首页 > 最新文献

Dermatology and Therapy最新文献

英文 中文
A Narrative Review of the OX40-OX40L Pathway as a Potential Therapeutic Target in Atopic Dermatitis: Focus on Rocatinlimab and Amlitelimab. OX40-OX40L 通路作为特应性皮炎潜在治疗靶点的叙述性综述:聚焦 Rocatinlimab 和 Amlitelimab。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-20 DOI: 10.1007/s13555-024-01308-8
Asaad Abdelhalim, Orhan Yilmaz, Mohamed Elshaikh Berair, Tiago Torres

Atopic dermatitis (AD) is a common chronic inflammatory skin disease involving complex immune dysregulation, including the OX40-OX40L pathway. Rocatinlimab and amlitelimab, monoclonal antibodies targeting OX40 and OX40L, respectively, have shown promise in treating moderate-to-severe AD. Both therapies have demonstrated significant efficacy in reducing disease severity, with favorable safety profiles and no serious treatment-related adverse events. Both treatments outperformed placebo across key clinical endpoints, including skin clearance and symptom reduction, highlighting their potential as effective AD therapies. Although initial results are promising, further research is needed to evaluate the long-term effects, durability of response, and safety of these treatments. These findings support the therapeutic potential of targeting the OX40-OX40L pathway in AD, providing new options for patients with moderate-to-severe disease, with ongoing trials necessary to confirm their sustained benefits.

特应性皮炎(AD)是一种常见的慢性炎症性皮肤病,涉及复杂的免疫失调,包括 OX40-OX40L 通路。分别针对 OX40 和 OX40L 的单克隆抗体 Rocatinlimab 和 amlitelimab 已显示出治疗中重度特应性皮炎的前景。这两种疗法在降低疾病严重程度方面疗效显著,安全性良好,没有出现与治疗相关的严重不良反应。在皮肤清除率和症状减轻等关键临床终点上,这两种疗法的表现均优于安慰剂,凸显了它们作为有效的注意力缺失症疗法的潜力。虽然初步结果令人鼓舞,但还需要进一步的研究来评估这些疗法的长期效果、反应的持久性和安全性。这些研究结果支持了靶向OX40-OX40L通路对AD的治疗潜力,为中重度患者提供了新的选择,但还需要继续进行试验以确认其持续疗效。
{"title":"A Narrative Review of the OX40-OX40L Pathway as a Potential Therapeutic Target in Atopic Dermatitis: Focus on Rocatinlimab and Amlitelimab.","authors":"Asaad Abdelhalim, Orhan Yilmaz, Mohamed Elshaikh Berair, Tiago Torres","doi":"10.1007/s13555-024-01308-8","DOIUrl":"https://doi.org/10.1007/s13555-024-01308-8","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a common chronic inflammatory skin disease involving complex immune dysregulation, including the OX40-OX40L pathway. Rocatinlimab and amlitelimab, monoclonal antibodies targeting OX40 and OX40L, respectively, have shown promise in treating moderate-to-severe AD. Both therapies have demonstrated significant efficacy in reducing disease severity, with favorable safety profiles and no serious treatment-related adverse events. Both treatments outperformed placebo across key clinical endpoints, including skin clearance and symptom reduction, highlighting their potential as effective AD therapies. Although initial results are promising, further research is needed to evaluate the long-term effects, durability of response, and safety of these treatments. These findings support the therapeutic potential of targeting the OX40-OX40L pathway in AD, providing new options for patients with moderate-to-severe disease, with ongoing trials necessary to confirm their sustained benefits.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Alopecia Areata Treatment Patterns and Satisfaction: Results of a Real-World Cross-Sectional Survey in Europe. 更正:脱发治疗模式与满意度:欧洲真实世界横断面调查结果。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-14 DOI: 10.1007/s13555-024-01307-9
Peter Anderson, James Piercy, Jenny Austin, Simran Marwaha, Kent A Hanson, Ernest H Law, Gregor Schaefer, Samantha K Kurosky, Sergio Vañó-Galván
{"title":"Correction: Alopecia Areata Treatment Patterns and Satisfaction: Results of a Real-World Cross-Sectional Survey in Europe.","authors":"Peter Anderson, James Piercy, Jenny Austin, Simran Marwaha, Kent A Hanson, Ernest H Law, Gregor Schaefer, Samantha K Kurosky, Sergio Vañó-Galván","doi":"10.1007/s13555-024-01307-9","DOIUrl":"https://doi.org/10.1007/s13555-024-01307-9","url":null,"abstract":"","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rocatinlimab Improves Patient-Reported Outcomes in Adults with Moderate-to-Severe Atopic Dermatitis: Results from a Double-Blind Placebo-Controlled Phase 2b Study. Rocatinlimab 可改善中重度特应性皮炎成人患者的疗效报告:双盲安慰剂对照 2b 期研究结果。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-12 DOI: 10.1007/s13555-024-01303-z
Melinda Gooderham, Emma Guttman-Yassky, Ken Igawa, Kenji Kabashima, Ehsanollah Esfandiari, Angela J Rylands, Angela Williams, Annabel Nixon, Jennifer E Dent, Eric Simpson

Introduction: In adults with moderate-to-severe atopic dermatitis (AD), rocatinlimab demonstrated significant and progressive improvement in clinical measures of disease severity compared with placebo. This post hoc analysis of a phase 2b study was undertaken to understand the disease burden and to assess the impact of rocatinlimab on patient-reported outcomes (PROs).

Methods: This analysis used baseline data from a multicenter, randomized, double-blind study of adults with moderate-to-severe AD, who completed a Worst Pruritus numerical rating scale (NRS), Sleep Disturbance NRS, and the Dermatology Life Quality Index (DLQI). A mixed model for repeated measures was used to estimate changes in PRO scores from baseline; scores were also compared with clinically meaningful change benchmarks.

Results: The analysis included 267 subjects, mean (SD) age 37.9 (14.7) years, 40.8% female; 55.1% grade 3 and 44.9% grade 4 Investigator Global Assessment for AD. Mean (SD) scores were: Worst Pruritus NRS 7.5 (1.9), Sleep Disturbance NRS 5.5 (2.9), DLQI total score 12.6 (7.1). Worst Pruritus and Sleep NRS scores had low positive correlations with SCORing AD (SCORAD) score (r = 0.44, r = 0.45 respectively) and negligible correlations with Eczema Area and Severity Index (EASI) score and area affected (r < 0.30). DLQI score varied by sex, study country, race, age, longer disease duration, disease severity (EASI and SCORAD), presence of asthma, and Worst Pruritus NRS, Sleep disturbance NRS, and DLQI scores. Rocatinlimab showed benefit on all three PROs, with significant improvements from baseline at the end of the double-blind period (week 18) and active treatment extension (week 36). Benefits were maintained over 20 weeks' post-treatment follow-up. The benefit of rocatinlimab treatment on PROs is rapid and maintained for at least 20 weeks following treatment completion.

Conclusion: This analysis demonstrates the importance of characterizing the burden of moderate-to-severe AD from the patient's perspective, alongside clinical disease measures, to develop a fuller picture of treatment benefit.

Trial registration: ClinicalTrials.gov identifier, NCT03703102.

