A short video raising awareness of Pompe disease

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Pompe Disease Awareness

A short video raising awareness of Pompe disease

A short video outlining the mechanism of Pompe disease

Pompe Mechanism of Disease

A short video outlining the mechanism of Pompe disease

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Praluent®&nbsp;can be injected subcutaneously into the thigh, abdomen or upper arm. Patients should rotate the injection site with each injection.1

<h4>Watch this video to see how to administer Praluent</h4>

Praluent® (alirocumab) Administration

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Praluent® (alirocumab) Administration

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<h3>Praluent®</h3>
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Praluent® (alirocumab) Prescribing Information (UK)

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<a href="${link:{uuid:{3c621072-b317-4715-bb3e-c63ceb933735},repository:{dam},path:{/Portal/UK/Prescribing-Information/Dupixent-AD-and-PN-UK-PI.pdf}}}">DUPIXENT® (dupilumab) Prescribing&nbsp;Information UK</a>
<h3>Introduction</h3>
AD, a chronic inflammatory skin condition, poses significant challenges in paediatric, adolescent and adult patients.1 A key factor in the pathophysiology of AD is the underlying type 2 inflammation, driven by cytokines such as IL-4 and IL-13.2,3 This type 2 inflammation can contribute to barrier dysfunction, intense itch and increased risk of skin infections.2,3 The impact of moderate-to-severe AD is multifaceted, and the long-term risks of uncontrolled AD may extend beyond visible skin symptoms.4,5
<h3>Understanding the Burden Beyond Skin Symptoms</h3>
The symptoms of AD can affect not only the skin but also the overall QoL, including social, emotional, and physical health. The combined effect of these factors, over time, in uncontrolled AD can lead to cumulative life course impairment (CLCI) for some patients.4–7 Recognising these broader implications is essential for an effective management.6 
 A range of tools have been developed to help identify those patients whose AD remains uncontrolled despite current therapy.6,8&nbsp;
<h3>Tools for Identifying Uncontrolled AD</h3>
The Atopic Dermatitis Control Tool (ADCT) provides valuable insights into evaluating the extent of the condition and guiding healthcare providers to make informed treatment decisions.9,10
Atopic Dermatitis Control Tool (ADCT): This patient-reported tool is designed to facilitate meaningful discussions between patients and healthcare providers regarding the control of AD in clinical practice. This validated tool is appropriate for patients 12 years and older and it consists of six questions that evaluate the severity of symptoms, including itch and sleep disturbances, and their impact on daily activities and mood. Within a range of 0 to 24, a score of ≥7 indicates inadequate disease control, which prompts a reassessment of treatment strategies. The ADCT helps in identifying the degree of disease control and making informed decisions about escalating therapy.9,10

Please <a href="${link:{uuid:{ee62ecbc-89df-4b77-8236-bbe80b41b5ed},repository:{tools-resources},path:{/UK/adct}}}">Click here</a> to access the ADCT – a validated, brief and easily scored patient self-assessment tool.
Potential Future Tools for Assessing Cumulative Life Course Impairment: 
 Tools to address the CLCI caused by AD will be essential for understanding and managing the profound impacts of AD throughout patients’ lives. Recent developments in this area show promise, though it's important to note these tools have not been validated and are still in development stages for AD (and other chronic skin conditions).8&nbsp;

Dermatology CLCI Retrospective (DermCLCI-r) tool&nbsp; Aims to assess the CLCI caused by AD, focusing on how the disease has affected patients’ lives over time. It includes questions on physical, emotional, and social domains, offering a comprehensive view of past impacts.8&nbsp;

Dermatology CLCI prospective (DermCLCI-p) tool&nbsp; 
 Conversely, the DermCLCI-p tool is intended to predict future risks associated with AD, helping to identify patients at risk for life impairment.8

