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Matching-Adjusted Indirect Comparison of the Efficacy and Safety of Difamilast 1% and Delgocitinib 0.5% in Patients with Moderate-to-Severe Atopic Dermatitis. 中重度特应性皮炎患者服用1%地拉米司特和地戈西替尼0.5%的疗效和安全性的匹配调整间接比较研究
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-10-04 DOI: 10.1007/s13555-024-01282-1
Takeshi Nakahara, Hiroyuki Murota, Miyuki Matsukawa, Hiroe Takeda, Yilong Zhang, Tomohiro Kondo

Background: Atopic dermatitis (AD) is a chronic condition with an increasing incidence in Japan. Difamilast and delgocitinib are both new topical drugs for AD proven to be efficacious and safe in phases 2 and 3 clinical trials in Japan. However, there are no head-to-head trials comparing their efficacy and safety. The aim of this study was to determine the proportion of patients by severity and compare the clinical efficacy and safety of difamilast with delgocitinib among patients with moderate-to-severe AD using a matching-adjusted indirect comparison (MAIC).

Methods: Phase 3 clinical trials of difamilast and delgocitinib for treating AD were included. The trials had similar designs but differed in baseline population characteristics. Anchored MAIC was used to align the baseline characteristics and calculate clinical outcomes. The primary outcome was to determine severity stages of the proportion of patients with AD through Eczema Area and Severity Index (EASI), while the secondary outcome included comparing other clinical efficacy and safety of difamilast with delgocitinib.

Results: A total of 340 patients were selected (170 each received difamilast and placebo) from the difamilast trial, with 158 (106 received delgocitinib; 52 received placebo) from the delgocitinib trial for the analysis. After matching patients from the difamilast trial with those from the delgocitinib trial, the effective sample sizes (ESS) reduced to 32.7-43.3% of the original difamilast (treatment/placebo) patients. At week 4, the ESS in the difamilast group demonstrated no statistically significant differences in the distribution of AD severity stages, as per EASI scores, compared with the delgocitinib group. In addition, no significant differences were found in modified EASI (mEASI) scores, mEASI 50 and 75 scores, and safety outcomes between the two treatments.

Conclusions: The anchored MAIC analysis indicates that difamilast treatment, like delgocitinib, is a useful option for the treatment of patients with moderate-to-severe AD in Japan.

背景:特应性皮炎(AD)是一种慢性疾病,在日本的发病率越来越高。在日本进行的 2 期和 3 期临床试验证明,地拉米司特和德尔戈西替尼都是治疗特应性皮炎的新型外用药物,具有良好的疗效和安全性。然而,目前还没有头对头的试验来比较它们的疗效和安全性。本研究旨在确定中重度AD患者的严重程度比例,并采用匹配调整间接比较法(MAIC)比较地拉米司特和德戈西替尼在中重度AD患者中的临床疗效和安全性:方法:纳入了地拉米司特和德戈西替尼治疗AD的3期临床试验。这些试验设计相似,但基线人群特征不同。使用锚定MAIC来调整基线特征并计算临床结果。主要结果是通过湿疹面积和严重程度指数(EASI)确定AD患者比例的严重程度分级,次要结果包括比较地拉米司特和德戈西替尼的其他临床疗效和安全性:从地法米司特试验中选取了340例患者(地法米司特和安慰剂各170例)进行分析,从德戈西替尼试验中选取了158例患者(德戈西替尼106例;安慰剂52例)进行分析。将地法米司特试验的患者与德尔戈西替尼试验的患者进行配对后,有效样本量(ESS)减少到原来地法米司特患者(治疗/安慰剂)的32.7%-43.3%。第4周时,根据EASI评分,地拉米司特组的ESS与delgocitinib组相比,在AD严重程度分期分布方面没有统计学意义上的显著差异。此外,两种治疗方法在改良EASI(mEASI)评分、mEASI 50和75评分以及安全性结果方面也没有发现明显差异:锚定MAIC分析表明,在日本,地拉司特治疗与delgocitinib一样,都是治疗中重度AD患者的有效选择。
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引用次数: 0
Correction: Certolizumab Pegol for the Treatment of Plaque Psoriasis in Routine Clinical Practice: One-Year Results from the CIMREAL Study. 更正:常规临床实践中用于治疗斑块状银屑病的赛妥珠单抗 Pegol:CIMREAL研究的一年结果。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 DOI: 10.1007/s13555-024-01271-4
Bernhard Korge, Olivier Vanhooteghem, Charles W Lynde, Alena Machovcova, Marc Perrussel, Elisavet Lazaridou, Claudio Marasca, David Vidal Sarro, Ines Duenas Pousa, Frederik Fierens, Paulette Williams, Saori Shimizu, Tanja Heidbrede, Richard B Warren
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引用次数: 0
A Descriptive, Post Hoc Analysis of Efficacy and Safety of Risankizumab in Diverse Racial and Ethnic Patient Populations With Moderate-to-Severe Psoriasis. 中度至重度银屑病患者中不同种族和人种利赞单抗疗效和安全性的描述性事后分析。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-10-02 DOI: 10.1007/s13555-024-01268-z
Andrew F Alexis, Melinda Gooderham, Shawn G Kwatra, Ahmad Amin, Susan Taylor, Ramon Espaillat, Trisha Rettig, Tianshuang Wu, Linyu Shi, Mark I Kaldas, Deanne M Dilley, Ranjeeta Sinvhal, Chudy Nduaka, Benjamin Lockshin

