00: They're determined to elevate the current standard of care, solving for the challenges others haven't.
• 1:02
  SPEAKER_01: Hello and welcome to the Science of Skin Podcast.
• 1:05
  SPEAKER_01: My name is Dr.
• 1:05
  SPEAKER_01: Ted Lane.
• 1:06
  SPEAKER_01: I'm a dermatologist in Austin, Texas, and your host for today.
• 1:10
  SPEAKER_01: And we have a great guest today, as well, Dr.
• 1:13
  SPEAKER_01: Mona Shariari.
• 1:15
  SPEAKER_01: So, Mona, I'm so excited to have you on the program, first of all.
• 1:18
  SPEAKER_01: So thank you for coming on.
• 1:20
  SPEAKER_02: Well, thank you so much for having me.
• 1:21
  SPEAKER_02: I'm super stoked.
• 1:22
  SPEAKER_01: Yeah, absolutely.
• 1:23
  SPEAKER_01: So Mona is an associate clinical professor of dermatology at the Yale University School of Medicine.
• 1:29
  SPEAKER_01: She's also the Associate Director of Clinical Trials and a dermatologist at Central Connecticut Dermatology.
• 1:36
  SPEAKER_01: And finally, Mona is the host of her own podcast, the Medical Sisterhood Podcast, which you can find Mona on all major streaming platforms, I assume.
• 1:46
  SPEAKER_02: Yes, absolutely.
• 1:47
  SPEAKER_01: Awesome.
• 1:48
  SPEAKER_01: Guys, just let me get this out of the way.
• 1:50
  SPEAKER_01: Thank you so much for listening.
• 1:51
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• 1:54
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• 1:56
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• 1:59
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• 2:01
  SPEAKER_01: Also, if you have any questions or you have ideas for new podcast episodes, please shoot us an email.
• 2:07
  SPEAKER_01: Questions at scienceofskinsummit.com.
• 2:10
  SPEAKER_01: Questions at scienceofskinsummit.com.
• 2:13
  SPEAKER_01: Mona Mona, we are here to talk about avoiding polypharmacy and topical confusion with reflumolast.
• 2:20
  SPEAKER_01: And this episode is being sponsored by Arcutis.
• 2:23
  SPEAKER_01: So let's just go straight into it, Mona.
• 2:26
  SPEAKER_01: I mean, the nice thing about reflumolast or Zareve is that it can go anywhere.
• 2:32
  SPEAKER_03: Exactly.
• 2:33
  SPEAKER_03: And I think I'm thinking back to when I was in residency and we didn't have some of these more targeted once-a-day treatments.
• 2:39
  SPEAKER_03: I used to give someone one topical for their face, one topical for their body.
• 2:43
  SPEAKER_03: You use this twice a day for the next two weeks, then you just use a Saturday and Sunday, use this other medicine Monday through Friday.
• 2:49
  SPEAKER_03: But then if the rash comes back, I want you to go back to that original regimen, and then I'd send them home.
• 2:54
  SPEAKER_03: And they'd come back, no doubtly, putting that ultra high potency steroid on their face.
• 2:59
  SPEAKER_03: And guess what?
• 2:59
  SPEAKER_03: It worked great, but now they have a white mark where they put it.
• 3:02
  SPEAKER_03: So I feel like we were setting our patients up for failure when we were practicing medicine like that.
• 3:07
  SPEAKER_03: And now reflumolas has really become that easy button.
• 3:11
  SPEAKER_03: You can use it on any affected area, head to toe, for as long as you need to.
• 3:15
  SPEAKER_03: It's just once a day to effectively treat whether we're treating atopic dermatitis or psoriasis or even sepderum.
• 3:22
  SPEAKER_01: That's true.
• 3:23
  SPEAKER_01: Yeah, I remember before we had these wonderful non-steroidal alternatives, writing down that exact regimen like you were talking about, Mona.
• 3:32
  SPEAKER_01: Hey, listen, use this on the weekends.
• 3:33
  SPEAKER_01: I want you to use this in the morning on Monday through Friday.
• 3:36
  SPEAKER_01: Use this one at night.
• 3:37
  SPEAKER_01: And I'd be writing it on down.
• 3:38
  SPEAKER_01: And I remember giving that slip to patients, and they were so confused.