Both tools consist of 30-item questionnaire that helps assess the impairments of AD. This questionnaire assesses the following:8
<ul>
 <li>The effect of life course impairment on a 4-point Likert scale [0 (not at all) to 3 (very)] and whether these have been life-changing</li>
 <li>The effect of coping behaviours on a 5-point Likert scale [0 (not at all) to 4 (very)]</li>
</ul>
These tools are still in their early stages and await comprehensive psychometric testing for validity and reliability. Development of these tools is an important first step in better understanding the experience of disease burden within the context of additional impactful life events. With future study, they hold promise for integration into both routine clinical care and broader health services research.8 
 Using tools to identify where patients' AD is inadequately controlled could help inform treatment strategies. When AD is refractory to topical therapies, advanced treatment with phototherapy or systemic medications may be considered. Advanced systemic therapies, including biologics or JAKis, are considered effective in treating eligible patients with moderate-to-severe AD.11–14
<h3>Conclusion</h3>
Understanding and using these tools can contribute to better management of AD.10 By recognising the extensive burden of AD beyond the skin, clinicians are better equipped to identify patients who are not well-controlled on their current medications. This awareness may better inform decisions about when treatment escalation may be required to address both immediate symptoms and long-term impact on the patient’s QoL.8,10&nbsp; 
 Early identification of at-risk patients, using appropriate tools, and timely escalation to appropriate treatments are crucial in providing best practice care for patients.15–17

Discover tools that can help you identify AD patients that are uncontrolled.&nbsp;

DUPIXENT is approved for use in eligible patients as young as 6 months old in AD.18

DUPIXENT is indicated for use in patients who are candidates for systemic therapy, aged 12 years and older with moderate-to-severe atopic dermatitis (AD), and in patients aged 6 months to 11 years of age with severe AD.18
AD, atopic dermatitis; ADCT, Atopic Dermatitis Control Test; CLCI, Cumulative Life Course Impairment; IL, interleukin; JAKis, Janus kinase inhibitors; QoL, quality of life.&nbsp;

<h3>References</h3>
<ol>
 <li>Weidinger S et al. Lancet. 2016;387(10023):1109–1122.</li>
 <li>Haddad EB et al.&nbsp;Dermatol Ther (Heidelb). 2022;12(7):1501–1533.</li>
 <li>Moniaga CS et al.&nbsp;Diagnostics. 2021; 11(11):2090.</li>
 <li>Fasseeh AN et al.&nbsp;Dermatol Ther (Heidelb). 2022;12(12):2653–2668.</li>
 <li>Weidinger S et al.&nbsp;Br J Dermatol. 2024;190(6):846–857.</li>
 <li>Calzavara-Pinton P et al. Adv Ther. 2023;40(12):5366–5382.</li>
 <li>Augustin M et al. JEADV. 2022; 36(7):3–16.</li>
 <li>Braren-von Stülpnagel CC et al.&nbsp;J Eur Acad Dermatol Venereol. Published online February 18, 2023. doi:10.1111/jdv.18977</li>
 <li>Strober B et al.&nbsp;JAMA Dermatol. 2022;158(2):142–150.</li>
 <li>ADCT, Atopic Dermatitis Control Tool. Patient Form. <a href="https://www.adcontroltool.com/adct-downloads1">https://www.adcontroltool.com/adct-downloads1</a> Date last accessed: March 2026.</li>
 <li>Chovatiya R et al.&nbsp;Am J Clin Dermatol. 2022;23(4):459–468.</li>
 <li>Davis DMR et al.&nbsp;J Am Acad Dermatol. 2024;90(2):e43–e56.</li>
 <li>Chu DK et al. Ann Allergy Asthma Immunol. 2024;132(3):274–312.</li>
 <li>Chu AWL et al. J Allergy Clin Immunol. 2023;152(6):1470–1492.</li>
 <li>Augustin M, et al. JEADV. 2022; 36(7): 3–16.</li>
 <li>von Stülpnagel CC et al. J Eur Acad Dermatol Venereol. 2021; 35(11): 2166–2184.</li>
 <li>Bieber T. Nat Rev Drug Discov. 2023; 22(8): 662–680.</li>
 <li>DUPIXENT Summary of Product Characteristics. 2026.&nbsp; 
 &nbsp;</li>
</ol>

Read to learn more about what tools can help you identify your patients with uncontrolled AD

DUPIXENT® (dupilumab) Prescribing Information UK 

DUPIXENT

ATOPIC-DERMATITIS

DERMATOLOGY

Improving Quality of Life in Patients with Uncontrolled Atopic Dermatitis (AD): Tools for Timely Identification and Treatment 