简介在中重度特应性皮炎(AD)成人患者中,与安慰剂相比,罗卡替尼(rocatinlimab)在疾病严重程度的临床测量方面表现出了显著的渐进性改善。本研究对一项2b期研究进行了事后分析,以了解疾病负担并评估罗卡替尼对患者报告结果(PROs)的影响:这项分析采用了一项多中心、随机、双盲研究的基线数据,研究对象是中重度AD成人患者,他们填写了最差瘙痒数字评分量表(NRS)、睡眠障碍NRS和皮肤病生活质量指数(DLQI)。采用重复测量混合模型估算了PRO评分与基线相比的变化;还将评分与有临床意义的变化基准进行了比较:分析包括 267 名受试者,平均(标清)年龄为 37.9(14.7)岁,40.8% 为女性;55.1% 为 3 级,44.9% 为 4 级 AD 研究者总体评估。平均(标清)评分为最严重瘙痒 NRS 7.5 (1.9),睡眠障碍 NRS 5.5 (2.9),DLQI 总分 12.6 (7.1)。最差瘙痒和睡眠 NRS 评分与 SCORing AD(SCORAD)评分呈低正相关(r = 0.44,r = 0.45),与湿疹面积和严重程度指数(EASI)评分和受影响面积的相关性可忽略不计(r 结论:湿疹患者的瘙痒和睡眠 NRS 评分与 SCORing AD 评分呈低正相关(r = 0.44,r = 0.45),与湿疹面积和严重程度指数(EASI)评分和受影响面积的相关性可忽略不计:这项分析表明,除了临床疾病指标外,从患者角度描述中重度AD的负担特征对于更全面地了解治疗效果也非常重要:试验注册:ClinicalTrials.gov 标识符,NCT03703102。
{"title":"Rocatinlimab Improves Patient-Reported Outcomes in Adults with Moderate-to-Severe Atopic Dermatitis: Results from a Double-Blind Placebo-Controlled Phase 2b Study.","authors":"Melinda Gooderham, Emma Guttman-Yassky, Ken Igawa, Kenji Kabashima, Ehsanollah Esfandiari, Angela J Rylands, Angela Williams, Annabel Nixon, Jennifer E Dent, Eric Simpson","doi":"10.1007/s13555-024-01303-z","DOIUrl":"https://doi.org/10.1007/s13555-024-01303-z","url":null,"abstract":"<p><strong>Introduction: </strong>In adults with moderate-to-severe atopic dermatitis (AD), rocatinlimab demonstrated significant and progressive improvement in clinical measures of disease severity compared with placebo. This post hoc analysis of a phase 2b study was undertaken to understand the disease burden and to assess the impact of rocatinlimab on patient-reported outcomes (PROs).</p><p><strong>Methods: </strong>This analysis used baseline data from a multicenter, randomized, double-blind study of adults with moderate-to-severe AD, who completed a Worst Pruritus numerical rating scale (NRS), Sleep Disturbance NRS, and the Dermatology Life Quality Index (DLQI). A mixed model for repeated measures was used to estimate changes in PRO scores from baseline; scores were also compared with clinically meaningful change benchmarks.</p><p><strong>Results: </strong>The analysis included 267 subjects, mean (SD) age 37.9 (14.7) years, 40.8% female; 55.1% grade 3 and 44.9% grade 4 Investigator Global Assessment for AD. Mean (SD) scores were: Worst Pruritus NRS 7.5 (1.9), Sleep Disturbance NRS 5.5 (2.9), DLQI total score 12.6 (7.1). Worst Pruritus and Sleep NRS scores had low positive correlations with SCORing AD (SCORAD) score (r = 0.44, r = 0.45 respectively) and negligible correlations with Eczema Area and Severity Index (EASI) score and area affected (r < 0.30). DLQI score varied by sex, study country, race, age, longer disease duration, disease severity (EASI and SCORAD), presence of asthma, and Worst Pruritus NRS, Sleep disturbance NRS, and DLQI scores. Rocatinlimab showed benefit on all three PROs, with significant improvements from baseline at the end of the double-blind period (week 18) and active treatment extension (week 36). Benefits were maintained over 20 weeks' post-treatment follow-up. The benefit of rocatinlimab treatment on PROs is rapid and maintained for at least 20 weeks following treatment completion.</p><p><strong>Conclusion: </strong>This analysis demonstrates the importance of characterizing the burden of moderate-to-severe AD from the patient's perspective, alongside clinical disease measures, to develop a fuller picture of treatment benefit.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT03703102.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Risankizumab in Patients with Psoriasis Showing Suboptimal Response to Secukinumab or Ixekizumab: Results from a Phase 3b, Open-Label, Single-Arm (aIMM) Study. 对塞库单抗或伊克珠单抗疗效不佳的银屑病患者使用利抗珠单抗的疗效和安全性:3b期开放标签单臂(aIMM)研究结果。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-08 DOI: 10.1007/s13555-024-01292-z
Richard B Warren, Lev Pavlovsky, Antonio Costanzo, Michael Bukhalo, Neil J Korman, Yu-Huei Huang, Georgios Kokolakis, Andreas Pinter, Nadia Ibrahim, Yanbing Zheng, Leonidas Drogaris, Vassilis Stakias, Ahmed M Soliman, Simone Rubant, Diamant Thaçi

Introduction: Risankizumab has demonstrated superior efficacy compared to other psoriasis treatments, including secukinumab, adalimumab, and ustekinumab; switching to risankizumab from other psoriasis treatments has shown superior clinical and quality of life (QoL) outcomes. We evaluated the efficacy and safety of directly switching patients with moderate-to-severe plaque psoriasis and a suboptimal response to interleukin (IL)-17 inhibitors (secukinumab or ixekizumab) to risankizumab.

Methods: This 52-week, phase 3b study enrolled patients (≥ 18 years) with moderate-to-severe plaque psoriasis who had previously been treated with the recommended dose of secukinumab or ixekizumab for ≥ 6 months but did not achieve an optimal response (static Physician's Global Assessment [sPGA] 2/3; body surface are [BSA] 3- < 10%). Patients received subcutaneous risankizumab (150 mg) without washout. The primary endpoint was the proportion of patients achieving sPGA of 0/1 at week 16. Secondary endpoints included sPGA 0/1 at week 52, sPGA 0, Dermatology Life Quality Index (DLQI) 0/1, and Psoriasis Symptoms Scale (PSS) 0 at weeks 16 and 52. Safety was monitored throughout the study.

Results: The study included 244 patients. sPGA 0/1 was achieved by 57.4% and 62.3% at week 16 and 52. At week 16, sPGA 0, DLQI 0/1, and PSS 0 were achieved by 20.5%, 40.2%, and 20.9%, respectively. At week 52, these proportions increased to 27.1% for sPGA 0, 47.2% for DLQI 0/1, and 27.5% for PSS 0. Most frequently reported adverse events (reported in ≥ 5% of patients) in risankizumab-treated patients were COVID-19 infection (8.6%) and nasopharyngitis (5.7%). No new safety signals were observed.

Conclusions: Directly switching to risankizumab improved outcomes and QoL in patients with moderate-to-severe psoriasis who had suboptimal responses to anti-IL-17 inhibitors (secukinumab or ixekizumab). The safety results are consistent with previously reported safety of risankizumab. This study supports the efficacy of risankizumab in patients previously treated with biologics, including IL-17 inhibitors, and suggests a direct switch to risankizumab for improved clinical outcomes and QoL.

