Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.4950
Sonja Ständer, Gil Yosipovitch, Howard Sofen, Daniel Abramzon, Joshua Galanter, Sheldon Wang, John F Paolini
<p><strong>Importance: </strong>Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by severe pruritus and nodule formation, significantly affecting patients' quality of life. There is an unmet need for effective therapies to address both symptoms and disease progression.</p><p><strong>Objective: </strong>To evaluate the efficacy, safety, tolerability, and pharmacokinetics of monthly dosed vixarelimab in participants with moderate to severe PN.</p><p><strong>Design, setting, and participants: </strong>This double-blind (DB), placebo-controlled, phase 2b randomized clinical trial was conducted from December 1, 2020, to August 24, 2023, across 72 centers in the US, Canada, Europe, and Asia. The study included male and female participants aged 18 to 80 years with physician-diagnosed PN of at least 6 months' duration and moderate to severe pruritus. Data were analyzed from October 2023 to March 2024.</p><p><strong>Interventions: </strong>Participants were randomized into 4 arms during the 16-week DB period: vixarelimab, 540 mg (high-dose group); vixarelimab, 360 mg (mid-dose group); vixarelimab, 120 mg (low-dose group); or placebo. Vixarelimab and placebo were administered subcutaneously every 4 weeks. During the 36-week open-label extension, all participants received vixarelimab, 360 mg, every 2 weeks.</p><p><strong>Main outcomes and measures: </strong>Key outcomes included percentage change from baseline in the Worst Itch Numeric Rating Scale (WI-NRS) at week 16, the proportion of participants achieving at least a 4-point reduction in WI-NRS at week 16, and the proportion achieving scores of 0 or 1 in the PN Investigator Global Assessment at week 16.</p><p><strong>Results: </strong>Of 190 randomized participants, 189 received 1 or more doses of the study drug (141 vixarelimab, 48 placebo). A total of 114 (60.3%) were female, 75 (39.7%) were male, and the mean (SD) age was 55.4 (13.8) years. There were 47 participants in the high-dose vixarelimab group, 47 in the mid-dose group, 47 in the low-dose group, and 48 in the placebo group. Vixarelimab significantly reduced mean (SE) WI-NRS scores at week 16 compared with placebo across all doses (vixarelimab at high-dose, mid-dose, and low-dose levels: -56.2% [4.84], -51.0% [4.83], and -33.0% [4.86], respectively; placebo, -14.5% [4.76]). Clinically meaningful 4-point or greater reductions in WI-NRS were achieved by 31 (66.0%), 29 (61.7%), and 14 (29.8%) in the high-dose, mid-dose, and low-dose vixarelimab groups, respectively, compared with 8 (16.7%) in the placebo group. PN Investigator Global Assessment scores of 0 or 1 were also higher in vixarelimab groups (high-dose group, 18 [38.3%]; mid-dose group, 14 [29.8%]; low-dose group, 7 [14.9%]; placebo group, 5 [10.4%]). No fatal or serious drug-related treatment-emergent adverse events were reported during the study, and no serious treatment-related treatment-emergent adverse events were observed during the DB period.</p><p><strong
{"title":"Vixarelimab in Patients With Prurigo Nodularis: A Randomized Clinical Trial.","authors":"Sonja Ständer, Gil Yosipovitch, Howard Sofen, Daniel Abramzon, Joshua Galanter, Sheldon Wang, John F Paolini","doi":"10.1001/jamadermatol.2025.4950","DOIUrl":"10.1001/jamadermatol.2025.4950","url":null,"abstract":"<p><strong>Importance: </strong>Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by severe pruritus and nodule formation, significantly affecting patients' quality of life. There is an unmet need for effective therapies to address both symptoms and disease progression.</p><p><strong>Objective: </strong>To evaluate the efficacy, safety, tolerability, and pharmacokinetics of monthly dosed vixarelimab in participants with moderate to severe PN.