<h2>Beyfortus is the first RSV immunisation designed to offer protection to all infants, with effectiveness and public health impact supported by real-world data1-5</h2>
<h3>Watch Professor Saul N Faust and Dr Katrina Cathie discuss Beyfortus in a series of three videos</h3>

Professor of Paediatric Immunology &amp; Infectious Diseases
NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust 
 &nbsp;

Professor Saul N Faust

black

Consultant Paediatrician &amp; Associate Director,&nbsp;
NIHR Southampton Clinical Research Facility and University Hospital Southampton NHS Foundation Trust

Dr Katrina Cathie

Offers direct protection against RSV LRTD via administration of antibodies without relying on an infant's immune system1,6

Direct

Offers RSV protective antibodies starting Day 1 after injection, reaching maximum concentration within 6 days (range 1 to 28 days)1*

Rapid

Beyfortus is a long-acting monoclonal antibody modified to extend the half-life to ~71 days1†
A single dose offers protection for at least 5 to 6 months1

Durable

*Following intramuscular administration, maximum concentration was reached within 6 days (range 1‑28 days).1 †Beyfortus has been modified with a triple amino acid substitution (YTE) in the Fc region to extend serum half-life.1

<h3>Beyfortus reduced the risk of medically attended RSV LRTI and has demonstrated a reduction in RSV hospitalisation versus placebo7,8</h3>

Phase II/III MEDLEY trial (N=925)

Phase IIb trial (N=1,453)

Phase III MELODY trial (N=1,490)

<h3>Watch Professor Saul N Faust and Dr Katrina Cathie present the efficacy and safety profile of Beyfortus</h3>

Beyfortus®▼ (Nirsevimab)

VACCINES

RESPIRATORY-SYNCYTIAL-VIRUS

About Beyfortus®▼ (Nirsevimab): Clinical Efficacy, Real-World Impact, and Duration of Protection

Adapted from Hammitt L L et al, 20228 †Primary endpoint was met ‡Secondary endpoint did not meet statistical significance
Adverse events of grade 3 or higher severity were reported in 36 of the 987 infants (3.6%) who received Beyfortus and in 21 of the 491 infants (4.3%) who received placebo.8

<h3>A single dose of Beyfortus for an entire RSV season1,2,8§</h3>
A single dose of Beyfortus offers protection against RSV LRTI for at least 5-6 months, covering the duration of a typical RSV season.1,2,8§
For complete prescribing information, refer to the Summary of Product Characteristics.&nbsp; §Weight-based dosing regimen.1

<h3>Watch Professor Saul N Faust and Dr Katrina Cathie discuss the duration of protection and dosage of Beyfortus</h3>

<h3>Real‑world evidence for a single dose of Beyfortus3,10</h3>
Beyfortus® is indicated for prevention of RSV in all infants during their first RSV season. UK JCVI guidance recommends Beyfortus® for specific high-risk infants.
High effectiveness (versus no immunisation) and public health impact was consistently seen with Beyfortus in real‑world studies, supporting its use as an effective RSV immunisation.10,11

<h3>Watch Professor Saul N Faust and Dr Katrina Cathie further explore real-world evidence for Beyfortus</h3>

<h3 style="text-align:center;">NIRSE-GAL:3 hospitalisations for RSV-associated LRTI (catch-up cohort)‖</h3>

<h3 style="text-align:center;">Effectiveness</h3>

Intention‑to‑treat analysis (n=7,061) using catch-up group only; Beyfortus 24 events per 1,168,165 person‑days versus 15 events per 254,019 person‑days for non‑Beyfortus recipients
<h4>0.386% ARR per 10,000 person-days</h4>