• 3:43
  SPEAKER_01: And I was like, oh, this is a recipe for disaster.
• 3:46
  SPEAKER_01: This isn't going to work.
• 3:47
  SPEAKER_01: But I had no other choice.
• 3:48
  SPEAKER_01: Like I was trying to do the best thing I could for patients because, you know, we're trying to avoid all the local skin reactions and the local skin issues with topical steroids.
• 3:58
  SPEAKER_01: And now we know, Mona, actually, if if you don't mind going into it, like the systemic manifestations and the systemic effects of overuse of topical steroids.
• 4:08
  SPEAKER_03: Well, I see a lot of kids in my clinical practice, and the high body surface area to volume ratio is something I don't always think we think about.
• 4:15
  SPEAKER_03: And in that population specifically, I tend to gravitate toward non-steroidals because I am worried about the systemic absorption of a steroidal product.
• 4:23
  SPEAKER_03: And we're supposed to only use these for two to four weeks at a time and then take a break from it.
• 4:28
  SPEAKER_03: And it's partly because of the systemic absorption that can come with it.
• 4:32
  SPEAKER_01: Yeah.
• 4:32
  SPEAKER_01: And as you mentioned, there's a time limitation on the topical steroids, not only a body surface limitation, but also a time limitation.
• 4:40
  SPEAKER_01: And that makes a big issue for patients as well, because, for example, a chronic inflammatory disease such as sebderm, atopic dermatitis, psoriasis, it's not like it turns off when you turn when you stop using the steroid, right?
• 4:54
  SPEAKER_01: The resonant memory T cells are there, for example.
• 4:57
  SPEAKER_01: It's a process that continues.
• 4:58
  SPEAKER_01: And so you have to be able to treat it continuously.
• 5:02
  SPEAKER_01: And all we had really, Mona, were the topical calcinurin inhibitors, which as we know sting and burn for a lot of people.
• 5:08
  SPEAKER_01: Yes.
• 5:09
  SPEAKER_01: Then you've got the black box warning on pymecrolemus as well, which scared people.
• 5:14
  SPEAKER_01: And then finally, you know, other than that, we had these moisturizers.
• 5:17
  SPEAKER_01: And although moisturizing is great to repair the barrier, it just didn't get us where we needed to be because of that inflammation, right?
• 5:24
  SPEAKER_01: So here comes Zurif.
• 5:26
  SPEAKER_01: And we were all like, finally, this is amazing.
• 5:30
  SPEAKER_01: Because yes, it's a PDE4 inhibitor, but Mona, it's different than the previous PDE4 inhibitor that we had, right?
• 5:37
  SPEAKER_03: Yeah, it's not your grandfather's PDE4.
• 5:40
  SPEAKER_03: I have to say though, to be honest, when it first launched, I was clumping it into the same category as our previous PDE4s.
• 5:46
  SPEAKER_03: We had CRISPROL at the time that burned and stinged and didn't really work as well as I would have wanted it, especially my pediatric population.
• 5:53
  SPEAKER_03: But then when I started using it, I was like, wow, this medication is different.
• 5:57
  SPEAKER_03: It's just, it's so elegant.
• 5:59
  SPEAKER_03: It goes into the skin nicely.
• 6:00
  SPEAKER_03: It calms down the inflammation and the itch much more quickly than I would have traditionally expected from a non-steroidal agent.
• 6:07
  SPEAKER_03: So then once you figure out that it works and the patients come back loving it, you keep prescribing it.
• 6:11
  SPEAKER_03: And then I'll let you know a little secret.
• 6:13
  SPEAKER_03: I'm a Zaref patient myself.
• 6:14
  SPEAKER_03: That's how much I actually love the medicine.
• 6:16
  SPEAKER_03: I use it for separate dermatitis.
• 6:18
  SPEAKER_03: And it was just hearing all that positive feedback that made me say, hey, I might be someone who should use this medicine.
• 6:24
  SPEAKER_03: And I've been thrilled with the results thus far.
• 6:26
  SPEAKER_00: Thank you to our sponsor, Arcutus Biotherapeutics, for their support of the Science of Skin podcast and furthering derm education.
• 6:34
  SPEAKER_00: Arcutis is a medical dermatology company that champions meaningful innovation to address the urgent needs of individuals living with immune-mediated dermatological diseases and conditions.