</p><p><strong>Design, setting, and participants: </strong>This double-blind (DB), placebo-controlled, phase 2b randomized clinical trial was conducted from December 1, 2020, to August 24, 2023, across 72 centers in the US, Canada, Europe, and Asia. The study included male and female participants aged 18 to 80 years with physician-diagnosed PN of at least 6 months' duration and moderate to severe pruritus. Data were analyzed from October 2023 to March 2024.</p><p><strong>Interventions: </strong>Participants were randomized into 4 arms during the 16-week DB period: vixarelimab, 540 mg (high-dose group); vixarelimab, 360 mg (mid-dose group); vixarelimab, 120 mg (low-dose group); or placebo. Vixarelimab and placebo were administered subcutaneously every 4 weeks. During the 36-week open-label extension, all participants received vixarelimab, 360 mg, every 2 weeks.</p><p><strong>Main outcomes and measures: </strong>Key outcomes included percentage change from baseline in the Worst Itch Numeric Rating Scale (WI-NRS) at week 16, the proportion of participants achieving at least a 4-point reduction in WI-NRS at week 16, and the proportion achieving scores of 0 or 1 in the PN Investigator Global Assessment at week 16.</p><p><strong>Results: </strong>Of 190 randomized participants, 189 received 1 or more doses of the study drug (141 vixarelimab, 48 placebo). A total of 114 (60.3%) were female, 75 (39.7%) were male, and the mean (SD) age was 55.4 (13.8) years. There were 47 participants in the high-dose vixarelimab group, 47 in the mid-dose group, 47 in the low-dose group, and 48 in the placebo group. Vixarelimab significantly reduced mean (SE) WI-NRS scores at week 16 compared with placebo across all doses (vixarelimab at high-dose, mid-dose, and low-dose levels: -56.2% [4.84], -51.0% [4.83], and -33.0% [4.86], respectively; placebo, -14.5% [4.76]). Clinically meaningful 4-point or greater reductions in WI-NRS were achieved by 31 (66.0%), 29 (61.7%), and 14 (29.8%) in the high-dose, mid-dose, and low-dose vixarelimab groups, respectively, compared with 8 (16.7%) in the placebo group. PN Investigator Global Assessment scores of 0 or 1 were also higher in vixarelimab groups (high-dose group, 18 [38.3%]; mid-dose group, 14 [29.8%]; low-dose group, 7 [14.9%]; placebo group, 5 [10.4%]). No fatal or serious drug-related treatment-emergent adverse events were reported during the study, and no serious treatment-related treatment-emergent adverse events were observed during the DB period.</p><p><strong","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"133-141"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12712829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.4892
Peyton V Warp, Karishma R Desai, Alvaro J Alencar, Jonathan J Cohen, Andrea D Maderal
{"title":"Zanubrutinib for Immunoglobulin A Vasculitis With Monoclonal Gammopathy.","authors":"Peyton V Warp, Karishma R Desai, Alvaro J Alencar, Jonathan J Cohen, Andrea D Maderal","doi":"10.1001/jamadermatol.2025.4892","DOIUrl":"10.1001/jamadermatol.2025.4892","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"212-214"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.4792
Deonna M Ackermann, Ellie Medcalf, Robin M Turner, Jolyn K Hersch, Monika Janda, Pascale Guitera, H Peter Soyer, Karen Bracken, Linda K Martin, Victoria Mar, Katy J L Bell
<p><strong>Importance: </strong>Patient-performed teledermoscopy may improve access to dermatologic care, but evidence to guide dermatoscope selection for patient use is limited.</p><p><strong>Objective: </strong>To compare a lower-cost, ambient-light, nonpolarized dermatoscope with a higher-cost, illuminated, polarized dermatoscope for patient-performed teledermoscopy following treatment for early-stage melanoma.</p><p><strong>Design, setting, and participants: </strong>This randomized study within a trial was embedded within the MEL-SELF trial and recruited adults previously treated for early-stage melanoma (American Joint Committee on Cancer stages 0-II) in the patient-led surveillance arm of MEL-SELF from specialist and general practitioner-led skin cancer clinics in Australia from December 2021 to June 2024 with 12-month follow-up. Data were analyzed from February 6, 2025, to August 15, 2025.