NIRSE-GAL definition and results

Abbreviations and footnotes

References

Prescribing Information UK

<a href="${link:{uuid:{3c621072-b317-4715-bb3e-c63ceb933735},repository:{dam},path:{/Portal/UK/Prescribing-Information/Dupixent-AD-and-PN-UK-PI.pdf}}}">DUPIXENT® (dupilumab) Prescribing&nbsp;Information UK</a>
<h3>Introduction</h3>
AD is a chronic inflammatory skin condition characterised by intense itching and periodic flares of inflamed, dry skin which may eventually impair patients' quality of life (QoL).1,2 The underlying pathophysiology of AD typically involves type 2 inflammation (T2I), driven by cytokines such as IL-4 and IL-13, which exacerbate symptoms and contribute to the disease's complexity.3 However, the burden of uncontrolled moderate-to-severe AD can extend far beyond the visible symptoms, encompassing psychological and social impact that can contribute to CLCI.2,4&nbsp;
According to the Global Burden of Disease study, AD has the highest disability-adjusted life-year (DALY) burden among all skin diseases, with an age-standardised DALY rate significantly higher than psoriasis and urticaria.2&nbsp; This article focuses on understanding CLCI in AD, and the importance of recognising and addressing these hidden burdens.
<h3>Moderate-to-Severe Atopic Dermatitis–A Cumulative Burden</h3>
The multidimensional burdens of AD in patients with moderate-to-severe symptoms include more than just skin lesions and itching.1,5,6 Patients frequently suffer from specific elements of CLCI such as stigma, psychological distress, limited social support, and coping challenges, all of which contribute to CLCI.4&nbsp;

Stigma 
 Patients with AD often face social stigma due to overt public rejection, poor self-image, and &nbsp;lack of self-confidence4

Psychological Burden 
 Psychological comorbidities of people living with AD can include anxiety, depression and suicidal ideation — further complicating the patient's health profile4

Systemic Implications 
 The chronic inflammation associated with AD can lead to comorbidities and AD is associated with conditions such as poor bone health, cardiovascular diseases, hypertension, stroke, Type 2 diabetes, and other immune-related conditions7

Social Support 
 Additionally, the lack of adequate social support from family, friends, and colleagues can hinder effective management of the disease4

Coping Challenges 
 Maladaptive coping, denial, helplessness and family factors add to coping challenges. These challenges add to the cumulative burden, making it difficult for patients to maintain a normal lifestyle4

The cumulative effect of these burdens over the years can lead to a potentially irreversible damage, affecting various life domains such as productivity at school and work, and the ability to maintain social relationships.2,4,8
<h3>Listen to Dr Hywel Cooper discuss AD and the impact on patients QoL</h3>

Read to learn more about the burdens of uncontrolled AD.

RESPIRATORY

Unseen Burdens: How Cumulative Life Course Impairment (CLCI) Affects Patients with Moderate-to-Severe Atopic Dermatitis (AD)

<h3>CLCI–Potentially Irreversible Damage Due to Inadequate Treatment and Uncontrolled AD2,4,7,9,10</h3>

Timely identification and treatment escalation of patients with uncontrolled AD may improve the signs, symptoms and quality of life burdens these patients are currently experiencing.8 
 &nbsp;

<h3>Conclusion</h3>
The burdens of uncontrolled AD may become cumulative, impacting various aspects of a patient's life and contributing to CLCI.1,4,6 By understanding and addressing these multifaceted challenges, healthcare professionals can improve patient outcomes and quality of life.2,8
Early identification of at-risk patients, using appropriate tools, and timely escalation to appropriate treatments are crucial in providing best practice care for patients.4,8,11
Discover tools that can help you identify AD patients that are uncontrolled.

DUPIXENT is approved for use in eligible patients as young as 6 months old in AD.12

DUPIXENT is indicated for use in patients aged 12 years and older with moderate-to-severe atopic dermatitis (AD), and in patients aged 6 months to 11 years of age with severe AD, who are candidates for systemic therapy.12
AD, atopic dermatitis; CLCI, Cumulative Life Course Impairment; DALY, disability-adjusted life-year; IL, interleukin; QoL, quality of life; T2I, type 2 inflammation.

<h3>References</h3>
<ol>
 <li>Weidinger S et al. Lancet. 2016; 387(10023): 1109⁠—1122.</li>
 <li>Fasseeh AN et al. Dermatol Ther (Heidelb). 2022; 12(12): 2653⁠—2668.</li>
 <li>Moniaga CS et al. Diagnostics (Basel). 2021; 11(11): 2090.</li>
 <li>Augustin M, et al. JEADV. 2022; 36(7): 3⁠—16.</li>
 <li>Weidinger S et al. Br J Dermatol. 2024; 190(6): 846⁠—857.</li>
 <li>Calzavara-Pinton P et al. Adv Ther. 2023; 40(12): 5366⁠—5382.</li>
 <li>Thyssen JP et al. J Allergy Clin Immunol. 2023; 151(5): 1155⁠—1162.</li>
 <li>von Stülpnagel CC et al. J Eur Acad Dermatol Venereol. 2021; 35(11): 2166⁠⁠—2184.</li>
 <li>Davis DMR et al. J Am Acad Dermatol. 2022; 86(6): 1335⁠—1336.e18.</li>
 <li>Bacci ED et al. J Dermatolog Treat. 2023; 34(1): 2202288.</li>
 <li>Bieber T. Nat Rev Drug Discov. 2023; 22(8): 662⁠—680.</li>
 <li>DUPIXENT Summary of Product Characteristics. 2025.</li>
</ol>