Clinical trials: ClinicalTrials.gov identifier: NCT04102007.

简介与其他银屑病治疗方法(包括secukinumab、阿达木单抗和乌斯特库单抗)相比,利赞珠单抗的疗效更优;从其他银屑病治疗方法转用利赞珠单抗的临床和生活质量(QoL)结果更佳。我们评估了中重度斑块状银屑病且对白介素(IL)-17抑制剂(secukinumab或ixekizumab)反应不佳的患者直接转用利桑单抗的疗效和安全性:这项为期52周的3b期研究招募了中重度斑块状银屑病患者(≥18岁),这些患者曾接受推荐剂量的secukinumab或ixekizumab治疗≥6个月,但未获得最佳应答(静态医生总体评估[sPGA] 2/3;体表面积[BSA] 3- 结果):在第16周和第52周,分别有57.4%和62.3%的患者达到sPGA 0/1。在第 16 周,分别有 20.5%、40.2% 和 20.9% 的患者达到了 sPGA 0、DLQI 0/1 和 PSS 0。利坦珠单抗治疗患者最常报告的不良事件(≥5%的患者报告)是COVID-19感染(8.6%)和鼻咽炎(5.7%)。未观察到新的安全信号:结论:对于对抗IL-17抑制剂(secukinumab或ixekizumab)反应不佳的中重度银屑病患者,直接改用利抗珠单抗可改善疗效和生活质量。安全性结果与之前报道的利桑珠单抗的安全性一致。这项研究支持利坦珠单抗对既往接受过生物制剂(包括IL-17抑制剂)治疗的患者的疗效,并建议直接改用利坦珠单抗以改善临床疗效和生活质量:临床试验:ClinicalTrials.gov identifier:临床试验:ClinicalTrials.gov 标识符:NCT04102007。
{"title":"Efficacy and Safety of Risankizumab in Patients with Psoriasis Showing Suboptimal Response to Secukinumab or Ixekizumab: Results from a Phase 3b, Open-Label, Single-Arm (aIMM) Study.","authors":"Richard B Warren, Lev Pavlovsky, Antonio Costanzo, Michael Bukhalo, Neil J Korman, Yu-Huei Huang, Georgios Kokolakis, Andreas Pinter, Nadia Ibrahim, Yanbing Zheng, Leonidas Drogaris, Vassilis Stakias, Ahmed M Soliman, Simone Rubant, Diamant Thaçi","doi":"10.1007/s13555-024-01292-z","DOIUrl":"https://doi.org/10.1007/s13555-024-01292-z","url":null,"abstract":"<p><strong>Introduction: </strong>Risankizumab has demonstrated superior efficacy compared to other psoriasis treatments, including secukinumab, adalimumab, and ustekinumab; switching to risankizumab from other psoriasis treatments has shown superior clinical and quality of life (QoL) outcomes. We evaluated the efficacy and safety of directly switching patients with moderate-to-severe plaque psoriasis and a suboptimal response to interleukin (IL)-17 inhibitors (secukinumab or ixekizumab) to risankizumab.</p><p><strong>Methods: </strong>This 52-week, phase 3b study enrolled patients (≥ 18 years) with moderate-to-severe plaque psoriasis who had previously been treated with the recommended dose of secukinumab or ixekizumab for ≥ 6 months but did not achieve an optimal response (static Physician's Global Assessment [sPGA] 2/3; body surface are [BSA] 3- < 10%). Patients received subcutaneous risankizumab (150 mg) without washout. The primary endpoint was the proportion of patients achieving sPGA of 0/1 at week 16. Secondary endpoints included sPGA 0/1 at week 52, sPGA 0, Dermatology Life Quality Index (DLQI) 0/1, and Psoriasis Symptoms Scale (PSS) 0 at weeks 16 and 52. Safety was monitored throughout the study.</p><p><strong>Results: </strong>The study included 244 patients. sPGA 0/1 was achieved by 57.4% and 62.3% at week 16 and 52. At week 16, sPGA 0, DLQI 0/1, and PSS 0 were achieved by 20.5%, 40.2%, and 20.9%, respectively. At week 52, these proportions increased to 27.1% for sPGA 0, 47.2% for DLQI 0/1, and 27.5% for PSS 0. Most frequently reported adverse events (reported in ≥ 5% of patients) in risankizumab-treated patients were COVID-19 infection (8.6%) and nasopharyngitis (5.7%). No new safety signals were observed.</p><p><strong>Conclusions: </strong>Directly switching to risankizumab improved outcomes and QoL in patients with moderate-to-severe psoriasis who had suboptimal responses to anti-IL-17 inhibitors (secukinumab or ixekizumab). The safety results are consistent with previously reported safety of risankizumab. This study supports the efficacy of risankizumab in patients previously treated with biologics, including IL-17 inhibitors, and suggests a direct switch to risankizumab for improved clinical outcomes and QoL.</p><p><strong>Clinical trials: </strong>ClinicalTrials.gov identifier: NCT04102007.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intelligent Diagnosis of Hypopigmented Dermatoses and Intelligent Evaluation of Vitiligo Severity on the Basis of Deep Learning. 基于深度学习的色素减退性皮肤病智能诊断和白癜风严重程度智能评估。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-08 DOI: 10.1007/s13555-024-01296-9
Hequn Huang, Changqing Wang, Geng Gao, Zhuangzhuang Fan, Lulu Ren, Rui Wang, Zhu Chen, Maoxin Huang, Mei Li, Fei Yang, Fengli Xiao

Introduction: There is a lack of objective, accurate, and convenient methods for classification diagnostic hypopigmented dermatoses (HD) and severity evaluation of vitiligo. To achieve an accurate and intelligent classification diagnostic model of HD and severity evaluation model of vitiligo using a deep learning-based method.

Methods: A total of 11,483 images from 4744 patients with HD were included in this study. An optimal diagnostic model was constructed by merging the squeeze-and-excitation (SE) module with the candidate model, its diagnostic efficiency was compared with that of 98 dermatologists. An objective severity evaluation indicator was proposed through weighting method and combined with a segmentation model to form a severity evaluation model, which was then compared with the assessments conducted by three experienced dermatologists using the naked eye.

Results: The improved diagnosis model SE_ResNet-18 outperformed the other 11 classic models with an accuracy of 0.9389, macro-specificity of 0.9878, and macro-f1 score of 0.9395, and outperformed the different categories of 98 dermatologists (P < 0.001). The weighted Kappa test indicated medium consistency between the Indicatorv and the VASIchange (K = 0.567, P < 0.05). The optimal segmented model, HR-Net, had 0.8421 mIOU. The model-based severity evaluation results were not significantly different among the three experienced dermatologists.

Conclusions: This study proposes an objective, accurate, and convenient hybrid model for diagnosing HD and evaluating the severity of vitiligo, providing a method for dermatologists especially in grassroots hospitals, and provides a foundation for telemedicine.