• 6:45
  SPEAKER_00: With a commitment to solving the most persistent patient challenges in dermatology, Arcutis has a growing portfolio of advanced targeted topicals.
• 6:53
  SPEAKER_00: Arcutus's unique dermatology development platform, coupled with their dermatology expertise, allows them to develop differentiated therapies against biologically validated targets for a range of inflammatory dermatological conditions.
• 7:08
  SPEAKER_00: Arcutus strives to simplify disease management and optimize drug efficacy, safety, and tolerability.
• 7:15
  SPEAKER_00: They're determined to elevate the current standard of care, solving for the challenges others haven't.
• 7:21
  SPEAKER_01: You know, you mentioned sebreak dermatitis.
• 7:22
  SPEAKER_01: So we just like you, we run a lot of clinical trials and we had Zaref foam, uh, the phase three for Zaref uh for sebreak dermatitis.
• 7:30
  SPEAKER_01: I think we did the phase two and three.
• 7:31
  SPEAKER_01: But the phase three was so interesting, Mona, and I know you can relate to this, but at the end of the trial, it was an eight-week trial.
• 7:37
  SPEAKER_01: And at the end of the trial, when we it was time for the patients to wrap up and you know give us back your canister of foam, so many of them were like holding on to it.
• 7:46
  SPEAKER_01: I literally was like pulling it from their hands because it was the one thing that worked.
• 7:51
  SPEAKER_01: And remember, during the trials, they couldn't use any other medicated shampoo.
• 7:56
  SPEAKER_01: So it's not like they were using a ketoconosol or a parathion zinc shampoo or selenium sulfide shampoo.
• 8:01
  SPEAKER_01: So it was all they were using.
• 8:03
  SPEAKER_01: And and as you know, especially if if you've been suffering from SEBDERM, Mona, many patients use five or six products at a time.
• 8:10
  SPEAKER_03: Oh, yeah, easy.
• 8:12
  SPEAKER_03: And then when you're traveling as much as we do, to take all these with you, have TSA potentially take it away from you.
• 8:17
  SPEAKER_03: We were talking about the polypharmacy earlier, but you remember the Ziploc bags that people would bring in with all their different treatments, whether it's SEBDERM or even another indication, AD or psoriasis.
• 8:27
  SPEAKER_03: So I definitely think it's simplified the regimen for um our patients dramatically.
• 8:32
  SPEAKER_03: And I as a clinical trialist, you know, we have to sometimes beg and plead with our patients just to make them get to that eight-week mark.
• 8:38
  SPEAKER_03: So the fact that they didn't want to give up their medicine at the end of the eight weeks, I think is a testament to how well it was working for them.
• 8:44
  SPEAKER_01: 100%.
• 8:44
  SPEAKER_01: And I was just thinking back about how many clinical trials I've run where the patients would not give me back the medicine.
• 8:51
  SPEAKER_01: I mean, that was definitely one of maybe four or five that I can remember.
• 8:56
  SPEAKER_01: Uh, and and so it just tells you how desperate these patients are for something that works and something that's simple.
• 9:02
  SPEAKER_01: I mean, for the foam, you know, it's indicated for what's that, nine and above for sebury dermatitis.
• 9:09
  SPEAKER_01: Uh it's once daily.
• 9:11
  SPEAKER_01: Um it can be used on the scalp, it can be used on the face, it can be used for textured hair, any kind of hair, really.
• 9:18
  SPEAKER_01: And the the way it's formulated is so beautiful that patients don't mind using it.
• 9:23
  SPEAKER_01: I I have not had negative patient feedback on the foam.
• 9:26
  SPEAKER_01: Have have you had anything like that?
• 9:28
  SPEAKER_03: I have not.
• 9:29
  SPEAKER_03: Actually, what I do sometimes is I give them a sample of the cream and the foam in my exam room and tell them which one do you want me to prescribe for you?
• 9:37
  SPEAKER_03: And sometimes I'm surprised, but a lot of people gravitate toward the foam.
• 9:40
  SPEAKER_03: I think it's that versatility of being able to use it in all those different areas.
• 9:44
  SPEAKER_03: And I don't know if it's just me, but I get a little bit of a volume boost when I use it in my scalp.