Read to learn more about the burdens of uncontrolled AD.

DUPIXENT® (dupilumab) Prescribing Information UK

<a href="${link:{uuid:{3c621072-b317-4715-bb3e-c63ceb933735},repository:{dam},path:{/Portal/UK/Prescribing-Information/Dupixent-AD-and-PN-UK-PI.pdf}}}">DUPIXENT® (dupilumab) Prescribing&nbsp;Information UK</a>
<h3>Introduction</h3>
Skin diseases are the fourth most common cause of nonfatal morbidity, impacting nearly one-third of the global population. Chronic diseases cause substantial burden, and despite their high prevalence, this burden is often underestimated.1,2
Chronic skin diseases including atopic dermatitis (AD), notably affect patients' health-related quality of life (HRQoL), including physical health, emotional well-being, and social interactions. Patients with inflammatory skin diseases often suffer from symptoms that contribute to psychological distress, including anxiety and depression, ultimately resulting in cumulative long-term impairment.3 Understanding CLCI is essential to fully grasp the enduring burden of chronic skin diseases and the irreversible impact on patients' lives over time.4
<h3>CLCI in Dermatology: What You Need to Know?</h3>
CLCI is a theoretical concept that describes the non-reversible burden of chronic skin diseases over time. In some cases, this persistent burden can lead to chronic impairment and missed opportunities resulting in lasting psychosocial and personal damage. Some individuals are less vulnerable to CLCI, while others are more affected by factors such as stigma, physical comorbidities, and psychological comorbidities. Difficulty in coping with these factors increases the patients' risk of vulnerability.4

Hypothetical impairment over a patient’s life&nbsp;course4 
 Adapted from Augustin A et al. 2013.4
Recognising these factors is crucial for healthcare professionals to develop comprehensive management strategies aimed at mitigating the long-term effects of chronic skin diseases such as AD.
<h3>The Chronic Nature of AD: A&nbsp;Multidimensional Burden</h3>
AD is a chronic, relapsing condition marked by eczematous lesions and severe pruritus. Although AD often manifests in infancy, affecting approximately 20% of children, it remains highly prevalent in adults, indicating a lifelong disposition.5
The chronic nature of AD can lead to a continuous cycle of flare-ups and remissions. The atopic comorbidities such as food allergies, asthma, allergic rhinitis, other immune-mediated inflammatory diseases, and non-atopic comorbidities such as mental health disorders, may develop in patients with severe disease.4–6

The burden of uncontrolled AD may further lead to other factors such as sleep loss, impaired functioning, self-esteem issues, reduced productivity, cardiovascular diseases, poor bone health, financial strain, and loss of opportunities.23–27
<h3>Listen to Dr Antonia Lloyd-Lavery discuss the comorbidities associated with AD</h3>

Read to learn more about the concept of CLCI, how it manifests in atopic dermatitis and its impact on patients.

The Hidden Impact of Cumulative Life Course Impairment (CLCI) in Dermatology: An Overview

<h3>High Disease Burden in Low BSA Involvement</h3>
This chronic and relapsing nature of AD underscores the importance of evaluating the disease's impact, even when the Body Surface Area (BSA) involvement is minimal.
Patients with a low BSA involvement may experience a high disease burden.28 The severity of symptoms and their impact on QoL are not solely dependent on the extent of skin involvement but also on the functionality and visibility of the affected areas.28,29 
 Hands and feet and face are commonly reported to be affected by AD. These areas can lead to significant physical impairments that affect the QoL, causing psychological distress and disrupting work and school productivity.29–34
Over time, these ongoing challenges can contribute to CLCI, highlighting the long-term, cumulative burden of chronic skin diseases.3 Timely intervention and escalation of therapy for patients with uncontrolled moderate to severe AD can be critical in helping to manage the signs, symptoms and quality of life impacts of uncontrolled AD.35