导言:色素减退性皮肤病(HD)的分类诊断和白癜风的严重程度评估缺乏客观、准确、便捷的方法。利用基于深度学习的方法,实现准确、智能的色素减退性皮肤病分类诊断模型和白癜风严重程度评估模型:本研究共纳入了来自 4744 名 HD 患者的 11,483 张图像。通过将挤压激发(SE)模块与候选模型合并,构建了最佳诊断模型,并将其诊断效率与98名皮肤科医生的诊断效率进行了比较。通过加权法提出了一个客观的严重程度评价指标,并与分割模型相结合形成了一个严重程度评价模型,然后与三位经验丰富的皮肤科医生用肉眼进行的评估进行了比较:结果:改进后的诊断模型 SE_ResNet-18 的准确度为 0.9389,宏观特异性为 0.9878,宏观-f1 得分为 0.9395,优于其他 11 个经典模型,并优于 98 位皮肤科医生的不同分类(P v)和 VASIchange(K = 0.567,P 结论:SE_ResNet-18 是一种新的诊断模型,其准确度为 0.9389,宏观特异性为 0.9878,宏观-f1 得分为 0.9395,优于其他 11 个经典模型:本研究提出了一种客观、准确、便捷的混合模型,用于诊断HD和评估白癜风的严重程度,为皮肤科医生尤其是基层医院的皮肤科医生提供了一种方法,并为远程医疗提供了基础。
{"title":"Intelligent Diagnosis of Hypopigmented Dermatoses and Intelligent Evaluation of Vitiligo Severity on the Basis of Deep Learning.","authors":"Hequn Huang, Changqing Wang, Geng Gao, Zhuangzhuang Fan, Lulu Ren, Rui Wang, Zhu Chen, Maoxin Huang, Mei Li, Fei Yang, Fengli Xiao","doi":"10.1007/s13555-024-01296-9","DOIUrl":"https://doi.org/10.1007/s13555-024-01296-9","url":null,"abstract":"<p><strong>Introduction: </strong>There is a lack of objective, accurate, and convenient methods for classification diagnostic hypopigmented dermatoses (HD) and severity evaluation of vitiligo. To achieve an accurate and intelligent classification diagnostic model of HD and severity evaluation model of vitiligo using a deep learning-based method.</p><p><strong>Methods: </strong>A total of 11,483 images from 4744 patients with HD were included in this study. An optimal diagnostic model was constructed by merging the squeeze-and-excitation (SE) module with the candidate model, its diagnostic efficiency was compared with that of 98 dermatologists. An objective severity evaluation indicator was proposed through weighting method and combined with a segmentation model to form a severity evaluation model, which was then compared with the assessments conducted by three experienced dermatologists using the naked eye.</p><p><strong>Results: </strong>The improved diagnosis model SE_ResNet-18 outperformed the other 11 classic models with an accuracy of 0.9389, macro-specificity of 0.9878, and macro-f1 score of 0.9395, and outperformed the different categories of 98 dermatologists (P < 0.001). The weighted Kappa test indicated medium consistency between the Indicator<sub>v</sub> and the VASI<sub>change</sub> (K = 0.567, P < 0.05). The optimal segmented model, HR-Net, had 0.8421 mIOU. The model-based severity evaluation results were not significantly different among the three experienced dermatologists.</p><p><strong>Conclusions: </strong>This study proposes an objective, accurate, and convenient hybrid model for diagnosing HD and evaluating the severity of vitiligo, providing a method for dermatologists especially in grassroots hospitals, and provides a foundation for telemedicine.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-Life Data of Secukinumab in Patients with Moderate to Severe Plaque Psoriasis, Psoriatic Arthritis, and Ankylosing Spondylitis: Patient Baseline Characteristics Data from the PROMPT Study. Secukinumab 用于中重度斑块状银屑病、银屑病关节炎和强直性脊柱炎患者的实际生活数据:来自 PROMPT 研究的患者基线特征数据。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.1007/s13555-024-01299-6
Ploysyne Rattanakaemakorn, Parawee Chevaisrakul, Chanisada Wongpraparut, Praveena Chiowchanwisawakit, Napatra Tovanabutra, Pimchanok Tantiwong, Warayuwadee Amornpinyo, Panlop Chakkavittumrong, Punchong Hanvivadhanakul, Sumapa Chaiamnuay, Supapat Laodheerasiri, Bensachee Pattamadilok, Charoen Choonhakarn, Ajanee Mahakkanukrauh, Duangkamol Aiewruengsurat, Siripan Sangmala, Nisa Pretikul, Kittiwan Sumethkul, Panchalee Satpanich, Metavee Boonsiri, Naruemon Sangob, Pravit Asawanonda

Introduction: Secukinumab has proven to be effective and safe in psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) in the phase 3 studies. However, data on real-world practice is limited.

Methods: This study is an ongoing, multicenter, 2-year observational study that focuses on patients with moderate to severe plaque PsO, active PsA, or AS receiving secukinumab. The aim of this study is to present baseline data for the entire study population.

Results: A total of 127 patients were enrolled, with 101 having PsO, 12 with PsA, and 14 with AS. Among the patients, approximately 54.0% were male. The mean body mass index ranged from 25.0 to 27.4 kg/m2 across all groups. Patients with PsO had the longest disease duration with an average of 11.0 years, followed by AS (3.0 years) and PsA (1.0 year). Previous biologic therapy was observed in 6.9-8.1% of patients. Baseline disease severity scores revealed moderate to severe disease. In the PsO group, the mean Psoriasis Area and Severity Index score was 16.1. For patients with PsA, the mean Tender Joint Count was 9.1, and the mean Swollen Joint Count was 6.7. In the AS group, the mean Bath Ankylosing Spondylitis Disease Activity Index score was 4.6, and the mean Ankylosing Spondylitis Disease Activity Score was 3.7.

Conclusion: The study demonstrates disease durations, disease activity, and treatment history in Thai patients that were generally consistent with previous randomized controlled studies. Long-term data on the efficacy and safety of the treatment will be presented in future publications.