• 9:49
  SPEAKER_03: So instead of a mousse for me, so everyone's gonna be a little bit different, but I do think it has some uh valuable virtues.
• 9:55
  SPEAKER_01: Note to self, it's a volumizing foam.
• 9:57
  SPEAKER_01: Good to know.
• 9:58
  SPEAKER_01: Okay.
• 9:58
  SPEAKER_02: We'll let our keto know.
• 10:00
  unknown: Yeah, right.
• 10:01
  SPEAKER_01: I had no idea.
• 10:02
  SPEAKER_01: Add that to the claims.
• 10:04
  SPEAKER_01: Um, yeah, you know, what I remember my patients uh in the clinical trial for the sebreic dermatitis um indication is that they loved it because when they had to use it around their eyes, because as we know, sebderm can occur between uh around the eyes uh on the nasal bridge and the nasal sidewalls, uh all over the mid face.
• 10:24
  SPEAKER_01: They weren't so nervous about it getting in their eyes because they were able to rub it in so easily.
• 10:29
  SPEAKER_01: Um, and I think everyone gets a little nervous using creams, even ointments around the eyes.
• 10:34
  SPEAKER_01: So the foam I found to be, and I continue to use it this way, I found to be a really helpful formulation for that area in particular.
• 10:44
  SPEAKER_01: And then Moni, it can be used in all areas.
• 10:46
  SPEAKER_01: I mean, the genitals included the underarms, it just doesn't really matter.
• 10:50
  SPEAKER_03: Yeah, and to your point in those areas, because sometimes I find foams, because of their alcohol content, can burn when you put on the skin.
• 10:57
  SPEAKER_03: I haven't seen that with the refulmalas foam.
• 10:59
  SPEAKER_03: It's very hydrating, it feels like this silky moisturizer that goes on your skin.
• 11:04
  SPEAKER_03: So it's something I think about that hydroarc technology that they came up with that is really nice in those sensitive areas.
• 11:11
  SPEAKER_01: Well, you make a really good point.
• 11:12
  SPEAKER_01: Your your colleague Chris Bunick and I had another episode where we reviewed all the different ingredients in the formulation, including Crotofos and Transcutol, and and then, of course, the lack of some of the ingredients that do cause so much irritation, isopropyl alcohol, ethanol, for example, examples, um, and and other propylene glycol.
• 11:33
  SPEAKER_01: Um gosh, parabens, uh, but there's so many different ingredients that are not included in these formulations, which especially with people that already have an impaired or uh otherwise uh a barrier which isn't working properly, you know, that they can get irritated very easily and experience local skin reactions like itching, burning, stinging, and we just haven't seen that with this drug at all.
• 11:58
  SPEAKER_03: Exactly.
• 11:59
  SPEAKER_03: I feel like it was very purposefully designed.
• 12:01
  SPEAKER_03: It's not just another non-steroidal.
• 12:03
  SPEAKER_03: They really took that patient experience into account.
• 12:05
  SPEAKER_03: And again, as a patient, I I just love the experience I have.
• 12:09
  SPEAKER_01: You know what's interesting, Mona?
• 12:10
  SPEAKER_01: I'm just thinking through this.
• 12:11
  SPEAKER_01: We haven't really seen anything new come out.
• 12:14
  SPEAKER_01: So we have the JAK inhibitors, which are really, you know, there's the obsolure and the and ZEPCO and ZEPCO really only indicated for hands and feet.
• 12:22
  SPEAKER_01: But it's been a few years now since we've had something new come out uh that is a non-steroidal that are not Jack inhibitors.
• 12:30
  SPEAKER_01: And I'm wondering if it's because Zareev raised the bar so high on formulation science that other companies are a little bit worried that expectations are so high.
• 12:41
  SPEAKER_01: And if they don't meet both the the efficacy, safety, as well as cosmetic expectations of creams, then they're gonna be a failure in the market.
• 12:51
  SPEAKER_01: And I I wonder if if they if they made it so great and that actually reduced the competitive landscape for them.
• 12:59
  SPEAKER_03: It absolutely is possible because if you think about it, like Zuri's been expanding their label, expanding the age uh indication.
• 13:05
  SPEAKER_03: Because I think they're gonna get a pediatric approval down to three months of age at some point in the near future, maybe by the end of the year.