The graph is a hypothetical model of CLCI throughout the course of AD, adapted from Kimball, et al. J Eur Acad Dermatol Venereol. 201027 and Bieber T, et al. Nat Rev Drug Discov. 2023.36

<h3>Conclusion</h3>
CLCI is a crucial concept in understanding the long-term impact of chronic skin conditions like AD.3,4 For patients with moderate-to-severe AD, the burden extends beyond the skin, causing psychological and social distress, and affecting the overall QoL.29–31
Timely and appropriate escalation for patients suffering with uncontrolled AD may help reduce the burdens they face.35
<h3>Watch Prof Michael Cork discuss disease modification in AD</h3>

<h6>DUPIXENT is approved for use in eligible patients as young as 6 months old in AD.37</h6>

DUPIXENT is indicated for use in patients aged 12 years and older with moderate-to-severe atopic dermatitis (AD), and in patients aged 6 months to 11 years of age with severe AD, who are candidates for systemic therapy.37

References
<ol>
 <li>Seth D et al. Curr Dermatol Rep. 2017; 6(3): 204–210.</li>
 <li>Flohr C et al. Br J Dermatol. 2021;184: 189–190.</li>
 <li>von Stülpnagel CC et al. J Eur Acad Dermatol Venereol. 2021; 35(11):2166–2184.</li>
 <li>Augustin A et al. Wound Medicine. 2013; 1: 2–6.</li>
 <li>Weidinger S et al. Lancet. 2016; 387(10023): 1109–1122.</li>
 <li>Simpson EL et al. J Am Acad Dermatol.&nbsp;2016; 74(3): 491–498.</li>
 <li>Wang V et al. Ann Allergy Asthma Immunol. 2021;126(1): 3–12.</li>
 <li>Cameron S et al. Allergy. 2024; 79(1):26–36.</li>
 <li>Weidinger S et al.&nbsp;Br J Dermatol. 2024; 190(6): 846–857.</li>
 <li>Calzavara-Pinton P et al. Adv Ther. 2023; 40(12): 5366–5382.</li>
 <li>Lee SW et al.&nbsp;Allergy Asthma Immunol Res. 2023;15(2): 231–245.</li>
 <li>Lundin S et al. J Eur Acad Dermatol Venereol. 2023; 37(9): 1854–1862.</li>
 <li>Wan J et al.&nbsp;J Allergy Clin Immunol Pract. 2023; 11(10):3123–3132.e3.</li>
 <li>Silverberg JI et al.&nbsp;JAMA Dermatol. 2015; 151(4): 401–409.</li>
 <li>Wu D et al.&nbsp;Ann Transl Med. 2021; 9(1): 40.</li>
 <li>Silverberg JI et al. J Invest Dermatol. 2015; 135: 56–66.</li>
 <li>Chang YS et al. J Allergy Clin Immunol. 2018; 142(4): 1033–1040.</li>
 <li>Paller AS et al. J Am Acad Dermatol. 2022; 87(5): 1104–1108.</li>
 <li>Paller AS et al. Dermatol Ther (Heidelb). 2023; 13(4): 961–980.</li>
 <li>Neri I et al.&nbsp;J Asthma Allergy. 2023; 16: 383–396.</li>
 <li>Girolomoni G et al.&nbsp;Dermatol Ther (Heidelb). 2021; 11(1): 117–130.</li>
 <li>Ibler K et al. Dermatol Reports. 2011; 3(1): e5.</li>
 <li>Bacci ED et al.&nbsp;J Dermatolog Treat. 2023; 34(1): 2202288.</li>
 <li>Fasseeh AN et al. Dermatol Ther (Heidelb). 2022; 12(12): 2653–2668.</li>
 <li>Davis DMR et al. J Am Acad Dermatol. 2022; 86(6): 1335–1336.e18.</li>
 <li>Thyssen JP et al. J Allergy Clin Immunol. 2023; 151(5): 1155–1162.</li>
 <li>Kimball AB et al. J Eur Acad Dermatol Venereol. 2010; 24(9):989–1004.</li>
 <li>Silverberg JI et al.&nbsp;Dermatitis. 2023; 34(2): 135–144.</li>
 <li>Simpson EL et al.&nbsp;J Am Acad Dermatol. 2024; 90(6): 1190–1199.</li>
 <li>Grant L et al.&nbsp;Adv Ther. 2020; 37(2): 692–706.</li>
 <li>Silverberg JI et al. J Am Acad Dermatol. 2023; 89(3): 519–528.</li>
 <li>Jaros J et al.&nbsp;Dermatitis. 2020; 31(3): 169–177.</li>
 <li>Rønnstad ATM et al. J Am Acad Dermatol.&nbsp;2024; 90: 616–618.</li>
 <li>Moore RA&nbsp;et al. Rule of Nines. Available&nbsp;at:&nbsp;<a href="https://www.ncbi.nlm.nih.gov/books/NBK513287/" target="_blank">https://www.ncbi.nlm.nih.gov/books/NBK513287/</a>. Date last accessed: December 2025.</li>
 <li>Davis DMR et al.&nbsp;J Am Acad Dermatol. 2024; 90(2): e43-e56.</li>
 <li>Bieber T. Nat Rev Drug Discov. 2023;22(8):662-680.</li>
 <li>DUPIXENT Summary of Product Characteristics. 2025.&nbsp;</li>
</ol>