简介在三期研究中,塞库单抗被证明对银屑病(PsO)、银屑病关节炎(PsA)和强直性脊柱炎(AS)有效且安全。然而,有关实际应用的数据却很有限:本研究是一项正在进行的多中心、为期两年的观察性研究,主要针对接受secukinumab治疗的中重度斑块型PsO、活动性PsA或AS患者。本研究旨在提供整个研究人群的基线数据:共有127名患者入组,其中101人患有PsO,12人患有PsA,14人患有AS。患者中约 54.0% 为男性。所有组别的平均体重指数在 25.0 至 27.4 kg/m2 之间。PsO患者的病程最长,平均为11.0年,其次是AS(3.0年)和PsA(1.0年)。6.9%-8.1%的患者曾接受过生物治疗。基线疾病严重程度评分显示患者患有中度至重度疾病。在 PsO 组中,牛皮癣面积和严重程度指数的平均值为 16.1 分。PsA患者的平均关节触痛数为9.1,平均关节肿胀数为6.7。在强直性脊柱炎组中,巴斯强直性脊柱炎疾病活动指数平均值为4.6分,强直性脊柱炎疾病活动评分平均值为3.7分:研究显示,泰国患者的病程、疾病活动度和治疗史与之前的随机对照研究基本一致。有关疗效和安全性的长期数据将在今后的出版物中介绍。
{"title":"Real-Life Data of Secukinumab in Patients with Moderate to Severe Plaque Psoriasis, Psoriatic Arthritis, and Ankylosing Spondylitis: Patient Baseline Characteristics Data from the PROMPT Study.","authors":"Ploysyne Rattanakaemakorn, Parawee Chevaisrakul, Chanisada Wongpraparut, Praveena Chiowchanwisawakit, Napatra Tovanabutra, Pimchanok Tantiwong, Warayuwadee Amornpinyo, Panlop Chakkavittumrong, Punchong Hanvivadhanakul, Sumapa Chaiamnuay, Supapat Laodheerasiri, Bensachee Pattamadilok, Charoen Choonhakarn, Ajanee Mahakkanukrauh, Duangkamol Aiewruengsurat, Siripan Sangmala, Nisa Pretikul, Kittiwan Sumethkul, Panchalee Satpanich, Metavee Boonsiri, Naruemon Sangob, Pravit Asawanonda","doi":"10.1007/s13555-024-01299-6","DOIUrl":"https://doi.org/10.1007/s13555-024-01299-6","url":null,"abstract":"<p><strong>Introduction: </strong>Secukinumab has proven to be effective and safe in psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) in the phase 3 studies. However, data on real-world practice is limited.</p><p><strong>Methods: </strong>This study is an ongoing, multicenter, 2-year observational study that focuses on patients with moderate to severe plaque PsO, active PsA, or AS receiving secukinumab. The aim of this study is to present baseline data for the entire study population.</p><p><strong>Results: </strong>A total of 127 patients were enrolled, with 101 having PsO, 12 with PsA, and 14 with AS. Among the patients, approximately 54.0% were male. The mean body mass index ranged from 25.0 to 27.4 kg/m<sup>2</sup> across all groups. Patients with PsO had the longest disease duration with an average of 11.0 years, followed by AS (3.0 years) and PsA (1.0 year). Previous biologic therapy was observed in 6.9-8.1% of patients. Baseline disease severity scores revealed moderate to severe disease. In the PsO group, the mean Psoriasis Area and Severity Index score was 16.1. For patients with PsA, the mean Tender Joint Count was 9.1, and the mean Swollen Joint Count was 6.7. In the AS group, the mean Bath Ankylosing Spondylitis Disease Activity Index score was 4.6, and the mean Ankylosing Spondylitis Disease Activity Score was 3.7.</p><p><strong>Conclusion: </strong>The study demonstrates disease durations, disease activity, and treatment history in Thai patients that were generally consistent with previous randomized controlled studies. Long-term data on the efficacy and safety of the treatment will be presented in future publications.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the Biological Effect of a Nicotinamide-Containing Broad-Spectrum Sunscreen on Photodamaged Skin. 评估含烟酰胺的广谱防晒霜对光损伤皮肤的生物效应。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-07 DOI: 10.1007/s13555-024-01298-7
Teresa Torres-Moral, Gemma Tell-Martí, Jaume Bague, Pau Rosés-Gibert, Neus Calbet-Llopart, Judit Mateu, Javiera Pérez-Anker, Míriam Potrony, Beatriz Alejo, Pablo Iglesias, Natalia Espinosa, Carmen Orte Cano, Elisa Cinotti, Véronique Del Marmol, Margot Fontaine, Makiko Miyamoto, Jilliana Monnier, Jean Luc Perrot, Pietro Rubegni, Linda Tognetti, Mariano Suppa, Anne Laure Demessant-Flavigny, Caroline Le Floc'h, Leonor Prieto, Josep Malvehy, Susana Puig

Introduction: UVA-UVB increases skin matrix metalloproteinases and breaks down extracellular proteins and fibrillar type 1 collagen, leading to photodamage. Topical application of nicotinamide prevents UV-induced immunosuppression. Several studies have demonstrated the importance of protection against UV. This study aims to determine the biological effect of a high broad-spectrum UVB-UVA sunscreen containing nicotinamide and panthenol (SSNP) on photodamaged skin using linear confocal optical coherence tomography (LC-OCT), immunohistochemistry, and RNA profiling.

Methods: Two areas of severely photodamaged forearm skin (L01 and L02) and one less sun-damaged (naturally protected) area on the inner part of the forearm (L03) were identified in 14 subjects. These areas were imaged using LC-OCT and L01 and L03 were biopsied at baseline. After 4 weeks of treatment with SSNP, L02 was reimaged using LC-OCT, and biopsied. Histology, immunostaining with p21, p53, PCNA, and CPD, and RNA sequencing were performed in all samples.

Results: LC-OCT analysis showed that epidermis thickness and the number of keratinocytes is higher in the sun-exposed areas than in the non-exposed areas. Comparing before and after treatment, even though there is a trend towards normalization, the differences were not statistically significant. The expression of p21, PCNA, p53, and CPD increased in severely photodamaged skin compared to less-damaged skin. When comparing before and after treatment, only p21 showed a trend to decrease expression. RNA sequencing analysis identified 1552 significant genes correlating with the progression from non-visibly photodamaged skin to post-treatment and pre-treatment samples; in the analysis comparing pre- and post-treatment samples, 5429 genes were found to be significantly associated. A total of 1115 genes are common in these two analyses. Additionally, nine significant genes from the first analysis and eight from the second are related to collagen. Six of these collagen genes are common in the two analyses. MAPK and cGMP-PKG signalling pathways are upregulated in the progression to photodamage analysis. In the pre- and post-treatment analysis, 32 pathways are downregulated after treatment, the most statistically significant being the ErbB, Hippo, NOD-like receptor, TNF, and NF-kB signalling pathways.

Conclusion: This study demonstrates the role of SSNP in collagen generation, highlights the relevance of the cGMP-PKG and MAPK signalling pathways in photodamage, and shows the ability of SSNP to downregulate pathways activated by UV exposure. Additionally, it deepens our understanding of the effect of SSNP on immune-related pathways.

