Italian Journal of Dermatology and Venereology最新文献

Background: Atopic dermatitis (AD) is an inflammatory skin disease. The monoclonal antibody dupilumab can provide a rapid response with achievement of stable clinical disease. This study aimed to confirm the effectiveness of a televisit approach for patients with AD and treated with dupilumab.

Methods: Demographic data and characteristics at baseline including mean EASI, mean NRSp, mean DLQI, and mean NRSds were retrospectively assessed and subsequently collected at up to 48 weeks, last visit in attendance, and up to the fourth televisit. The mean reduction of the above scores, and achievement at each time point of EASI≤7, EASI 75, EASI 90, DLQI 0/1, and NRSp≤4 were considered as endpoints.

Results: Twelve patients underwent at least 1 televisit. The mean follow-up on dupilumab before switching to a televisit was 28.5 months. The mean EASI at the last face-to-face visit was 0.75 and remained stable at subsequent televisit visits. All patients achieved EASI≤7 as early as week 16 which was during the televisits. A similar trend was seen for EASI 75. Only 1 patient discontinued the televisits after 2 visits, preferring to return in person.

Conclusions: In our case series of remotely-followed patients, clinical and patient-reported outcomes remained stable.

Background: The JADE COMPARE was a multicenter, phase 3 randomized, double-blind, placebo-controlled trial with the objective of comparing the 16-week efficacy and safety of oral abrocitinib 100 or 200 mg once daily, dupilumab 300 mg subcutaneous injection every 2 weeks, or placebo in adults with moderate-to-severe atopic dermatitis (AD). Pharmacoeconomic evaluation of these new drugs for AD is lacking. The objective of our study was to compare the cost per responder of abrocitinib versus dupilumab in patients with AD using the data from the JADE COMPARE trial.

Methods: The cost per responder was calculated by multiplying the cost of treatment by the number needed to treat for each therapy, as obtained from the JADE COMPARE trial. The 12-week primary endpoint was the Investigator global assessment (IGA) 0/1 and eczema area and severity index improvement of at least 75% (EASI75) response rate. The key secondary end points were itch response (defined as an improvement of ≥4 points in the score on the Peak Pruritus Numerical Rating Scale [PP-NRS; scores range from 0 to 10]) at week 2 and IGA and EASI-75 responses at week 16. The cost per responder model was based on the perspective of the Italian National Health System. Regarding the costs of drugs, ex-factory wholesale purchase prices were used, including the mandatory discounts according to the national legislation (5% discount, plus a further 5% reduction on the discount result). Abrocitinib 100 mg and 200 mg have flat price in Italy.

Results: The 12-week IGA 0/1 cost per responder was € 3955.77 and € 2984.94 for abrocitinib 100 mg and 200 mg, respectively, versus € 7467.96 for dupilumab; as for 12-week EASI75 the cost were € 2463.30 and € 2057.58 vs. € 4705.09, respectively. As far as the secondary end points, the costs per responder were always lower for abrocitinib 100 and 200 mg compared to dupilumab, including the PP-NRS (€ 3791.55 and € 2451.22, vs. € 6462.65), the IGA 0/1 at week 16 (€ 6931.05 and € 4854.15 vs. € 8787.85) and the EASI75 at week 16 (€ 3984.75 and € 3381.00 vs. € 5197.45).

Conclusions: According to JADE COMPARE trial data, the costs per responder of abrocitinib were considerably lower than dupilumab. The results of the study are limited to the short time frame of JADE COMPARE trial.

Solar cheilosis is a premalignant disease of the lip, typically presenting on the lower lip as a precursor to in situ squamous cell carcinoma. It is primarily caused by chronic exposure to sunlight and predominantly affects individuals with lighter skin pigmentation. This review explores solar cheilosis while providing an update on its epidemiology, etiology, pathogenesis, disease course, and other recent advancements. Specifically, we discuss the various molecular markers involved in the pathogenesis of solar cheilosis and their respective functions. Through our analysis, we aim to highlight the various clinical manifestations of solar cheilosis, emphasizing the importance of early detection, assessing risk factors, and analysis of histopathology to help confirm a diagnosis of solar cheilosis. Finally, we outline the latest available treatment modalities, ranging from conservative (non-surgical) approaches to surgical approaches. These conservative approaches include the use of laser therapy, topical agents, photodynamic therapy, and cryotherapy, while the most frequently employed surgical approach for treating solar cheilosis involves vermilionectomy.