</p><p><strong>Interventions: </strong>Participants were randomized (1:1) to receive a polarized (128 [51.0%]) or ambient-light (123 [49.0%]) dermatoscope smartphone attachment. Optional online training was provided. Participants submitted clinician-identified and self-detected lesion images via a secure teledermatology platform at 3-month intervals.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the proportion of participants submitting baseline images of sufficient quality for a teledermatologist to provide a management recommendation. Secondary outcomes included the proportion receiving a management recommendation for at least 1 image during the study period, per-image recommendation proportions, device costs, and qualitative assessments of image quality and usability.</p><p><strong>Results: </strong>Of 251 participants (mean [SD] age, 56.0 [11.6] years; 147 female individuals [59%]), 175 (69.7%) received a teledermatologist management recommendation for baseline images (polarized: 92 [71.9%]; ambient light: 83 [67.5%]; difference, 4.4%; 95% CI, -7.0% to 15.8%). By 12 months, the proportion receiving at least 1 recommendation was similar between groups (polarized: 104 of 128 [81.3%]; ambient light: 94 of 123 [76.4%]; difference, 4.3%; 95% CI, -8.1% to 16.6%). However, a per-image analysis showed more polarized images (913 of 961 [95.0%]) than ambient-light images (706 of 775 [91.1%]) were reportable and supported a recommendation (difference, 3.9%; 95% CI, 1.5% to 6.3%; self-directed lesions: 6.8%; 95% CI, 3.3% to 10.2%). Teledermatologists provided more positive feedback for polarized images; blurriness (n = 14 vs 9) and poor lighting (n = 6 vs 0) were more frequent with ambient-light images. Patient usability ratings were similar (moderately/very easy: 39.8% vs 36.6%; difference, 3.2%; 95% CI, -8.8% to 15.3%), but ambient-light dermatoscope users reported more image quality issues. The polarized device was more expensive ($324.16 vs $35.40).</p><p><strong>Conclusions and relevance: </strong>The results of this study withi
重要性：患者进行的远镜检查可以改善皮肤科护理的可及性，但指导患者使用的远镜选择的证据有限。目的：比较低成本、环境光、非偏光的皮肤镜与高成本、照明、偏光的皮肤镜在早期黑色素瘤治疗后患者进行远镜检查的效果。设计、环境和参与者：该试验中的随机研究嵌入MEL-SELF试验中，招募了2021年12月至2024年6月期间在澳大利亚专科医生和全科医生主导的皮肤癌诊所接受过早期黑色素瘤（美国癌症0-II期联合委员会）患者主导的MEL-SELF监测组中接受过治疗的成年人，随访12个月。数据分析时间为2025年2月6日至2025年8月15日。干预措施：参与者随机（1:1）接受偏振光（128[51.0%]）或环境光（123[49.0%]）皮肤镜智能手机附件。提供了可选的在线培训。参与者每隔3个月通过安全的远程皮肤科平台提交临床识别和自我检测的病变图像。主要结果和测量：主要结果是参与者提交足够质量的基线图像的比例，以便远程皮肤科医生提供管理建议。次要结果包括在研究期间接受至少1张图像管理推荐的比例，每张图像推荐比例，设备成本以及图像质量和可用性的定性评估。结果：251名参与者（平均[SD]年龄56.0[11.6]岁；147名女性[59%]）中，175名（69.7%）接受了远程皮肤科医生的基线图像管理建议（偏光：92[71.9%]；环境光：83[67.5%]；差异为4.4%；95% CI为-7.0%至15.8%）。到12个月时，接受至少1项建议的比例在两组之间相似（偏光：128 / 104[81.3%]；环境光：123 / 94[76.4%]；差异为4.3%；95% CI为-8.1%至16.6%）。然而，单幅图像分析显示，报告的极化图像（961张中的913张[95.0%]）比环境光图像（775张中的706张[91.1%]）更多，并支持推荐（差异为3.9%;95% CI， 1.5%至6.3%；自定向病变：6.8%;95% CI， 3.3%至10.2%）。远程皮肤科医生对偏光图像提供了更多的积极反馈；模糊（n = 14 vs 9）和光线不足（n = 6 vs 0）在环境光图像中更为常见。患者可用性评分相似（中度/非常容易：39.8% vs 36.6%；差异，3.2%;95% CI, -8.8%到15.3%），但环境光皮肤镜用户报告了更多的图像质量问题。偏光装置更贵（324.16美元对35.40美元）。结论和相关性：本研究在一项试验中的结果表明，这两种设备使患者能够进行皮肤镜检查并接受远程皮肤病学建议。偏振器件的适度图像质量优势必须与其高得多的成本相权衡。试验注册：anzctr.org.au标识符：ACTRN12621000176864。
{"title":"Mobile Dermatoscope Type in Patient-Performed Teledermoscopy: A Study Within A Trial.","authors":"Deonna M Ackermann, Ellie Medcalf, Robin M Turner, Jolyn K Hersch, Monika Janda, Pascale Guitera, H Peter Soyer, Karen Bracken, Linda K Martin, Victoria Mar, Katy J L Bell","doi":"10.1001/jamadermatol.2025.4792","DOIUrl":"10.1001/jamadermatol.2025.4792","url":null,"abstract":"<p><strong>Importance: </strong>Patient-performed teledermoscopy may improve access to dermatologic care, but evidence to guide dermatoscope selection for patient use is limited.</p><p><strong>Objective: </strong>To compare a lower-cost, ambient-light, nonpolarized dermatoscope with a higher-cost, illuminated, polarized dermatoscope for patient-performed teledermoscopy following treatment for early-stage melanoma.