• 13:11
  SPEAKER_03: Um, so I do think that that probably is playing a role because you have to go against the big brother who's really made a place in the space, and that unmet need that I used to always worry about in the space isn't as significant now.
• 13:24
  SPEAKER_03: Now I'm gonna ask you one question, Ted, because this happens with some of my patients.
• 13:28
  SPEAKER_03: Do you ever give a steroid for like a week or so to jumpstart the Zoro effect before you embark on your Zoro journey?
• 13:35
  SPEAKER_01: You're such a podcast host, Mona.
• 13:38
  SPEAKER_01: Um, you know what?
• 13:42
  SPEAKER_01: I used to, Mona, I used to because I didn't rely on Zorev, like I didn't have as much confidence, uh, especially for AD or psoriasis.
• 13:50
  SPEAKER_01: I knew for Sebderm I didn't need to do that.
• 13:52
  SPEAKER_01: And I actually did some of the trials for AD and psoriasis, and I knew it was going to work.
• 13:56
  SPEAKER_01: But I guess my 20 years of being a dermatologist came in where I've just relied on topical steroids for that acute phase and to try and get this under control that I felt like I needed to.
• 14:06
  SPEAKER_01: But over time, as I've gained confidence in Zareve and the mechanism of action and the formulation, I've really stopped doing that.
• 14:14
  SPEAKER_01: And what I've told patients is look, we know that this drug reduces itch very quickly.
• 14:19
  SPEAKER_01: Uh and so you're going to see a reduction of itch.
• 14:22
  SPEAKER_01: It may take longer for the redness and scaling and in duration to improve than what you're used to with your triumsenolone, your mometazone, your clobetazole, whatever you've been using.
• 14:32
  SPEAKER_01: But this is much safer for you.
• 14:34
  SPEAKER_01: And and I truly believe we're in a post-steroid era in dermatology.
• 14:39
  SPEAKER_01: And so because I speak about that on podium, I talk about it all the time, I feel like I have to practice it too.
• 14:45
  SPEAKER_01: And and that's just the way I practice.
• 14:47
  SPEAKER_01: And I set expectations and it seems to be okay.
• 14:51
  SPEAKER_03: Yeah, I couldn't agree with you more.
• 14:52
  SPEAKER_03: It's funny because I think patients who've been on steroids, they had that speed expectation, so there's a little more counseling involved.
• 14:57
  SPEAKER_03: But the patients who have never been on anything, or maybe they were on some steroid uh remotely, I tell them this is gonna work more quickly than you had to wait to see me in the office.
• 15:08
  SPEAKER_03: So that kind of gives them that perspective.
• 15:10
  SPEAKER_03: Because in my practice, it's about a three to four month wait to see me.
• 15:13
  SPEAKER_03: I promise you, in three to four months you're gonna be very, very happy, but much sooner, most likely.
• 15:18
  SPEAKER_01: It's amazing by having such a long wait time how many rashes get better on their own, isn't it?
• 15:22
  SPEAKER_02: It is.
• 15:25
  SPEAKER_02: That might be why we do this.
• 15:27
  SPEAKER_01: Yeah, right.
• 15:29
  SPEAKER_01: Uh, you know, the other thing we should talk about, Mona, is the once daily aspect of Zareb, whether we're talking about the foam or the cream.
• 15:36
  SPEAKER_01: And that we know that, for example, Steve Feldman has published on this extensively, and it just makes sense logically that by giving people a medication that not giving, prescribing people a medication that is a once daily, we really enhance the compliance.
• 15:51
  SPEAKER_01: I I don't remember the exact statistics, but it's dramatic in terms of compliance with QD once daily versus twice daily.
• 15:59
  SPEAKER_03: I absolutely agree.
• 16:00
  SPEAKER_03: So I think myself, I have a daughter, and if I have to put her moisturizer on twice a day, it is a feat.
• 16:07
  SPEAKER_03: So once a day is probably the best that I can do.
• 16:09
  SPEAKER_03: So to have a drug that is gonna work just as well with once a day is easy for a lot of people's regimens.
• 16:14
  SPEAKER_03: And also depending on the body site involved.
• 16:16
  SPEAKER_03: Like think of your hands.
• 16:17
  SPEAKER_03: You might put it on in the morning, you're gonna be washing your hands 50 times over the next 30 to 45 minutes.