Introduction: Historically, patients with skin of color are underdiagnosed with psoriasis and underrepresented in clinical trials. In this study, we assess the efficacy and safety of risankizumab in patients with moderate-to-severe plaque psoriasis by race and ethnicity in the open label extension LIMMitless (NCT03047395).

Methods: Patients received continuous treatment with 150 mg risankizumab through their initial trial and the open label extension. Patients self-identified their race and ethnicity. Efficacy was assessed using Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). Safety is reported by events/100 patient-years.

Results: A total of 897 patients (race: 662 White, 196 Asian, 25 Black or African American, 14 Other; ethnicity: 98 Hispanic or Latino, 799 non-Hispanic or Latino) were included in this analysis. Compared to baseline, patients had a mean percent reduction in PASI between 94.6% (Asian) and 99.3% (Black or African American) and reported mean percent improvements in DLQI ranging from 87.1% (Asian and Black or African American) to 93.7% (Hispanic or Latino) at week 100.

Conclusion: While the data presented here comprise a small retrospective descriptive analysis and cannot detect statistical differences, efficacy of risankizumab for the treatment of moderate-to-severe plaque psoriasis appears similar across the racial and ethnic groups studied and no new safety signals were detected.

简介:一直以来,有色人种银屑病患者的诊断率较低,在临床试验中的代表性也不足。在这项研究中,我们将在开放标签扩展项目 LIMMitless(NCT03047395)中,按种族和民族评估利妥珠单抗对中重度斑块状银屑病患者的疗效和安全性:患者在初始试验和开放标签扩展试验中持续接受 150 毫克利抗珠单抗治疗。患者自报种族和民族。疗效采用银屑病面积严重程度指数(PASI)和皮肤病生活质量指数(DLQI)进行评估。安全性按每 100 患者年发生的事件进行报告:本分析共纳入 897 名患者(种族:662 名白人、196 名亚裔、25 名黑人或非裔美国人、14 名其他;族裔:98 名西班牙裔或拉丁裔、799 名非西班牙裔或拉丁裔)。与基线相比,患者的 PASI 平均下降率介于 94.6%(亚裔)和 99.3%(黑人或非裔美国人)之间,第 100 周的 DLQI 平均改善率介于 87.1%(亚裔和黑人或非裔美国人)和 93.7%(西班牙裔或拉丁裔美国人)之间:虽然本文提供的数据只是一个小型的回顾性描述分析,无法检测出统计学差异,但利桑珠单抗治疗中重度斑块状银屑病的疗效在所研究的种族和民族群体中似乎相似,而且没有发现新的安全信号。
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引用次数: 0
Correction: Consensus Recommendations for the Management of Atopic Dermatitis in the United Arab Emirates. 更正:阿拉伯联合酋长国特应性皮炎管理共识建议》。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 DOI: 10.1007/s13555-024-01276-z
Ahmed Ameen, Ahmed Al Dhaheri, Ashraf M Reda, Ayman Alnaeem, Fatima Al Marzooqi, Fatima Albreiki, Huda Rajab Ali, Hussein Abdel Dayem, Jawaher Alnaqbi, Mariam Al Zaabi, Mohammed Ahmed, Georg Stingl, Muna Al Murrawi
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引用次数: 0
Advanced Systemic Treatments in Patients with Moderate-to-Severe Atopic Dermatitis: Key Learnings from Physicians Practicing in Nine Asian Countries and Territories. 中重度特应性皮炎患者的先进系统治疗:九个亚洲国家和地区执业医师的主要经验。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-28 DOI: 10.1007/s13555-024-01278-x
Chia-Yu Chu, Ramesh Bhat Marne, Christina Man-Tung Cheung, Le Ngoc Diep, Nopadon Noppakun, Endi Novianto, Maria Lourdes H Palmero, Yong-Kwang Tay, Azizan Noor Zalmy

