In Conversation with Dr Kashini Andrew: Dermatology Trial Insights

Clinical trials in dermatology play a crucial role in advancing new treatments, but they come with unique challenges.

From patient recruitment to trial execution, researchers must navigate various hurdles to ensure meaningful results. Today, we sit down with Dr Kashini Andrew , Sub Investigator at VCTC, to discuss the complexities of dermatology research and how innovative approaches are shaping the future of clinical trials.

Q1: Can you start by telling us a bit about yourself, your background, and what led you to specialise in dermatology clinical research?

I graduated from the Ahmadu Bello University, Medical School, Zaria in Nigeria in 2012. I then gained experience in various specialties, including dermatology, emergency obstetrics, HIV/AIDS and infectious diseases, and general practice. I chose dermatology because of its diverse range of diagnoses and the variety — one day, I could be treating pediatric patients, and the next, performing surgery or conducting patch testing, followed by managing complex inflammatory skin diseases.

My dermatology training began with two years of general medicine in Swansea, Wales, followed by a Research fellowship in Portsmouth, where I gained significant experience in SAFA clinical trials for Acne. I then completed four years of dermatology training in the West Midlands rotation/Deanery, exposing me to further clinical trials as an Associate PI in UK Irish ASTAR eczema Trial.

I have also published extensively in peer-reviewed journals and presented my research at various conferences. These experiences shaped my interest in clinical trials and clinical research in Dermatology.

Q2: Dermatology encompasses a wide range of conditions, from acne to rare skin diseases. What are some unique challenges in conducting dermatology trials compared to other therapeutic areas?

Dermatology is a highly visual specialty, and one of the key challenges in clinical trials is managing patient expectations, as many hope to see immediate results rather than gradual improvement.

Another significant hurdle is the limited availability of ready and willing participants, which can impact trial recruitment and progression due to strict inclusion and exclusion criteria. Additionally, assessing treatment efficacy in dermatology relies on subjective scoring systems, such as PASI and EASI, which can introduce variability in trial outcomes.

Q3: Patient recruitment is often one of the biggest hurdles in clinical trials. Why is this especially difficult in dermatology research?

Many clinical trials are prematurely discontinued due to inadequate patient recruitment, leading to lost resources. In dermatology, the challenge is compounded by the wide range of available treatments for each condition, including topical therapies, biologics, and systemic medications.Patients often prefer to try established therapies before considering clinical trials, especially if they are seeing some improvement.

Additionally, there is a lack of diversity in dermatology clinical research, which further limits recruitment and representation,impacting the generalisability of trial findings across different ethnic groups.

Q4: Virtual visits, telemedicine, and decentralised trials are changing the landscape of clinical research. How are these innovations improving accessibility and the overall patient experience in dermatology trials?

These innovations are crucial in reducing patient travel, minimising the environmental impact of clinical trials, and improving accessibility for underrepresented populations, particularly those in rural or underserved areas.

Pop-up trial sites and virtual visits make it easier for trials to fit into patients' daily and weekly routines, reducing disruptions and ultimately enhancing both recruitment and retention rates, which improves trial completion. Furthermore, digital tools, including AI-powered image analysis, allow for real-time monitoring of skin conditions, enhancing the accuracy of remote assessments.

Q5: What excites you most about the future of dermatology clinical research?

I am particularly excited about the advancements in personalised medicine and targeted treatments in dermatology, which will allow for more precise and effective therapies. The future holds great potential for tailored therapies that will improve patient outcomes and treatment efficacy, leading to better disease control and quality of life.

Additionally, the integration of artificial intelligence and genomics in dermatology research will drive innovations in diagnosis and therapeutic strategies, expanding treatment possibilities.

Thank you, Dr. Andrew, for sharing your insights into the complexities and innovations shaping dermatology clinical trials. For a deeper dive into the challenges and strategies discussed, read our latest article .

Partner with VCTC and experience the difference in dermatology clinical research. Together, we can advance treatments and improve patient lives. Contact us today for more information.