</p><p><strong>Design, setting, and participants: </strong>This randomized study within a trial was embedded within the MEL-SELF trial and recruited adults previously treated for early-stage melanoma (American Joint Committee on Cancer stages 0-II) in the patient-led surveillance arm of MEL-SELF from specialist and general practitioner-led skin cancer clinics in Australia from December 2021 to June 2024 with 12-month follow-up. Data were analyzed from February 6, 2025, to August 15, 2025.</p><p><strong>Interventions: </strong>Participants were randomized (1:1) to receive a polarized (128 [51.0%]) or ambient-light (123 [49.0%]) dermatoscope smartphone attachment. Optional online training was provided. Participants submitted clinician-identified and self-detected lesion images via a secure teledermatology platform at 3-month intervals.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the proportion of participants submitting baseline images of sufficient quality for a teledermatologist to provide a management recommendation. Secondary outcomes included the proportion receiving a management recommendation for at least 1 image during the study period, per-image recommendation proportions, device costs, and qualitative assessments of image quality and usability.</p><p><strong>Results: </strong>Of 251 participants (mean [SD] age, 56.0 [11.6] years; 147 female individuals [59%]), 175 (69.7%) received a teledermatologist management recommendation for baseline images (polarized: 92 [71.9%]; ambient light: 83 [67.5%]; difference, 4.4%; 95% CI, -7.0% to 15.8%). By 12 months, the proportion receiving at least 1 recommendation was similar between groups (polarized: 104 of 128 [81.3%]; ambient light: 94 of 123 [76.4%]; difference, 4.3%; 95% CI, -8.1% to 16.6%). However, a per-image analysis showed more polarized images (913 of 961 [95.0%]) than ambient-light images (706 of 775 [91.1%]) were reportable and supported a recommendation (difference, 3.9%; 95% CI, 1.5% to 6.3%; self-directed lesions: 6.8%; 95% CI, 3.3% to 10.2%). Teledermatologists provided more positive feedback for polarized images; blurriness (n = 14 vs 9) and poor lighting (n = 6 vs 0) were more frequent with ambient-light images. Patient usability ratings were similar (moderately/very easy: 39.8% vs 36.6%; difference, 3.2%; 95% CI, -8.8% to 15.3%), but ambient-light dermatoscope users reported more image quality issues. The polarized device was more expensive ($324.16 vs $35.40).</p><p><strong>Conclusions and relevance: </strong>The results of this study withi","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"124-132"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.5205
Christopher Willy Schwarz, Nikolai Loft, Lars Erik Bryld, Christoffer Valdemar Nissen, Kawa Khaled Ajgeiy, Trine Bertelsen, Kasper Fjellhaugen Hjuler, Tomas Norman Dam, Lars Iversen, Mads Kirchheiner Rasmussen, Lone Skov
<p><strong>Importance: </strong>Drug survival is an important measure to help guide treatment selection. However, clinical evidence for newer biologics, including bimekizumab, is limited.</p><p><strong>Objective: </strong>To determine the drug survival of biologics used for treating psoriasis in a routine clinical practice setting.</p><p><strong>Design, setting, and participants: </strong>This cohort study was based on data from the DERMBIO registry, which includes all patients treated with biologics for psoriasis in Denmark. All adult patients enrolled in DERMBIO from its inception in May 2007 until June 2025 were assessed for eligibility. Data were extracted in June 2025 and analyzed separately among those without previous biologic exposure (bionaive patients) and those with previous biologic exposure (bioexperienced patients).</p><p><strong>Exposures: </strong>Adalimumab, secukinumab, and ustekinumab among bionaive patients and adalimumab, bimekizumab, brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab among bioexperienced patients.</p><p><strong>Main outcomes and measures: </strong>The main outcome was standardized absolute risks of treatment discontinuation at 1, 2, and 5 years. Kaplan-Meier estimator was used to determine crude drug survival estimates and the Aalen-Johansen estimator was used to determine crude cause-specific absolute risks.