New Clinical Trials Are Testing Breakthrough Eczema Treatments—Here's What Patients Need to Know

UC San Diego is conducting four major clinical trials for atopic dermatitis (eczema), testing everything from new oral medications to innovative bacterial treatments that could reshape how doctors manage this chronic skin condition. These studies represent a significant shift in eczema research, moving beyond traditional steroids to explore targeted therapies that address the underlying causes of this itchy, inflammatory skin disease.

What New Eczema Treatments Are Being Tested Right Now?

Researchers at UCSD are investigating several promising approaches to treat moderate-to-severe eczema. The trials include testing abrocitinib, an oral medication designed specifically for children ages 6 to 11 with moderate-to-severe eczema, as well as a groundbreaking bacterial therapy called S. hominis A9 (ShA9) for adolescents and adults. The ShA9 treatment represents a completely different approach—instead of fighting bacteria on the skin, it uses beneficial bacteria to help restore balance and reduce inflammation.

One particularly important trial is monitoring the safety of tralokinumab, a biologic medication, in pregnant people with eczema. This study recognizes that many women develop or worsen eczema during pregnancy and need safe treatment options.

How Do These New Treatments Work Differently From Current Options?

Traditional eczema treatments rely heavily on topical corticosteroids—creams and ointments that reduce inflammation but don't address the root cause. The new trials are testing systemic therapies that work throughout the body. Abrocitinib, for example, is an oral medication that targets specific immune pathways involved in eczema development. The ShA9 bacterial treatment takes an even more innovative approach by using a naturally occurring skin bacterium to help restore the skin's protective barrier and reduce harmful bacterial colonization.

The TIME-2 trial (Targeted Investigation of Microbiome 2 Treat Atopic Dermatitis) specifically focuses on people whose skin is colonized with Staphylococcus aureus, a bacterium that commonly worsens eczema. By introducing beneficial bacteria, researchers hope to outcompete the harmful bacteria and reduce flare-ups.

Steps to Determine If You're Eligible for an Eczema Clinical Trial

• Age Requirements: The abrocitinib trial is for children ages 6 to 11, while the ShA9 bacterial treatment and pregnancy safety studies accept adolescents and adults ages 12 and older.
• Severity Level: Most trials require moderate-to-severe eczema, meaning your condition significantly impacts daily life and hasn't responded adequately to standard treatments.
• Bacterial Status: The ShA9 trial specifically enrolls people who test positive for Staphylococcus aureus colonization, so screening is part of the enrollment process.
• Pregnancy Status: The PROTECT trial is exclusively for pregnant people or those planning pregnancy who have eczema or have been exposed to tralokinumab.
• Location Access: Trials are based in San Diego, California, with some accepting participants from other locations, though the pregnancy study (PROTECT) operates remotely with no required in-person visits.

Why Is Pregnancy Safety in Eczema Treatment Such a Big Deal?

Eczema often flares during pregnancy due to hormonal changes and immune system shifts, yet many effective treatments are considered risky for developing babies. The PROTECT trial addresses this critical gap by following pregnant people exposed to tralokinumab and comparing their pregnancy and infant outcomes to those with untreated eczema. Participants complete phone interviews during and after pregnancy, provide medical records, and answer surveys about their baby's development at 4 months and 12 months. This remote-only approach removes barriers for pregnant people who may have difficulty traveling to medical appointments.

What Makes the Bacterial Treatment Approach Revolutionary?

The ShA9 treatment challenges the traditional "kill all bacteria" approach to skin health. Instead of using antibiotics or steroids to eliminate bacteria, this therapy introduces a specific beneficial bacterium to restore balance. The trial runs for 14 weeks total, with an initial two-week period combining ShA9 with topical corticosteroids, followed by 12 weeks of ShA9 alone to assess how long it maintains eczema control. This combination approach allows researchers to measure both the safety and effectiveness of the bacterial therapy while ensuring participants receive adequate initial treatment.

The TARGET-DERM registry, another UCSD initiative, takes a broader approach by creating a research database of patients with atopic dermatitis and other immune-mediated inflammatory skin conditions across academic and community practices. This real-world data collection helps researchers understand how current and future therapies perform outside controlled clinical settings, providing insights that benefit all eczema patients.

Who's Leading This Research?

UCSD's eczema research is led by a team of renowned dermatologists and immunologists, including Richard Gallo, MD, PhD; Tissa Hata, MD; Christina Chambers, PhD, MPH; and Lawrence F. Eichenfield, MD. These experts bring decades of combined experience in understanding both the immune mechanisms driving eczema and the practical challenges patients face managing this chronic condition.

If you or a family member has moderate-to-severe eczema that isn't adequately controlled with current treatments, these trials represent an opportunity to access cutting-edge therapies while contributing to research that could help millions of people. Contact UCSD's clinical trials office to learn more about eligibility and enrollment for the specific trial that matches your situation.