引言UVA-UVB 会增加皮肤基质金属蛋白酶,分解细胞外蛋白和纤维状 1 型胶原蛋白,导致光损伤。局部使用烟酰胺可防止紫外线引起的免疫抑制。多项研究证明了抵御紫外线的重要性。本研究旨在使用线性共焦光学相干断层扫描(LC-OCT)、免疫组织化学和 RNA 图谱确定含有烟酰胺和泛醇的高广谱 UVB-UVA 防晒霜(SSNP)对光损伤皮肤的生物效应:在 14 名受试者的前臂皮肤上确定了两个严重光损伤的区域(L01 和 L02),以及前臂内侧一个日光损伤较轻(自然保护)的区域(L03)。使用 LC-OCT 对这些区域进行成像,并在基线时对 L01 和 L03 进行活检。使用 SSNP 治疗 4 周后,使用 LC-OCT 对 L02 重新成像并进行活组织检查。对所有样本进行了组织学检查、p21、p53、PCNA 和 CPD 免疫染色以及 RNA 测序:结果:LC-OCT分析表明,日晒区的表皮厚度和角质细胞数量高于非日晒区。对比治疗前后,尽管有趋于正常的趋势,但差异无统计学意义。与受损程度较轻的皮肤相比,严重光损伤皮肤中 p21、PCNA、p53 和 CPD 的表达增加。比较治疗前后,只有 p21 的表达呈下降趋势。RNA 测序分析发现,1552 个重要基因与非明显光损伤皮肤到治疗后和治疗前样本的进展相关;在比较治疗前和治疗后样本的分析中,发现 5429 个基因与之显著相关。在这两项分析中,共有 1115 个基因是共同的。此外,第一项分析中的 9 个重要基因和第二项分析中的 8 个重要基因与胶原蛋白有关。其中 6 个胶原蛋白基因在两次分析中都有共性。在光损伤进展分析中,MAPK 和 cGMP-PKG 信号通路上调。在治疗前和治疗后的分析中,有 32 个通路在治疗后下调,其中统计学意义最大的是 ErbB、Hippo、NOD 样受体、TNF 和 NF-kB 信号通路:这项研究证明了 SSNP 在胶原蛋白生成中的作用,强调了 cGMP-PKG 和 MAPK 信号通路在光损伤中的相关性,并显示了 SSNP 下调紫外线照射激活的通路的能力。此外,它还加深了我们对 SSNP 对免疫相关途径影响的理解。
{"title":"Evaluation of the Biological Effect of a Nicotinamide-Containing Broad-Spectrum Sunscreen on Photodamaged Skin.","authors":"Teresa Torres-Moral, Gemma Tell-Martí, Jaume Bague, Pau Rosés-Gibert, Neus Calbet-Llopart, Judit Mateu, Javiera Pérez-Anker, Míriam Potrony, Beatriz Alejo, Pablo Iglesias, Natalia Espinosa, Carmen Orte Cano, Elisa Cinotti, Véronique Del Marmol, Margot Fontaine, Makiko Miyamoto, Jilliana Monnier, Jean Luc Perrot, Pietro Rubegni, Linda Tognetti, Mariano Suppa, Anne Laure Demessant-Flavigny, Caroline Le Floc'h, Leonor Prieto, Josep Malvehy, Susana Puig","doi":"10.1007/s13555-024-01298-7","DOIUrl":"https://doi.org/10.1007/s13555-024-01298-7","url":null,"abstract":"<p><strong>Introduction: </strong>UVA-UVB increases skin matrix metalloproteinases and breaks down extracellular proteins and fibrillar type 1 collagen, leading to photodamage. Topical application of nicotinamide prevents UV-induced immunosuppression. Several studies have demonstrated the importance of protection against UV. This study aims to determine the biological effect of a high broad-spectrum UVB-UVA sunscreen containing nicotinamide and panthenol (SSNP) on photodamaged skin using linear confocal optical coherence tomography (LC-OCT), immunohistochemistry, and RNA profiling.</p><p><strong>Methods: </strong>Two areas of severely photodamaged forearm skin (L01 and L02) and one less sun-damaged (naturally protected) area on the inner part of the forearm (L03) were identified in 14 subjects. These areas were imaged using LC-OCT and L01 and L03 were biopsied at baseline. After 4 weeks of treatment with SSNP, L02 was reimaged using LC-OCT, and biopsied. Histology, immunostaining with p21, p53, PCNA, and CPD, and RNA sequencing were performed in all samples.</p><p><strong>Results: </strong>LC-OCT analysis showed that epidermis thickness and the number of keratinocytes is higher in the sun-exposed areas than in the non-exposed areas. Comparing before and after treatment, even though there is a trend towards normalization, the differences were not statistically significant. The expression of p21, PCNA, p53, and CPD increased in severely photodamaged skin compared to less-damaged skin. When comparing before and after treatment, only p21 showed a trend to decrease expression. RNA sequencing analysis identified 1552 significant genes correlating with the progression from non-visibly photodamaged skin to post-treatment and pre-treatment samples; in the analysis comparing pre- and post-treatment samples, 5429 genes were found to be significantly associated. A total of 1115 genes are common in these two analyses. Additionally, nine significant genes from the first analysis and eight from the second are related to collagen. Six of these collagen genes are common in the two analyses. MAPK and cGMP-PKG signalling pathways are upregulated in the progression to photodamage analysis. In the pre- and post-treatment analysis, 32 pathways are downregulated after treatment, the most statistically significant being the ErbB, Hippo, NOD-like receptor, TNF, and NF-kB signalling pathways.</p><p><strong>Conclusion: </strong>This study demonstrates the role of SSNP in collagen generation, highlights the relevance of the cGMP-PKG and MAPK signalling pathways in photodamage, and shows the ability of SSNP to downregulate pathways activated by UV exposure. Additionally, it deepens our understanding of the effect of SSNP on immune-related pathways.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Equity and Outcome Events in Hidradenitis Suppurativa: Exploring Effect Modifiers Associated with Diagnostic Delay in the Real World. 化脓性扁桃体炎的公平与结果事件:探索现实世界中与诊断延迟相关的效应调节因素
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-02 DOI: 10.1007/s13555-024-01291-0
Nicole Murray, Isabel Truman, Gary Milligan, Himanshu Modi, Nicholas Adlard

Introduction: Patients with hidradenitis suppurativa (HS) experience significantly delayed diagnoses of 7-10 years from symptom onset on average, but the reasons for this remain largely unknown. This study investigated drivers of diagnostic delay from the perspective of healthcare system equity.

Methods: A literature review was performed to identify published factors associated with delayed HS diagnosis to inform data analysis. Clinical and demographic data from the Adelphi HS Disease Specific Programme (DSP)™, a real-world cross-sectional survey of dermatologists and their consulting patients in France, Germany, Italy, Spain, the UK and the USA in 2020/2021, were used to model factors influencing delay to diagnosis from onset of symptoms and first consultation.

Results: Factors influencing delay to HS diagnosis in the literature with the most available evidence were misdiagnosis, delay in specialist referral and patient embarrassment. Data analysis revealed that increasing age was associated with reduced diagnostic delay after symptom onset. Patients with HS who were White or in Germany were also more likely to receive a faster diagnosis. Smokers, patients with concomitant conditions, or a family history of HS were slower to be diagnosed. When time to diagnosis following first consultation was assessed, increasing age was associated with quicker diagnosis. Moreover, patients with a family history of HS were diagnosed quicker, whereas those with high body mass index, more concomitant conditions, in employment, managed by multiple physicians or European were more delayed.

Conclusion: On the basis of a thorough analysis of real-world data, multiple factors that potentially influenced the timely diagnosis of HS have been identified. For the first time, this study quantifies the relative impact of these modifiers, providing valuable insights into areas that require attention for faster diagnoses and improved disease outcomes.