</p><p><strong>Results: </strong>The study included 4438 unique patients with psoriasis (2717 [61.2%] male; mean [SD] age, 45.0 [14.6] years at the time of their first treatment included in the study), 1039 (23.4%) of whom had comorbid psoriatic arthritis. A total of 3790 treatment series from bionaive patients were analyzed: 2646 were with adalimumab, 377 with secukinumab, and 767 with ustekinumab. The 5-year standardized risk of discontinuing ustekinumab was 0.37 (95% CI, 0.33-0.41), which was significantly lower than the standardized risks for adalimumab (0.51; 95% CI, 0.49-0.54) and secukinumab (0.54; 95% CI, 0.48-0.60). A total of 3403 treatment series from bioexperienced patients were analyzed: 790 were with adalimumab, 376 with bimekizumab, 192 with brodalumab, 218 with guselkumab, 556 with ixekizumab, 78 with risankizumab, 466 with secukinumab, and 727 with ustekinumab. The 2-year standardized absolute risk of discontinuing ustekinumab was 0.39 (95% CI, 0.36-0.43). Only bimekizumab (0.27; 95% CI, 0.20-0.34), guselkumab (0.29; 95% CI, 0.22-0.36), and risankizumab (0.25; 95% CI, 0.15-0.36) were associated with a significantly lower standardized absolute risk of discontinuation compared with ustekinumab.</p><p><strong>Conclusions and relevance: </strong>In this cohort study in Denmark, among bionaive patients with psoriasis, ustekinumab had superior drug survival compared with adalimumab and secukinumab, and among bioexperienced patients with psoriasis, bimekizumab, guselkumab, and risankizumab had superior drug survival. These results offer insight into the performance o
{"title":"Drug Survival of Biologics in Bionaive and Bioexperienced Patients With Psoriasis.","authors":"Christopher Willy Schwarz, Nikolai Loft, Lars Erik Bryld, Christoffer Valdemar Nissen, Kawa Khaled Ajgeiy, Trine Bertelsen, Kasper Fjellhaugen Hjuler, Tomas Norman Dam, Lars Iversen, Mads Kirchheiner Rasmussen, Lone Skov","doi":"10.1001/jamadermatol.2025.5205","DOIUrl":"10.1001/jamadermatol.2025.5205","url":null,"abstract":"<p><strong>Importance: </strong>Drug survival is an important measure to help guide treatment selection. However, clinical evidence for newer biologics, including bimekizumab, is limited.</p><p><strong>Objective: </strong>To determine the drug survival of biologics used for treating psoriasis in a routine clinical practice setting.</p><p><strong>Design, setting, and participants: </strong>This cohort study was based on data from the DERMBIO registry, which includes all patients treated with biologics for psoriasis in Denmark. All adult patients enrolled in DERMBIO from its inception in May 2007 until June 2025 were assessed for eligibility. Data were extracted in June 2025 and analyzed separately among those without previous biologic exposure (bionaive patients) and those with previous biologic exposure (bioexperienced patients).</p><p><strong>Exposures: </strong>Adalimumab, secukinumab, and ustekinumab among bionaive patients and adalimumab, bimekizumab, brodalumab, guselkumab, ixekizumab, risankizumab, secukinumab, and ustekinumab among bioexperienced patients.</p><p><strong>Main outcomes and measures: </strong>The main outcome was standardized absolute risks of treatment discontinuation at 1, 2, and 5 years. Kaplan-Meier estimator was used to determine crude drug survival estimates and the Aalen-Johansen estimator was used to determine crude cause-specific absolute risks.</p><p><strong>Results: </strong>The study included 4438 unique patients with psoriasis (2717 [61.2%] male; mean [SD] age, 45.0 [14.6] years at the time of their first treatment included in the study), 1039 (23.4%) of whom had comorbid psoriatic arthritis. A total of 3790 treatment series from bionaive patients were analyzed: 2646 were with adalimumab, 377 with secukinumab, and 767 with ustekinumab. The 5-year standardized risk of discontinuing ustekinumab was 0.37 (95% CI, 0.33-0.41), which was significantly lower than the standardized risks for adalimumab (0.51; 95% CI, 0.49-0.54) and secukinumab (0.54; 95% CI, 0.48-0.60). A total of 3403 treatment series from bioexperienced patients were analyzed: 790 were with adalimumab, 376 with bimekizumab, 192 with brodalumab, 218 with guselkumab, 556 with ixekizumab, 78 with risankizumab, 466 with secukinumab, and 727 with ustekinumab. The 2-year standardized absolute risk of discontinuing ustekinumab was 0.39 (95% CI, 0.36-0.43). Only bimekizumab (0.27; 95% CI, 0.20-0.34), guselkumab (0.29; 95% CI, 0.22-0.36), and risankizumab (0.25; 95% CI, 0.15-0.36) were associated with a significantly lower standardized absolute risk of discontinuation compared with ustekinumab.