• 16:22
  SPEAKER_03: This I can put on before I go to bed.
• 16:24
  SPEAKER_03: Now I know I have the whole night for it to work.
• 16:26
  SPEAKER_03: It just, I do think it improves that compliance and adherence and overall better outcomes.
• 16:31
  SPEAKER_01: Totally.
• 16:32
  SPEAKER_01: And, you know, we used to also think about adding the moisturizer, right?
• 16:36
  SPEAKER_01: So it would be another layer of treatment, which is the prescribed topical and then a moisturizer.
• 16:42
  SPEAKER_01: I found that I don't often need to use a moisturizer with Zurich.
• 16:46
  SPEAKER_01: Do you agree with that?
• 16:48
  SPEAKER_03: 100%.
• 16:48
  SPEAKER_03: Because there was that um study that came out a couple of years ago where they compared it to CeraVee, which was like the leading moisturizer, and it was quite comparable.
• 16:57
  SPEAKER_03: I didn't know about that study.
• 16:58
  SPEAKER_03: I just realized my patients didn't need their moisturizer as much, and I felt it was so hydrating.
• 17:02
  SPEAKER_03: But to know there's some data to back it up, I think again further simplifies that regimen, especially for our patients who need that extra support.
• 17:10
  SPEAKER_01: It's interesting also that this mechanism of action is applicable to uh what we consider a TH2 driven disease as well as psoriasis, which we consider more of a TH1.
• 17:20
  SPEAKER_01: And Chris and I went into this a little bit regarding kind of it's it's a little bit PDE4 inhibition is a little bit higher up, and increasing cyclic AMP is a little bit higher up in the pathway in terms of the production of these inflammatory cytokines.
• 17:34
  SPEAKER_01: And so it is type one or type two inflammation agnostic, really, which is so helpful because I I really feel like as I move on in my career, I'm seeing a lot more overlap between psoriasis and AD.
• 17:47
  SPEAKER_01: Um, certainly we think of sebderm as a distinct condition, but we also know that in some patients, sebderm develops into psoriasis.
• 17:55
  SPEAKER_01: And so to have something that's higher, again, a little bit more less specific, uh, but also incredibly safe, really helps us so much as practicing dermatologists, doesn't it?
• 18:06
  SPEAKER_03: It does.
• 18:07
  SPEAKER_03: And I actually think what I think of are some of our patients that are on biologics, whether it's AD biologics that block the TH2 pathway or psoriasis biologics that block TH1, sometimes we see a shift in someone's cytokine milieu.
• 18:19
  SPEAKER_03: So if you gave them xori for either their AD or psoriasis diagnosis, and now they're on a biologic as well, that's shifting the um inflammatory storm, the xurive will still work.
• 18:29
  SPEAKER_03: So we don't have to think about another treatment.
• 18:31
  SPEAKER_03: And for our patient who may not know is this eczema or is this psoriasis that's popping up, they know they'll still get benefit from that one cream.
• 18:37
  SPEAKER_03: I like that.
• 18:37
  SPEAKER_03: Um, one stop shop.
• 18:39
  SPEAKER_01: I mean, that's a great point where we have this shifting within patients of the kind of primary or principal inflammatory milieu, right?
• 18:48
  SPEAKER_01: Whether it's the th1 cytokines, the th2 cytokines, it doesn't really matter with cereborn.
• 18:52
  SPEAKER_01: We know that we can use zereva, it's safe to use with biologics.
• 18:56
  SPEAKER_01: And so it's kind of the Swiss Army knife of it of medications for us.
• 19:02
  SPEAKER_01: Just like just like steroids were, let's be honest, right?
• 19:05
  SPEAKER_01: Yeah, steroids really were.
• 19:06
  SPEAKER_01: I mean, we had to be careful of the potency in different areas and the length of time, but we knew they would work on inflammation.
• 19:12
  SPEAKER_01: Um, but this is just so much safer.
• 19:15
  SPEAKER_01: So um, again, just fits the needs.
• 19:17
  SPEAKER_01: I I think we've really addressed the idea that this avoids polypharmacy, it avoids topical confusion that we have historically had to deal with, our poor patients had to.
• 19:26
  SPEAKER_01: And you know, we would get so many callbacks in the office regarding, hey, where do I use where and and which one again?