Introduction: Rapid progress made in the management of atopic dermatitis (AD) in recent years and the differences in patient journey between Asian and non-Asian populations call for a review of current atopic dermatitis landscape in Asia.

Methods: A roundtable meeting with nine regional dermatological experts was held in June 2023 to discuss the optimal management approaches for moderate-to-severe AD, focusing on the use of advanced therapies.

Results: Disease burden on patients' quality of life, treatment adherence, and financial constraints were identified as major concerns when managing patients with moderate-to-severe AD in parts of Asia. It was agreed that the Hanifin and Rajka's criteria or the UK Working Party's Diagnostic Criteria for Atopic Dermatitis can be used to guide the clinical diagnosis of AD. Meanwhile, patient-reported outcome scales including the Dermatology Life Quality Index and Atopic Dermatitis Control Tool can be used alongside depression monitoring scales to monitor treatment outcomes in patients with AD, allowing a better understanding for individualized treatment. When managing moderate-to-severe AD, phototherapy should be attempted after failure with topical treatments, followed by conventional disease-modifying antirheumatic drugs and, subsequently, biologics or Janus kinase inhibitors. Systemic corticosteroids can be used as short-term therapy for acute flares. Although these advanced treatments are known to be effective, physicians have to take into consideration safety concerns and limitations when prescribing these treatments.

Conclusions: Treatments in AD have evolved and its management varies country by country. Unique challenges across Asian countries necessitate a different management approach in Asian patients with AD.

简介:近年来,特应性皮炎(AD)的治疗取得了突飞猛进的进展,而亚洲与非亚洲人群在患者治疗过程中存在差异,因此有必要对亚洲特应性皮炎的现状进行回顾:方法:2023年6月,九位地区皮肤科专家召开了一次圆桌会议,讨论中重度特应性皮炎的最佳治疗方法,重点是先进疗法的使用:结果:在亚洲部分地区,疾病对患者生活质量造成的负担、治疗依从性和经济限制被认为是管理中重度 AD 患者的主要问题。与会者一致认为,哈尼芬和拉杰卡的标准或英国特应性皮炎工作组的诊断标准可用于指导 AD 的临床诊断。同时,包括皮肤科生活质量指数和特应性皮炎控制工具在内的患者报告结果量表可与抑郁监测量表一起用于监测AD患者的治疗结果,以便更好地了解个体化治疗。在治疗中重度 AD 时,应在局部治疗失败后尝试光疗,然后使用传统的改变病情抗风湿药物,最后使用生物制剂或 Janus 激酶抑制剂。全身性皮质类固醇激素可作为急性发作的短期疗法。虽然这些先进的治疗方法已知有效,但医生在开具处方时必须考虑到安全问题和局限性:AD 的治疗方法在不断发展,各国的治疗方法也不尽相同。亚洲各国面临的独特挑战要求对亚洲的 AD 患者采取不同的管理方法。
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引用次数: 0
Comprehensive Codified Algorithms to Identify the Underestimated Burden of Hidradenitis Suppurativa in the United States. 综合编纂算法,确定美国被低估的化脓性扁桃体炎负担。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-24 DOI: 10.1007/s13555-024-01259-0
John R Ingram, Yvonne Geissbühler, John Darcy, Stephen Foley, Alex Gaffney, Aine McConnon, Craig Richardson, Amit Garg

Introduction: Hidradenitis suppurativa (HS) is a painful, inflammatory skin disease associated with a high disease burden and long diagnostic delay. Prevalence estimates of HS vary widely in the literature owing to differing estimation methodologies. This study aimed to apply stepwise algorithms to estimate the prevalence of possible/diagnosed cases of HS in the US.