</p><p><strong>Conclusions and relevance: </strong>In this cohort study in Denmark, among bionaive patients with psoriasis, ustekinumab had superior drug survival compared with adalimumab and secukinumab, and among bioexperienced patients with psoriasis, bimekizumab, guselkumab, and risankizumab had superior drug survival. These results offer insight into the performance o","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"166-175"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.5496
Ivo Abraham, Adewole S Adamson, Kanade Shinkai
{"title":"Biologics Prescribing in Dermatology by Advanced Practice Clinicians-Trends in the Practice of Advanced Practice Clinicians in Dermatology.","authors":"Ivo Abraham, Adewole S Adamson, Kanade Shinkai","doi":"10.1001/jamadermatol.2025.5496","DOIUrl":"10.1001/jamadermatol.2025.5496","url":null,"abstract":"","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"209-210"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.4824
Jiaqi Ye, Wanlong Wu, Haixi Wu, Can Xia, Mingyu Ye, Kaile He, Jiaming Teng, Xiaoqing Zhao, Hao Li, Qian Zhao, Jie Zheng, Shuang Ye, Hua Cao
Importance: Cancer is a life-threatening complication of dermatomyositis (DM) and contributes significantly to mortality. A validated association-based tool is urgently needed to optimize early cancer detection and reduce diagnostic delays.
Objective: To develop and validate a practical prediction model for cancer-associated likelihood in adult patients with DM.
Design, setting, and participants: A retrospective multicenter cohort study including adults with DM or clinically amyopathic DM was carried out. Participants were recruited from the Department of Dermatology at Ruijin Hospital (training cohort) and the Department of Rheumatology at Renji Hospital (validation cohort) over the period from 2015 to 2022. Multivariate logistic regression and machine learning techniques were employed for model development and validation. The analysis took place in 2024.
Exposure: DM and clinically amyopathic DM.
Main outcomes and measures: The primary outcome was the occurrence of cancer in patients with DM. Model performance was assessed using the area under the curve to evaluate predictive accuracy.
Results: A total of 546 adults with DM or clinically amyopathic DM were included, with a mean (SD) age of 49.8 (14.2) years, comprising 166 male individuals (30.4%) and 380 female individuals (69.6%). Five factors significantly associated with concomitant cancers in patients with DM were used to construct the TIP-CA model: anti-transcriptional intermediary factor 1-γ (TIF1-γ) antibody (positive scored as 1; negative scored as 0), interstitial lung disease (present scored as -1; absent scored as 0), poikiloderma (present scored as 1; absent scored as 0), DM subtypes (DM scored as 1; clinically amyopathic DM scored as 0), and anemia (present scored as 1; absent scored as 0). The model demonstrated good discriminatory capability, achieving an area under the curve of 0.809 and 0.808 in the derivation and validation cohorts, respectively.
Conclusions and relevance: This cohort study found that the TIP-CA model effectively stratified cancer-associated likelihood in patients with DM using routinely available clinical data. By using data from multidisciplinary patient cohorts and incorporating machine learning techniques, the model minimized referral bias. This proposed model may have the potential to guide clinicians in implementing targeted cancer screening strategies and improve patient outcomes.