Read to learn more about the concept of CLCI, how it manifests in atopic dermatitis and its impact on patients.

<h2 style="text-align:center;">When to start patients on insulin¹</h2>
Oﬀer basal insulin as the initial insulin therapy to adults with type 2 diabetes. &nbsp;Consider combining basal and short acting insulin as the initial insulin therapy for adults with type 2 diabetes, especially if the person's HbA1c is 75 mmol/mol (9.0%) or higher. This should be injected either separately or as a pre-mixed (biphasic) preparation.
<h3>Practical information for starting patients on Toujeo (insulin glargine U/300mL)¹</h3>
NG28 advises providing a structured education programme to adults with type 2 diabetes starting insulin therapy. The programme should include:
<ul>
 <li>Injection technique, including rotating injection sites and avoiding repeated injections at the same point within sites</li>
 <li>Self-monitoring</li>
 <li>Dose titration to target levels</li>
 <li>Dietary advice</li>
 <li>The DVLA’s Assessing ﬁtness to drive: a guide for medical professionals</li>
 <li>Managing hypoglycaemia</li>
 <li>Managing acute changes in plasma glucose control</li>
 <li>Support from a healthcare professional trained in insulin therapy.</li>
</ul>
<h3>When initiating insulin for adults with type 2 diabetes:</h3>
<ul>
 <li>Continue to oﬀer metformin to people already taking it</li>
 <li>Stop any other medicines being used solely to manage hyperglycaemia</li>
 <li>Discuss with the person the risks and beneﬁts of continuing medicines for other beneﬁts such as cardiovascular protection or weight management&nbsp;</li>
</ul>
<h3>Choosing an insulin¹</h3>
Make a shared decision with the person on the choice of basal insulin preparation, based on considerations that are speciﬁc to them, including whether:
<ul>
 <li>The person needs help from a carer or healthcare professional to inject insulin or</li>
 <li>There is a particular concern about nocturnal hypoglycaemia or</li>
 <li>The person has a strong preference for once-daily injections.</li>
</ul>
NG28 states that when multiple basal insulin types (including biosimilars) and regimens meet the person’s needs, choose the one with the lowest acquisition cost.&nbsp;

Toujeo®

Lantus®

<h5>References</h5>
1. National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. NICE guideline DRAFT [NG28]. 2025.
MAT-XU-2504691(v1.0) | Date of preparation: December 2025&nbsp;

Key indicators and timing for insulin initiation in Type 2 diabetes care pathways

OTHER-DIABETES-TOPICS

TYPE-2-DIABETES

TYPE-1-DIABETES

DIABETES

When to Start People with Diabetes on Insulin

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Development of ADCT involved literature review as well as interviews with patients and physicians, and was funded by Sanofi and Regeneron.

The ADCT gives a measure of how controlled your patient’s eczema is. Use these 6 concise questions to evaluate all dimensions of atopic dermatitis control.

Atopic dermatitis, a type of eczema, may be affecting your patient’s life in more ways than you know.

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