Methods: This was a retrospective cohort study in adult and pediatric patients with HS which utilized data from four US databases (MarketScan [Medicare and Medicaid] and Optum [electronic health record (EHR) and Clinformatics Data Mart (CDM)]). Patients with possible/diagnosed HS were identified using two algorithms (termed Algorithm 1 and Algorithm 2), which assessed symptoms such as multiple skin boils in site-specific areas based on international classification of disease (ICD) codes. Patients with diagnosed HS were defined as having ≥ 2 outpatient or ≥ 1 inpatient diagnosis codes of HS. In each database, patients with continuous medical and pharmacy benefits in the 365 days pre-index and 0-365 days post-index periods were eligible for inclusion.

Results: Across all databases, Algorithm 2 (MarketScan Medicare [N = 309,916]; MarketScan Medicaid [N = 188,783]; Optum EHR [N = 366,158]; Optum CDM [N = 173,812]) identified more patients with possible/diagnosed HS than Algorithm 1 (MarketScan Medicare [N = 194,353]; MarketScan Medicaid [N = 99,276]; Optum EHR [N = 177,957]; Optum CDM [N = 112,244]). Based on ICD-9/10 codes, the 5-year period prevalence of HS ranged from 0.06% to 0.12% across all databases, while for Algorithm 1 and Algorithm 2, this ranged from 0.27% to 0.41% and 0.49% to 0.78%, respectively. Adults and females generally had a higher 5-year period prevalence versus pediatric patients and males, respectively.

Conclusion: This real-world study highlights that HS diagnosis codes alone may be insufficient to estimate the prevalence of HS, demonstrating the value of employing algorithms in practice which assess for parameters such as multiple skin boils in site-specific areas. Integrating robust methods to identify the prevalence of HS may improve the diagnostic delay observed in HS and improve treatment outcomes.