{"title":"A Novel Tool for Predicting Malignant Disease in Adult Patients With Dermatomyositis.","authors":"Jiaqi Ye, Wanlong Wu, Haixi Wu, Can Xia, Mingyu Ye, Kaile He, Jiaming Teng, Xiaoqing Zhao, Hao Li, Qian Zhao, Jie Zheng, Shuang Ye, Hua Cao","doi":"10.1001/jamadermatol.2025.4824","DOIUrl":"10.1001/jamadermatol.2025.4824","url":null,"abstract":"<p><strong>Importance: </strong>Cancer is a life-threatening complication of dermatomyositis (DM) and contributes significantly to mortality. A validated association-based tool is urgently needed to optimize early cancer detection and reduce diagnostic delays.</p><p><strong>Objective: </strong>To develop and validate a practical prediction model for cancer-associated likelihood in adult patients with DM.</p><p><strong>Design, setting, and participants: </strong>A retrospective multicenter cohort study including adults with DM or clinically amyopathic DM was carried out. Participants were recruited from the Department of Dermatology at Ruijin Hospital (training cohort) and the Department of Rheumatology at Renji Hospital (validation cohort) over the period from 2015 to 2022. Multivariate logistic regression and machine learning techniques were employed for model development and validation. The analysis took place in 2024.</p><p><strong>Exposure: </strong>DM and clinically amyopathic DM.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the occurrence of cancer in patients with DM. Model performance was assessed using the area under the curve to evaluate predictive accuracy.</p><p><strong>Results: </strong>A total of 546 adults with DM or clinically amyopathic DM were included, with a mean (SD) age of 49.8 (14.2) years, comprising 166 male individuals (30.4%) and 380 female individuals (69.6%). Five factors significantly associated with concomitant cancers in patients with DM were used to construct the TIP-CA model: anti-transcriptional intermediary factor 1-γ (TIF1-γ) antibody (positive scored as 1; negative scored as 0), interstitial lung disease (present scored as -1; absent scored as 0), poikiloderma (present scored as 1; absent scored as 0), DM subtypes (DM scored as 1; clinically amyopathic DM scored as 0), and anemia (present scored as 1; absent scored as 0). The model demonstrated good discriminatory capability, achieving an area under the curve of 0.809 and 0.808 in the derivation and validation cohorts, respectively.</p><p><strong>Conclusions and relevance: </strong>This cohort study found that the TIP-CA model effectively stratified cancer-associated likelihood in patients with DM using routinely available clinical data. By using data from multidisciplinary patient cohorts and incorporating machine learning techniques, the model minimized referral bias. This proposed model may have the potential to guide clinicians in implementing targeted cancer screening strategies and improve patient outcomes.</p>","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"176-180"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1001/jamadermatol.2025.5163
Michael R Nock, Sherry Ershadi, Abizairie Sánchez-Feliciano, Anissa Valentina Amstutz, David J Margolis, Andrea L Pusic, John S Barbieri
<p><strong>Importance: </strong>Patient-Reported Outcomes Measurement Information System (PROMIS) is a generalized set of patient-reported outcome measures (PROMs) that can be readily integrated into the dermatologic clinic setting, but the measurement properties of these PROMs among patients with a range of chronic skin diseases have yet to be established.</p><p><strong>Objective: </strong>To evaluate the structural validity, internal consistency, construct validity, and responsiveness of PROMIS short-form measures for anxiety, depression, social satisfaction, and social isolation as well as the construct validity and responsiveness of single-item pain and itch intensity measures.</p><p><strong>Design, setting, and participants: </strong>In this cohort study, adults 18 years and older with a self-reported chronic skin disease (eg, atopic dermatitis, acne, psoriasis) were recruited in February 2025 from across the US via an online survey platform. Enrolled participants completed a baseline survey of PROMIS and several other relevant measures and then a follow-up survey 3 months later.</p><p><strong>Main outcomes and measures: </strong>Measures collected include the PROMIS measures, Dermatology Life Quality Index, Skindex-29, a baseline patient global assessment, and a change in skin disease anchor question at follow-up. Structural validity, internal consistency, construct validity, and responsiveness were evaluated for the short-form measures. Construct validity and responsiveness were assessed for the single-item measures.