Meet the Councilor | Robert Bissonnette, IEC Immediate Past President

Our first installment of ‘Meet the Councilor’ features Robert Bissonnette, MD, FRCPC, MSc, who is the current IEC immediate past president. Dr. Bissonnette, from Montreal, QC, Canada, is the CEO and medical director of Innovaderm Research, a contract research organization specializing in the design, conduct, and analysis of clinical trials in dermatology. Read the summary of our Q&A with Dr. Bissonnette below, or listen to his 9-minute audio interview here.

What is your proudest accomplishment in the atopic dermatitis (AD) space to date?

I’m most proud of my involvement in clinical research related to the development of new topical drugs in AD. I was the main investigator in the first study of a topical Janus kinase (JAK) inhibitor in patients with AD, which showed very impressive improvement in AD. I was also involved in the design and conduct of the first study performed in AD with a topical aryl hydrocarbon receptor (AhR)-modulating agent.

What do you value most about being involved with the IEC?

What I value most about being an IEC Councilor is meeting other dermatologists with a strong interest in AD and learning more about AD, which is an extremely common, but very complex disease. IEC Councilors are conducting research in areas such as epidemiology, prevention, treatment, and the molecular aspects of AD. We have numerous opportunities to attend symposia, for discussion with colleagues, and to be involved in surveys and publications.

As president, I want to continue the success of IEC symposia at international dermatology meetings, and would like to conduct more activities outside North America and Western Europe—to be a truly global organization devoted to AD. I want to continue our successful IEC publications, which are a mix of reviews and surveys conducted with IEC Councilors to reach consensus on what is really important to focus on in terms of AD research and care. We also need to build on our diversity as an organization by bringing on board more Councilors from regions that are underrepresented, such as South America, Asia, and Africa.

Based on your experience in AD, what do you think will garner the most attention over the coming year in this field?

From a short-term perspective, I would say that new topical treatments will transform the way we treat AD. We have seen major advancements in systemic therapy, with the approval of the first biologic a number of years ago, with others systemic treatments to follow in the near future. But we have not had a transformative topical product. A number of topical products now in late-stage clinical development will change how we treat AD, because most patients have mild-to-moderate disease and do not necessarily have access to systemic therapy. Even patients treated with systemic therapy may have remaining disease activity that would be amenable to a topical drug with a good safety and efficacy profile.

From a mid- to long-term perspective, having new drugs approved for AD fuels research, not only directed towards developing new treatments, but also to understand AD from a molecular perspective, such as the importance of barrier abnormalities versus inflammation, and how this differs from one patient to another.

One of the things with AD that is very different from psoriasis is the development of biologics. I was involved in early studies with biologics in psoriasis—the first agents had limited efficacy, but from one year to another, new biologics brought to the clinic were more and more efficacious. I don’t see this progressing as fast in AD. Possibly because of the complexity and heterogeneity of AD, we may not have one single biologic that will have very high efficacy in all patients. I may be wrong and we may eventually find the key cytokine target. But if I’m right, it could be that personalized medicine will enter general dermatology practice through the door of AD.

What do you see as the biggest need among AD patients?

Preventing the appearance of AD and comorbidities in infants and children at risk is an area of intense interest, both from a patient and physician perspective. The IEC can help by focusing research on better understanding the pathogenesis of AD and prevention. This year we initiated the IEC Fellowship Program to train the next generation of dermatologists. The 1-year Research Fellowships enable early career physicians to participate in AD research at top academic research centers.