简介化脓性扁平湿疹(HS)是一种疼痛的炎症性皮肤病,疾病负担重,诊断时间长。由于估算方法不同,文献中对化脓性扁平湿疹患病率的估算也大相径庭。本研究旨在应用逐步算法估算美国 HS 可能/确诊病例的患病率:这是一项针对成人和儿童 HS 患者的回顾性队列研究,利用了美国四个数据库(MarketScan [医疗保险和医疗补助] 和 Optum [电子健康记录 (EHR) 和 Clinformatics Data Mart (CDM)])中的数据。使用两种算法(称为算法 1 和算法 2)确定可能/确诊为 HS 的患者,这两种算法根据国际疾病分类 (ICD) 代码评估特定部位的多发性皮肤疖等症状。确诊为 HS 的患者定义为门诊患者中 HS 诊断代码≥2 个或住院患者中 HS 诊断代码≥1 个。在每个数据库中,在指数发布前的 365 天和指数发布后的 0-365 天内连续享受医疗和药房福利的患者均符合纳入条件:在所有数据库中,算法 2(MarketScan Medicare [N = 309,916]; MarketScan Medicaid [N = 188,783]; Optum EHR [N = 366,158];Optum CDM [N = 173,812]) 相比算法 1(MarketScan Medicare [N = 194,353]; MarketScan Medicaid [N = 99,276]; Optum EHR [N = 177,957]; Optum CDM [N = 112,244])识别出更多可能/确诊为 HS 的患者。根据 ICD-9/10 编码,所有数据库的 5 年期 HS 患病率介于 0.06% 到 0.12% 之间,而算法 1 和算法 2 的患病率分别介于 0.27% 到 0.41% 和 0.49% 到 0.78% 之间。与儿科患者和男性相比,成人和女性的 5 年患病率普遍较高:这项真实世界的研究强调,仅凭HS诊断代码可能不足以估算HS的患病率,这表明在实践中采用算法评估特定部位多发皮肤疖等参数的价值。整合可靠的方法来确定HS的患病率,可以改善HS的诊断延迟并提高治疗效果。
{"title":"Comprehensive Codified Algorithms to Identify the Underestimated Burden of Hidradenitis Suppurativa in the United States.","authors":"John R Ingram, Yvonne Geissbühler, John Darcy, Stephen Foley, Alex Gaffney, Aine McConnon, Craig Richardson, Amit Garg","doi":"10.1007/s13555-024-01259-0","DOIUrl":"10.1007/s13555-024-01259-0","url":null,"abstract":"<p><strong>Introduction: </strong>Hidradenitis suppurativa (HS) is a painful, inflammatory skin disease associated with a high disease burden and long diagnostic delay. Prevalence estimates of HS vary widely in the literature owing to differing estimation methodologies. This study aimed to apply stepwise algorithms to estimate the prevalence of possible/diagnosed cases of HS in the US.</p><p><strong>Methods: </strong>This was a retrospective cohort study in adult and pediatric patients with HS which utilized data from four US databases (MarketScan [Medicare and Medicaid] and Optum [electronic health record (EHR) and Clinformatics Data Mart (CDM)]). Patients with possible/diagnosed HS were identified using two algorithms (termed Algorithm 1 and Algorithm 2), which assessed symptoms such as multiple skin boils in site-specific areas based on international classification of disease (ICD) codes. Patients with diagnosed HS were defined as having ≥ 2 outpatient or ≥ 1 inpatient diagnosis codes of HS. In each database, patients with continuous medical and pharmacy benefits in the 365 days pre-index and 0-365 days post-index periods were eligible for inclusion.</p><p><strong>Results: </strong>Across all databases, Algorithm 2 (MarketScan Medicare [N = 309,916]; MarketScan Medicaid [N = 188,783]; Optum EHR [N = 366,158]; Optum CDM [N = 173,812]) identified more patients with possible/diagnosed HS than Algorithm 1 (MarketScan Medicare [N = 194,353]; MarketScan Medicaid [N = 99,276]; Optum EHR [N = 177,957]; Optum CDM [N = 112,244]). Based on ICD-9/10 codes, the 5-year period prevalence of HS ranged from 0.06% to 0.12% across all databases, while for Algorithm 1 and Algorithm 2, this ranged from 0.27% to 0.41% and 0.49% to 0.78%, respectively. Adults and females generally had a higher 5-year period prevalence versus pediatric patients and males, respectively.</p><p><strong>Conclusion: </strong>This real-world study highlights that HS diagnosis codes alone may be insufficient to estimate the prevalence of HS, demonstrating the value of employing algorithms in practice which assess for parameters such as multiple skin boils in site-specific areas. Integrating robust methods to identify the prevalence of HS may improve the diagnostic delay observed in HS and improve treatment outcomes.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"2859-2876"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307279","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
Demographics, Disease Characteristics, and Time to Effective Treatment of Patients with Psoriasis in the Ghent PsoPlus Cohort of 2021. 2021 年根特 PsoPlus 队列中银屑病患者的人口统计、疾病特征和有效治疗时间。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-10-04 DOI: 10.1007/s13555-024-01277-y
Evelyn Meulewaeter, Anke Eylenbosch, Evelien Verhaeghe, Rani Soenen, Jo Lambert

Introduction: Psoriasis is a chronic immune-mediated skin disease with several comorbidities and a considerable influence on quality of life. Many patients with moderate-to-severe psoriasis are undertreated and have a substantial disease duration before effective treatment is started. This study analyzed patient and disease characteristics and time to effective treatment of patients with psoriasis who consulted PsoPlus. It also examined whether a treat-to-target (T2T) approach, which is implemented in PsoPlus, has an impact on treatment choice and disease progression.

Methods: Through a single center, retrospective study, 170 patients in the PsoPlus dedicated clinic were compared at moment of enrollment in PsoPlus and at the last recorded consultation in 2021.

Results: Median disease duration at the first PsoPlus consultation was 16.0 (interquartile range (IQR) 19.0) years. There was a significant difference in Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) between the first and the last recorded PsoPlus consultation (PASI 6.0 (IQR 6.4) vs. 0.6 (IQR 2.6); DLQI 11 (IQR 11) vs. 2 (IQR 6); p < 0.001). A weak positive Spearman correlation (rs) was found between disease duration and PASI at the first PsoPlus consultation (rs = 0.175; p = 0.034), while a weak negative correlation (rs = - 0.2; p = 0.013) was found at the last registered PsoPlus consultation. Patients with a disease duration of more than 20 years had significantly more switches of treatment than those with a shorter disease duration (p < 0.001). Median time from psoriasis onset until PASI ≤ 2 was 16.0 years. Median time from the first PsoPlus consultation until PASI ≤ 2 was 7.0 months.