导言:化脓性扁桃体炎(HS)患者的诊断严重滞后,从症状出现到确诊平均需要 7-10 年时间,但造成这种情况的原因在很大程度上仍不为人所知。本研究从医疗保健系统公平性的角度调查了诊断延迟的驱动因素:方法:我们进行了文献综述,以确定已发表的与房颤诊断延迟相关的因素,为数据分析提供依据。阿德尔菲HS疾病专项计划(DSP)™是2020/2021年对法国、德国、意大利、西班牙、英国和美国的皮肤科医生及其就诊患者进行的一项真实世界横断面调查,该计划提供的临床和人口统计学数据被用于模拟从症状出现到首次就诊的诊断延迟影响因素:在现有证据最多的文献中,影响 HS 诊断延误的因素包括误诊、专家转诊延误和患者尴尬。数据分析显示,年龄的增加与症状出现后诊断延迟的减少有关。白种人或德国人的 HS 患者也更有可能更快得到诊断。吸烟者、合并症患者或有HS家族史的患者确诊速度较慢。在评估首次就诊后的诊断时间时,年龄越大,诊断越快。此外,有 HS 家族史的患者确诊较快,而体重指数高、并发症多、在职、由多名医生管理或欧洲人的患者确诊较晚:在对真实世界数据进行全面分析的基础上,确定了可能影响 HS 及时诊断的多种因素。本研究首次量化了这些影响因素的相对影响,为更快诊断和改善疾病预后需要关注的领域提供了有价值的见解。
{"title":"Equity and Outcome Events in Hidradenitis Suppurativa: Exploring Effect Modifiers Associated with Diagnostic Delay in the Real World.","authors":"Nicole Murray, Isabel Truman, Gary Milligan, Himanshu Modi, Nicholas Adlard","doi":"10.1007/s13555-024-01291-0","DOIUrl":"https://doi.org/10.1007/s13555-024-01291-0","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with hidradenitis suppurativa (HS) experience significantly delayed diagnoses of 7-10 years from symptom onset on average, but the reasons for this remain largely unknown. This study investigated drivers of diagnostic delay from the perspective of healthcare system equity.</p><p><strong>Methods: </strong>A literature review was performed to identify published factors associated with delayed HS diagnosis to inform data analysis. Clinical and demographic data from the Adelphi HS Disease Specific Programme (DSP)™, a real-world cross-sectional survey of dermatologists and their consulting patients in France, Germany, Italy, Spain, the UK and the USA in 2020/2021, were used to model factors influencing delay to diagnosis from onset of symptoms and first consultation.</p><p><strong>Results: </strong>Factors influencing delay to HS diagnosis in the literature with the most available evidence were misdiagnosis, delay in specialist referral and patient embarrassment. Data analysis revealed that increasing age was associated with reduced diagnostic delay after symptom onset. Patients with HS who were White or in Germany were also more likely to receive a faster diagnosis. Smokers, patients with concomitant conditions, or a family history of HS were slower to be diagnosed. When time to diagnosis following first consultation was assessed, increasing age was associated with quicker diagnosis. Moreover, patients with a family history of HS were diagnosed quicker, whereas those with high body mass index, more concomitant conditions, in employment, managed by multiple physicians or European were more delayed.</p><p><strong>Conclusion: </strong>On the basis of a thorough analysis of real-world data, multiple factors that potentially influenced the timely diagnosis of HS have been identified. For the first time, this study quantifies the relative impact of these modifiers, providing valuable insights into areas that require attention for faster diagnoses and improved disease outcomes.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Efficacy and Safety of Bimekizumab and Other Biologics in Moderate to Severe Plaque Psoriasis: Updated Systematic Literature Review and Network Meta-analysis. 比美单抗和其他生物制剂对中度至重度斑块状银屑病的长期疗效和安全性:最新系统文献综述和网络 Meta 分析。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-01 DOI: 10.1007/s13555-024-01302-0
Richard B Warren, Kerry Donnelly, Sandeep Kiri, Vanessa Taieb, Mahmoud Slim, Kyle Fahrbach, Binod Neupane, Marissa Betts, April Armstrong

Introduction: Biologic treatments have made complete skin clearance in moderate to severe plaque psoriasis a real possibility. Although clinical trials demonstrated the superiority of bimekizumab over secukinumab, adalimumab, and ustekinumab, direct comparisons with other biologics are not available. This systematic literature review (SLR) and network meta-analysis (NMA) aimed to evaluate the 1-year efficacy and safety of bimekizumab versus other biologic systemic therapies for moderate to severe plaque psoriasis.

Methods: We conducted an SLR to retrieve published randomised controlled trials (RCTs) in patients with moderate to severe plaque psoriasis. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and PsycINFO on 13 January 2022. Two NMA types were used to analyse the long-term achievement of 100% improvement from baseline in Psoriasis Area and Severity Index (PASI 100): (1) NMA of cumulative clinical benefits, based on the area under the curve, from week 0 to 52; (2) multinomial NMA at weeks 44‒60. Binomial NMA was used to evaluate long-term serious adverse events (SAEs).

Results: The SLR identified 38 RCTs, of which 19 were included in the NMA. Bimekizumab 320 mg administered every 4 weeks to week 16 then every 8 weeks (Q4W/Q8W) showed a greater cumulative average number of days of PASI 100 response compared with all other biologics. These differences were statistically significant versus all biologics, except risankizumab 150 mg. The multinomial NMA demonstrated that interleukin (IL)-17 and IL-23 inhibitors were the most efficacious treatments. No significant differences were found in long-term occurrence of SAEs.

Conclusion: Bimekizumab 320 mg Q4W/Q8W was superior to most other treatments in maintaining complete skin clearance during the first year of treatment. It demonstrated a greater cumulative average number of days with completely clear skin while displaying a comparable safety profile compared with all other biologics.