• 19:32
  SPEAKER_01: And I'm out of the one for the face, but I still have more for the body.
• 19:35
  SPEAKER_01: Ugh.
• 19:35
  SPEAKER_01: It was a nightmare.
• 19:37
  SPEAKER_01: So much easier with Zareve, right?
• 19:39
  SPEAKER_03: It is, it is.
• 19:39
  SPEAKER_03: And again, as someone who sees kids, if you think of that six to eleven crowd where they're just starting to become independent, they want to do things their way, they don't mommy and daddy to help them.
• 19:49
  SPEAKER_03: Zareev just gives me peace of mind that they're not gonna screw it up and God forbid have some sort of um unforeseen uh side effects.
• 19:56
  SPEAKER_03: So there's so many different places this drug fits in.
• 19:58
  SPEAKER_03: I love your Swiss Army knife analogy because I'm trying to think of where I wouldn't use Zoeve, and I'm really having a tough time coming up with an answer.
• 20:05
  SPEAKER_01: I know, I know, yeah, and that's why it's so easy.
• 20:08
  SPEAKER_01: It's kind of a decide and prescribe drug.
• 20:10
  SPEAKER_01: You just decide that you need it, you prescribe it, you don't have to worry.
• 20:13
  SPEAKER_01: You know, there's not much more counseling that needs to happen.
• 20:16
  SPEAKER_01: Um, Mona, thank you so much uh I for taking the time to talk with me.
• 20:21
  SPEAKER_01: I know your your podcast again is called the Medical Sisterhood Podcast.
• 20:26
  SPEAKER_01: Yes.
• 20:26
  SPEAKER_01: I did see that you interviewed Jim Del Rosso.
• 20:28
  SPEAKER_01: I I could be another Y chromosome on the podcast.
• 20:32
  SPEAKER_01: I'm just putting myself out there.
• 20:34
  SPEAKER_02: Love it.
• 20:37
  SPEAKER_01: Otherwise, Mona Shariari, everybody, she's an amazing KOL in dermatology across inflammatory disease states.
• 20:44
  SPEAKER_01: Uh, she's an expert that I turn to.
• 20:45
  SPEAKER_01: I read her uh all of her publications as well.
• 20:49
  SPEAKER_01: She's wonderful on podium.
• 20:50
  SPEAKER_01: Uh, Mona, thank you for all you do for dermatology.
• 20:54
  SPEAKER_01: Uh, my name is Dr.
• 20:55
  SPEAKER_01: Ted Lane, your host for today.
• 20:56
  SPEAKER_01: Again, thank you so much for listening.
• 20:58
  SPEAKER_01: This podcast supports the Science of Skin Summit, taking place in September in Austin.
• 21:02
  SPEAKER_01: And then we just added the Science of Skin Longevity Summit taking place in February 2027 in Scottsdale, Arizona, to learn more, science of skinsummit.com.
• 21:11
  SPEAKER_01: Thank you so much for listening, and thank you, Mona, for your time, knowledge, and expertise.
• 21:16
  SPEAKER_03: Thank you so much, Ted.
• 21:17
  SPEAKER_03: And I'm gonna put a plug in for your podcast because I am an avid listener and I want everyone else to continue to subscribe.
• 21:23
  SPEAKER_01: There you go.
• 21:24
  SPEAKER_01: Thanks, Mona.
• 21:32
  SPEAKER_00: Thank you to our sponsor, Arcutis Biotherapeutics, for their support of the Science of Skin podcast and furthering Durham education.
• 21:40
  SPEAKER_00: Arcutis is a medical dermatology company that champions meaningful innovation to address the urgent needs of individuals living with immune-mediated dermatological diseases and conditions.
• 21:51
  SPEAKER_00: With a commitment to solving the most persistent patient challenges in dermatology, Arcutis has a growing portfolio of advanced targeted topicals.
• 22:00
  SPEAKER_00: Arcutis's unique dermatology development platform, coupled with their dermatology expertise, allows them to develop differentiated therapies against biologically validated targets for a range of inflammatory dermatological conditions.
• 22:14
  SPEAKER_00: Arcutis strives to simplify disease management and optimize drug efficacy, safety, and tolerability.
• 22:21
  SPEAKER_00: They're determined to elevate the current standard of care, solving for the challenges others haven't.