Conclusion: The PsoPlus program with its T2T approach effectively improves clinical outcomes and quality of life for patients with psoriasis in a relatively short period, emphasizing the value of a structured, personalized treatment plan for long-term management.

简介银屑病是一种免疫介导的慢性皮肤病,有多种并发症,对生活质量有很大影响。许多中重度银屑病患者治疗不足,在开始有效治疗前病程较长。本研究分析了就诊于 PsoPlus 的银屑病患者的病情特征和有效治疗时间。研究还探讨了 PsoPlus 采用的 "靶向治疗"(T2T)方法是否会对治疗选择和疾病进展产生影响:通过单中心回顾性研究,对PsoPlus专科门诊的170名患者在加入PsoPlus时和2021年最后一次就诊记录进行了比较:首次接受 PsoPlus 诊疗时的中位病程为 16.0 年(四分位距(IQR)为 19.0 年)。牛皮癣面积和严重程度指数(PASI)和皮肤科生活质量指数(DLQI)在首次和最后一次 PsoPlus 咨询记录之间存在明显差异(PASI 6.0 (IQR 6.4) vs. 0.6 (IQR 2.6);DLQI 11 (IQR 11) vs. 2 (IQR 6);PASI 6.0 (IQR 6.4) vs. 0.6 (IQR 2.6);DLQI 11 (IQR 11) vs. 0.6 (IQR 2.6))。在第一次 PsoPlus 会诊时,病程与 PASI 之间发现了微弱的负相关(rs = 0.175;p = 0.034),而在最后一次登记的 PsoPlus 会诊时则发现了微弱的负相关(rs = - 0.2;p = 0.013)。与病程较短的患者相比,病程超过 20 年的患者接受治疗的次数明显较多(p 结论:PsoPlus 计划是一种有效的治疗方法,它能帮助患者在最短的时间内获得最佳治疗效果:采用 T2T 方法的 PsoPlus 计划能在较短时间内有效改善银屑病患者的临床疗效和生活质量,强调了结构化、个性化治疗计划在长期管理中的价值。
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引用次数: 0
What's New After NICE Acne Guidelines. NICE 痤疮指南之后的新动向。
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-21 DOI: 10.1007/s13555-024-01275-0
Alison M Layton, Girish Gupta, Daron Seukeran, Thivi Maruthappu, Stephanie Gaillard, Heather Whitehouse, Faisal R Ali, Angelika Razzaque, Firas Al-Niaimi, Sarah Copperwheat

Introduction: Acne remains one of the most common inflammatory dermatoses seen worldwide. There are significant challenges when managing acne relating to a variety of factors, including (1) lack of consensus on the use of the numerous available grading systems and outcome measures, (2) appreciation of the numerous areas that relate to severity, (3) the chronic nature of acne which requires a longitudinal approach to management (including both facial and truncal disease), and (4) the need to target acne early to avoid physical and psychosocial scarring. Consideration of these aspects when managing acne should result in improved outcomes. Acne guidelines review the available evidence based on robust clinical trials and are usually supplemented with some expert opinion when evidence is not available.

Methods: In this paper, the UK Acne Working Group reflects on the latest National Institute for Health and Care Excellence (NICE) acne guidelines with a goal of providing additional practical insights.

Conclusion: The group have identified areas where new evidence has now become available since the formulation of the NICE acne guidelines. This publication considers newly approved acne medications in the UK, guidance on assessing acne severity, approaches to managing truncal acne, acne sequelae, and adult female acne with hormonal therapies.