</p><p><strong>Results: </strong>Of 549 included participants with chronic skin diseases, 287 (52.3%) were female, 262 (47.7%) were male, and the median (IQR) age was 36 (30-45) years. A total of 249 patients (45.1%) had atopic dermatitis, 246 (44.8%) had acne, and 113 (20.6%) had psoriasis. The anxiety, depression, social satisfaction, and social isolation short-form measures demonstrated adequate structural validity (ie, all with comparative fit index and/or Tucker-Lewis index values greater than 0.95; standardized root mean residual values less than 0.08) and internal consistency (Cronbach α values greater than 0.90). All measures showed sufficient construct validity on known-groups and convergent validity testing (eg, magnitude of Pearson correlations between measures evaluating similar underlying constructs with values of 0.30 or greater). When comparing responsiveness based on standardized response means (SRMs), the pain (SRM, 0.41) and itch intensity (SRM range, 0.32-0.44) measures showed similar responsiveness as the Skindex-29 symptoms domain (SRM, 0.47), and the social satisfaction (SRM, -0.20) and isolation (SRM, 0.27) measures showed similar responsiveness to the Skindex-29 functioning domain (SRM, 0.25). Responsiveness of the anxiety (SRM, 0.11) and depression (SRM, 0.16) measures were lower than the Skindex-29 emotions domain (SRM, 0.43).</p><p><strong>Conclusions and relevance: </strong>In this study, PROMIS meas
{"title":"Measurement Properties of PROMIS Measures Relevant to Chronic Skin Diseases.","authors":"Michael R Nock, Sherry Ershadi, Abizairie Sánchez-Feliciano, Anissa Valentina Amstutz, David J Margolis, Andrea L Pusic, John S Barbieri","doi":"10.1001/jamadermatol.2025.5163","DOIUrl":"10.1001/jamadermatol.2025.5163","url":null,"abstract":"<p><strong>Importance: </strong>Patient-Reported Outcomes Measurement Information System (PROMIS) is a generalized set of patient-reported outcome measures (PROMs) that can be readily integrated into the dermatologic clinic setting, but the measurement properties of these PROMs among patients with a range of chronic skin diseases have yet to be established.</p><p><strong>Objective: </strong>To evaluate the structural validity, internal consistency, construct validity, and responsiveness of PROMIS short-form measures for anxiety, depression, social satisfaction, and social isolation as well as the construct validity and responsiveness of single-item pain and itch intensity measures.</p><p><strong>Design, setting, and participants: </strong>In this cohort study, adults 18 years and older with a self-reported chronic skin disease (eg, atopic dermatitis, acne, psoriasis) were recruited in February 2025 from across the US via an online survey platform. Enrolled participants completed a baseline survey of PROMIS and several other relevant measures and then a follow-up survey 3 months later.</p><p><strong>Main outcomes and measures: </strong>Measures collected include the PROMIS measures, Dermatology Life Quality Index, Skindex-29, a baseline patient global assessment, and a change in skin disease anchor question at follow-up. Structural validity, internal consistency, construct validity, and responsiveness were evaluated for the short-form measures. Construct validity and responsiveness were assessed for the single-item measures.</p><p><strong>Results: </strong>Of 549 included participants with chronic skin diseases, 287 (52.3%) were female, 262 (47.7%) were male, and the median (IQR) age was 36 (30-45) years. A total of 249 patients (45.1%) had atopic dermatitis, 246 (44.8%) had acne, and 113 (20.6%) had psoriasis. The anxiety, depression, social satisfaction, and social isolation short-form measures demonstrated adequate structural validity (ie, all with comparative fit index and/or Tucker-Lewis index values greater than 0.95; standardized root mean residual values less than 0.08) and internal consistency (Cronbach α values greater than 0.90). All measures showed sufficient construct validity on known-groups and convergent validity testing (eg, magnitude of Pearson correlations between measures evaluating similar underlying constructs with values of 0.30 or greater). When comparing responsiveness based on standardized response means (SRMs), the pain (SRM, 0.41) and itch intensity (SRM range, 0.32-0.44) measures showed similar responsiveness as the Skindex-29 symptoms domain (SRM, 0.47), and the social satisfaction (SRM, -0.20) and isolation (SRM, 0.27) measures showed similar responsiveness to the Skindex-29 functioning domain (SRM, 0.25). Responsiveness of the anxiety (SRM, 0.11) and depression (SRM, 0.16) measures were lower than the Skindex-29 emotions domain (SRM, 0.43).</p><p><strong>Conclusions and relevance: </strong>In this study, PROMIS meas","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":" ","pages":"157-165"},"PeriodicalIF":11.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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