简介:生物制剂治疗已使中度至重度斑块状银屑病患者的皮肤完全清除成为可能。尽管临床试验证明了bimekizumab优于secukinumab、adalimumab和ustekinumab,但尚无与其他生物制剂的直接比较。本系统性文献综述(SLR)和网络荟萃分析(NMA)旨在评估bimekizumab与其他生物制剂系统疗法治疗中重度斑块状银屑病的1年疗效和安全性:我们进行了一次SLR检索,以检索已发表的针对中重度斑块状银屑病患者的随机对照试验(RCT)。我们检索了2022年1月13日的MEDLINE、Embase、Cochrane对照试验中央登记册、Cochrane系统综述数据库和PsycINFO。采用两种NMA类型分析牛皮癣面积和严重程度指数(PASI 100)从基线改善100%的长期成就:(1)基于曲线下面积的累积临床获益NMA,从第0周到第52周;(2)第44-60周的多项式NMA。二项式 NMA 用于评估长期严重不良事件 (SAE):SLR确定了38项RCT,其中19项纳入了NMA。与所有其他生物制剂相比,比美单抗 320 毫克每 4 周给药一次至第 16 周,然后每 8 周给药一次(Q4W/Q8W),PASI 100 反应的累积平均天数更多。除利桑珠单抗 150 毫克外,与所有生物制剂相比,这些差异均具有统计学意义。多项式 NMA 显示,白细胞介素 (IL)-17 和 IL-23 抑制剂是最有效的治疗方法。在SAEs的长期发生率方面没有发现明显差异:结论:Bimekizumab 320 mg Q4W/Q8W 在治疗第一年保持皮肤完全清除方面优于大多数其他治疗方法。结论:与所有其他生物制剂相比,比美单抗 320 毫克 Q4W/Q8W 在保持皮肤完全清除方面优于大多数其他治疗方法,其皮肤完全清除的累积平均天数更多,同时显示出相当的安全性。
{"title":"Long-Term Efficacy and Safety of Bimekizumab and Other Biologics in Moderate to Severe Plaque Psoriasis: Updated Systematic Literature Review and Network Meta-analysis.","authors":"Richard B Warren, Kerry Donnelly, Sandeep Kiri, Vanessa Taieb, Mahmoud Slim, Kyle Fahrbach, Binod Neupane, Marissa Betts, April Armstrong","doi":"10.1007/s13555-024-01302-0","DOIUrl":"10.1007/s13555-024-01302-0","url":null,"abstract":"<p><strong>Introduction: </strong>Biologic treatments have made complete skin clearance in moderate to severe plaque psoriasis a real possibility. Although clinical trials demonstrated the superiority of bimekizumab over secukinumab, adalimumab, and ustekinumab, direct comparisons with other biologics are not available. This systematic literature review (SLR) and network meta-analysis (NMA) aimed to evaluate the 1-year efficacy and safety of bimekizumab versus other biologic systemic therapies for moderate to severe plaque psoriasis.</p><p><strong>Methods: </strong>We conducted an SLR to retrieve published randomised controlled trials (RCTs) in patients with moderate to severe plaque psoriasis. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and PsycINFO on 13 January 2022. Two NMA types were used to analyse the long-term achievement of 100% improvement from baseline in Psoriasis Area and Severity Index (PASI 100): (1) NMA of cumulative clinical benefits, based on the area under the curve, from week 0 to 52; (2) multinomial NMA at weeks 44‒60. Binomial NMA was used to evaluate long-term serious adverse events (SAEs).</p><p><strong>Results: </strong>The SLR identified 38 RCTs, of which 19 were included in the NMA. Bimekizumab 320 mg administered every 4 weeks to week 16 then every 8 weeks (Q4W/Q8W) showed a greater cumulative average number of days of PASI 100 response compared with all other biologics. These differences were statistically significant versus all biologics, except risankizumab 150 mg. The multinomial NMA demonstrated that interleukin (IL)-17 and IL-23 inhibitors were the most efficacious treatments. No significant differences were found in long-term occurrence of SAEs.</p><p><strong>Conclusion: </strong>Bimekizumab 320 mg Q4W/Q8W was superior to most other treatments in maintaining complete skin clearance during the first year of treatment. It demonstrated a greater cumulative average number of days with completely clear skin while displaying a comparable safety profile compared with all other biologics.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"3133-3147"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Melasma: A Clinical and Epidemiological Single-Group Observational Study in the Greek Population. 黄褐斑:希腊人群的临床和流行病学单组观察研究。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-11-01 DOI: 10.1007/s13555-024-01297-8
Eftychia Platsidaki, Vasiliki Markantoni, Electra Nicolaidou, Alexander Katoulis, Dimitrios Rigopoulos, Alexandros J Stratigos, Stamatios Gregoriou

Introduction: Melasma is a common acquired disorder of melanogenesis that predominately affects women and presents as hyperpigmented skin lesions mainly located on the face. The study aims to investigate the epidemiologic characteristics and hormonal profiles in melasma patients.

Methods: One hundred fifty patients were enrolled in this study in a tertiary care hospital. Clinical patterns, pigment depth, disease severity, underlying conditions, and heredity were recorded. Endocrinologic profile and vitamin D levels were assessed.

Results: On clinical examination, the condition indicated a centrofacial localization in 74% of the patients. Extra facial melasma was noticed in 10 patients who had centrofacial melasma to begin with. Wood's lamp examination showed the dermal type as the most common. A family history of melasma was noted in 38% of the patients. Melasma Area and Severity Index (MASI) score ranged from 0.3 to 10.8, with a mean score of 4.12 ± 2.06. Pregnancy-induced melasma was reported in 36.1% of the patients. In 17.4% of women, melasma was related to using oral contraceptives. In 22% of patients, mild vitamin D deficiency was detected, while 21% had thyroid disorders.

Conclusion: There is a strong correlation between family history and prevalence of melasma. Sun exposure is a major precipitating factor and should be carefully addressed in Mediterranean countries like Greece. However, other factors such as concomitant medication, multiple pregnancies, use of oral contraceptives, thyroid disorders and vitamin D deficiency might precipitate melasma.

导言:黄褐斑是一种常见的后天性黑色素生成障碍,主要影响女性,表现为色素沉着性皮肤损害,主要位于面部。本研究旨在调查黄褐斑患者的流行病学特征和荷尔蒙特征:方法:本研究在一家三甲医院招募了 150 名黄褐斑患者。记录了临床模式、色素深度、疾病严重程度、基础疾病和遗传情况。对内分泌情况和维生素 D 水平进行了评估:临床检查显示,74%的患者的病症位于面部中央。有 10 名患者的面部黄褐斑在一开始就位于面部中心位置。伍德灯检查显示,真皮型黄褐斑最为常见。38%的患者有黄褐斑家族史。黄褐斑面积和严重程度指数(MASI)从 0.3 到 10.8 不等,平均值为 4.12 ± 2.06。据报告,36.1%的患者有妊娠引起的黄褐斑。17.4%的妇女的黄褐斑与使用口服避孕药有关。22%的患者被检测出轻度缺乏维生素D,21%的患者患有甲状腺疾病:结论:家族病史与黄褐斑发病率之间存在密切联系。在希腊等地中海国家,日晒是一个主要诱发因素,应谨慎对待。然而,其他因素,如同时服用药物、多次怀孕、使用口服避孕药、甲状腺疾病和维生素D缺乏症也可能诱发黄褐斑。
{"title":"Melasma: A Clinical and Epidemiological Single-Group Observational Study in the Greek Population.","authors":"Eftychia Platsidaki, Vasiliki Markantoni, Electra Nicolaidou, Alexander Katoulis, Dimitrios Rigopoulos, Alexandros J Stratigos, Stamatios Gregoriou","doi":"10.1007/s13555-024-01297-8","DOIUrl":"10.1007/s13555-024-01297-8","url":null,"abstract":"<p><strong>Introduction: </strong>Melasma is a common acquired disorder of melanogenesis that predominately affects women and presents as hyperpigmented skin lesions mainly located on the face. The study aims to investigate the epidemiologic characteristics and hormonal profiles in melasma patients.</p><p><strong>Methods: </strong>One hundred fifty patients were enrolled in this study in a tertiary care hospital. Clinical patterns, pigment depth, disease severity, underlying conditions, and heredity were recorded. Endocrinologic profile and vitamin D levels were assessed.</p><p><strong>Results: </strong>On clinical examination, the condition indicated a centrofacial localization in 74% of the patients. Extra facial melasma was noticed in 10 patients who had centrofacial melasma to begin with. Wood's lamp examination showed the dermal type as the most common. A family history of melasma was noted in 38% of the patients. Melasma Area and Severity Index (MASI) score ranged from 0.3 to 10.8, with a mean score of 4.12 ± 2.06. Pregnancy-induced melasma was reported in 36.1% of the patients. In 17.4% of women, melasma was related to using oral contraceptives. In 22% of patients, mild vitamin D deficiency was detected, while 21% had thyroid disorders.</p><p><strong>Conclusion: </strong>There is a strong correlation between family history and prevalence of melasma. Sun exposure is a major precipitating factor and should be carefully addressed in Mediterranean countries like Greece. However, other factors such as concomitant medication, multiple pregnancies, use of oral contraceptives, thyroid disorders and vitamin D deficiency might precipitate melasma.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"3183-3192"},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Dermatology and Therapy
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1