导言:痤疮是全球最常见的炎症性皮肤病之一。痤疮的治疗面临诸多挑战,其中包括:(1) 在使用众多可用的分级系统和疗效衡量标准方面缺乏共识;(2) 对与严重程度相关的众多领域缺乏了解;(3) 由于痤疮具有慢性性质,因此需要采取纵向治疗方法(包括面部和躯干疾病);(4) 需要及早针对痤疮进行治疗,以避免在身体和心理上留下疤痕。在治疗痤疮时考虑到这些方面,应能改善治疗效果。痤疮指南以可靠的临床试验为基础,对现有证据进行审查,在没有证据的情况下,通常会辅以一些专家意见:在本文中,英国痤疮工作组对最新的美国国家健康与护理优化研究所(NICE)痤疮指南进行了反思,旨在提供更多实用的见解:工作组确定了自 NICE 制定痤疮指南以来出现新证据的领域。本出版物考虑了英国新批准的痤疮药物、评估痤疮严重程度的指南、管理截肢痤疮的方法、痤疮后遗症以及使用激素疗法的成年女性痤疮。
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引用次数: 0
Vorasidenib-Induced Trichomegaly and Hypertrichosis: a New Side Effect in a Patient with Diffuse Astrocytoma. 沃拉西地尼诱发的毛细血管扩张和多毛症:弥漫性星形细胞瘤患者的一种新副作用
IF 3.5 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-31 DOI: 10.1007/s13555-024-01263-4
Michela Starace, Stephano Cedirian, Luca Rapparini, Francesca Bruni, Bianca Maria Piraccini

Vorasidenib, an oral dual inhibitor targeting mutant enzymes isocitrate dehydrogenase 1 and 2, is utilized in the management of diffuse low-grade gliomas. Despite limited documentation of its adverse events, we present the case of a 44-year-old male who exhibited trichomegaly and hypertrichosis of body hair, eyebrows, and eyelashes following one month of vorasidenib treatment. Notably, the patient experienced diffuse hair regrowth on the scalp, including in areas affected by severe androgenetic alopecia. This report holds significance as it highlights a previously unreported side effect, thereby enhancing our understanding of emerging therapies for brain tumors and their associated adverse reactions.

Vorasidenib是一种针对异柠檬酸脱氢酶1和2突变酶的口服双重抑制剂,用于治疗弥漫性低级别胶质瘤。尽管有关该药不良反应的文献有限,但我们仍发现一名 44 岁的男性患者在接受沃拉西地尼治疗一个月后,体毛、眉毛和睫毛出现了毛囊扩张和多毛症。值得注意的是,患者的头皮出现了弥漫性毛发再生,包括受严重雄激素性脱发影响的部位。这份报告的意义在于,它强调了一种以前未报道过的副作用,从而加深了我们对脑肿瘤新兴疗法及其相关不良反应的了解。
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引用次数: 0
A New TGF-β Mimetic, XEP™-716 Miniprotein™, Exhibiting Regenerative Properties Objectivized by Instrumental Evaluation 一种新型 TGF-β 拟态物质 XEP™-716 Miniprotein™,通过仪器评估显示出客观的再生特性
IF 3.4 3区 医学 Q1 DERMATOLOGY Pub Date : 2024-09-19 DOI: 10.1007/s13555-024-01273-2
Hanane Chajra, Thibaut Saguet, Corinne Granger, Lionel Breton, Pedro Contreiras Pinto, Mickael Machicoane, Jean Marc Le Doussal
<h3 data-test="abstract-sub-heading">Introduction</h3><p>Skin aging, which results from intrinsic and extrinsic factors, is characterized by a rough, uneven and wrinkled appearance of the skin at the macroscopic level. At the microscopic level, aging shows lowered keratinocyte turnover, flattened dermal-epidermal junction and reduced collagen fiber density; however, use of skin biopsies to evaluate characteristic properties of these microscopic changes is too limiting for panelists and rarely used. The development of non-invasive techniques is an opportunity to be considered for such evaluations. Our objective was to demonstrate the rejuvenating effects of XEP™-716 Miniprotein™ on skin, a miniprotein having TGF-β beta-like properties, in vitro on normal human fibroblasts and at the clinical level.</p><h3 data-test="abstract-sub-heading">Methods</h3><p>In vitro, the skin rejuvenation properties of XEP™-716 Miniprotein™ were studied by quantification of well-known dermal components such as collagen type I, hyaluronic acid and elastin. At the clinical level, we used a non-invasive technique, the confocal laser scanning microscopy (CLSM) system, which enabled non-invasive morphological characterization of skin structures (stratum corneum thickness, viable epidermis, full epidermis, dermal-epidermal junction, papillae, dermal collagen density) and high-frequency ultrasonography to quantify the dermal density and thickness, which are useful parameters for quantifying rejuvenating effects on skin. Lastly, a cutometer was used to assess the skin's biomechanical properties, mainly firmness and elasticity. This monocentric double-blind, split-face, randomized, placebo-controlled clinical trial compared the active ingredient XEP™-716 Miniprotein™ in a vehicle on one hemiface versus vehicle alone on the other (placebo) and enrolled panelists aged 40 to 60 years old. All measurements were carried out on the malar area before and after 28 and 56 days of twice daily application of a cosmetic cream formulation containing either 2.5% or 5% XEP™-716 Miniprotein™. The skin rejuvenating properties were demonstrated by studying dermo-epidermal junction (DEJ) flattening reduction using the measure of two parameters by CLSM: the DEJ length and number of edged papillae. Dermis rejuvenation was assessed by measuring the collagen fiber perimeters (CLSM), dermal density and dermal thickness (ultrasonography).</p><h3 data-test="abstract-sub-heading">Results</h3><p>The in vitro results confirmed the ability of XEP™-716 Miniprotein™ to stimulate the key extracellular macromolecules, namely collagen type I, hyaluronic acid and elastin, at a level comparable to that induced by TGF beta growth factor. The clinical data showed that after 28 and 56 days of topical XEP™-716 Miniprotein™ application, there was a statistically significant increase of DEJ length, number of edged papillae and collagen fiber perimeters. At the same time point, the B-scan images of facial skin showed a s
导言:皮肤老化是内在和外在因素共同作用的结果,在宏观层面上表现为皮肤粗糙、不平整和起皱。在微观层面上,衰老表现为角质细胞更替减少、真皮-表皮交界处变平以及胶原纤维密度降低;然而,使用皮肤活检来评估这些微观变化的特征特性对专家小组成员来说限制太多,很少使用。非侵入性技术的发展为此类评估提供了机会。我们的目标是在体外正常人成纤维细胞和临床层面上证明 XEP™-716 Miniprotein™ 对皮肤的嫩肤效果,它是一种具有 TGF-β 类似特性的微型蛋白。方法在体外,我们通过量化 I 型胶原蛋白、透明质酸和弹性蛋白等众所周知的真皮成分来研究 XEP™-716 Miniprotein™ 的嫩肤特性。在临床层面,我们使用了一种非侵入性技术--共焦激光扫描显微镜(CLSM)系统,该系统可对皮肤结构(角质层厚度、存活表皮、完整表皮、真皮-表皮交界处、乳头、真皮胶原蛋白密度)进行非侵入性形态学表征,并使用高频超声波成像技术对真皮密度和厚度进行量化,这些都是量化皮肤年轻化效果的有用参数。最后,使用切口计评估皮肤的生物力学特性,主要是紧致度和弹性。这项单中心、双盲、分面、随机、安慰剂对照临床试验比较了一侧半面的活性成分XEP™-716 Miniprotein™与另一侧半面的活性成分XEP™-716 Miniprotein™。在每天两次使用含有 2.5% 或 5% XEP™-716 Miniprotein™ 的化妆品乳霜配方 28 天和 56 天之前和之后,所有测量均在颧骨部位进行。通过 CLSM 测量两个参数:DEJ 长度和边缘乳头数量,研究真皮-表皮交界处(DEJ)扁平减少的情况,从而证明其嫩肤特性。通过测量胶原纤维周长(CLSM)、真皮密度和真皮厚度(超声波)来评估真皮年轻化情况。结果体外实验结果证实,XEP™-716 Miniprotein™ 能够刺激关键的细胞外大分子,即 I 型胶原蛋白、透明质酸和弹性蛋白,其刺激水平与 TGF beta 生长因子诱导的水平相当。临床数据显示,局部使用 XEP™-716 Miniprotein™ 28 天和 56 天后,DEJ 长度、边缘乳头数量和胶原纤维周长均有显著的统计学增长。在同一时间点,面部皮肤的 B 扫描图像显示,真皮密度和厚度在统计学上有显著增加。这些结果表明,DEJ变得更加起伏,与真皮的连接更加紧密,而乳头状真皮则更加致密,这两种特征都是年轻皮肤的典型特征。本文中介绍的体外和临床结果表明,XEP™-716 Miniprotein™ 是一种有效的成分,可使成熟皮肤的 DEJ 和真皮层恢复活力。
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Dermatology and Therapy
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