Journal of Drugs in Dermatology最新文献

Background: Acne pathophysiology and presentation may differ between pediatric/adolescent/young adult (9-24 years) and adult (≥25 years) patients. Fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel demonstrated superior efficacy to vehicle and component dyads with good safety/tolerability in 3 clinical trials of acne. This post hoc analysis evaluated the efficacy/safety of CAB in pediatric/adolescent/young adult ("younger") vs adult participants.

Methods: In one phase 2 (NCT03170388) and two phase 3 (NCT04214652, NCT04214639) trials, participants aged greater than or equal to 9 years with moderate-to-severe acne were randomized to once-daily CAB or vehicle gel. Pooled data were analyzed for participants grouped by age: younger (9-24 years; n=515) and adult (greater than or equal to 25 years; n=142). Endpoints included the percentage of participants achieving treatment success (greater than or equal to 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin) and least squares mean percent change from baseline in inflammatory/noninflammatory lesions at week 12. Treatment-emergent adverse events (TEAEs) were evaluated throughout.

Results: At week 12, approximately half of CAB-treated participants in both age groups achieved treatment success (9-24: 50.6%; greater than or equal to 25: 49.0%) vs less than one-fourth with vehicle (15.7%; 20.6%; P<0.01, both). Across groups, CAB yielded >70% reductions in inflammatory/noninflammatory lesions vs 45% to 62% with vehicle (P≤0.001, all). For all endpoints, CAB efficacy was similar across age groups. Most TEAEs with CAB were of mild-to-moderate severity, and there were no age-related trends in safety/tolerability.

Conclusions: Fixed-dose, triple-combination CAB gel was efficacious and well tolerated in participants with moderate-to-severe acne, regardless of age. Approximately half of the participants achieved clear/almost clear skin, with >70% reductions in lesion counts.

Background: The National Institutes of Health (NIH) funds a multitude of dermatology research. This study examines NIH funding for vitiligo studies and highlights key trends.

Methods: The NIH Research Portfolio Online Reporting Tool database was used to identify vitiligo research projects funded between 1985 and 2024, with results limited to project titles containing "vitiligo."

Results/discussion: The NIH awarded 166 grants for vitiligo research between 1985 and 2024. This study analyzed 144 of these awards, totaling $22,343,119. The greatest increase occurred between 1998 and 1999, with the average funding per grant rising by $124,316, leading to a total funding increase from $269,102 to $1,149,554. The most common funding mechanism was Non-Small Business Innovation Research (SBIR)/Small Business Technology Transfer (STTR). The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was the leading administering institute. Medical schools were the most awarded organization type. The most common grant types were R01 (n=59, 41%) and M01 (n=21, 15%). Among the 144 funded projects, 48 were unique, with most focusing on pathophysiology (n=36) and treatment (n=8).

Limitations: Study limitations include incomplete data on NIH research funding, with 22 awards missing total cost information and 25 awards calculated using subproject sums.

Conclusion: From 1985 to 2024, NIH funding for vitiligo research fluctuated with an upward trend in recent years. The most common funding mechanism was Non-SBIR/STTR. Among organization types, medical schools received the most awards. Most vitiligo research projects have been completed and have focused on understanding the pathophysiology and treatment of vitiligo.  .

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with obesity and metabolic dysregulation. Current therapies yield variable benefits and do not target metabolic drivers. Tirzepatide, a dual GLP-1/GIP receptor agonist, induces weight loss and exerts anti-inflammatory effects, offering a potential novel approach for the treatment of HS.

Objectives: To evaluate the efficacy and safety of tirzepatide in adults with moderate-to-severe HS.

Methods: In this open-label, single-center, single-arm proof-of-concept study, 20 adults with moderate-to-severe HS (Physician's Global Assessment greater than or equal to 3; BMI greater than or equal to 27) received once-weekly tirzepatide, titrated to maximum tolerated dose, for 24 weeks, followed by an 8-week washout. The primary endpoint was Hidradenitis Suppurativa Clinical Response (HiSCR) at week 24. Secondary endpoints included changes in PGA, Dermatology Life Quality Index (DLQI), pain visual analog scale (VAS), and Hospital Anxiety and Depression Scale (HADS). Analyses were conducted using an intention-to-treat approach.

Results: At week 24, 16 of 20 participants (80.0%; P<0.00001) achieved HiSCR. Improvements were also observed in DLQI, VAS, and PGA scores, with some benefits persisting through week 32. Treatment was well tolerated, with high adherence and favorable metabolic effects.

Limitations: Single-center, open-label design, modest sample size.

Conclusions: Tirzepatide demonstrated promising efficacy and tolerability in patients with moderate-to-severe HS and obesity. Larger randomized trials are warranted to confirm efficacy, durability, and safety.  .

Background: Cutaneous hyperpigmentation, which includes melasma, post-inflammatory hyperpigmentation, and solar lentigines, significantly impacts patients' quality of life. The overproduction of melanin is mediated by activation of the skin enzyme tyrosinase, leading to excess melanin deposition in the skin. Thiamidol (isobutylamido thiazolyl resorcinol) formulations have been previously shown to be effective in reducing the cutaneous pigmentation associated with this human skin enzyme.

Methods: A randomized study was performed with 90 subjects clinically presenting with facial hyperpigmentation (Thiamidol serum n=43; Thiamidol regimen n=47) as measured by colorimeter and individual typology angle (ITA0) to assess the efficacy of a Thiamidol-based serum (2X daily application; morning/night) or a Thiamidol-based regimen (day lotion with SPF 30 + serum in morning; night cream + serum at night) for 12 weeks with a 6-week regression period.

Results: A significant visible reduction in facial hyperpigmentation, assessed by increases in L* and ITA° values, along with an increase in skin radiance and shine, were observed as early as week 2, with continued improvement through week 12 in both the treatment groups relative to baseline. At week 12, changes in radiance and shine were trending toward enhancement in the regimen group compared with the serum group.

Discussion: This study demonstrates the clinical effectiveness of Thiamidol-containing formulations in the visible improvement of facial hyperpigmentation and in overall skin radiance and shine.

Conclusion: These data support the use of Thiamidol-containing formulations as part of the overall management strategy for individuals affected by facial hyperpigmentation.  .

Psoriasis has profound negative impacts on quality of life (QOL), including stigmatization, discrimination, occupational challenges, and mental health concerns, which are correlated with disease severity. Effective, long-term symptom control can dramatically improve the psychological and social outcomes for patients with psoriasis, though certain mechanisms of action of biologic therapies may contribute to reduced or diminished efficacy, need for treatment switching, and reduced QOL. Brodalumab is the only approved biologic indicated for moderate-to-severe plaque psoriasis that binds to interleukin-17 (IL-17) receptor A rather than targets specific IL-17 cytokines, which may contribute to its high clinical efficacy among patients who have lost responses to other biologic therapies and may also lead to sustained improvements in QOL. In biologic-experienced and biologic-naive patients, brodalumab has demonstrated optimal efficacy and improvements in QOL in both clinical trials and real-world studies, including improvements over other biologic therapies. This has the potential to dramatically improve the mental and social burdens faced by patients with moderate-to-severe psoriasis.  .

Background: A novel gel-matrix moisturizer was designed to 1) deliver immediate, long-lasting hydration benefits in a lightweight, non-greasy, noncomedogenic formula that is suitable for use on dry, oily, acne-prone, and sensitive skin; 2) reduce acne-related and acne medication–induced skin irritation and dryness; and 3) improve quality of life (QoL), when used as an adjunctive moisturizer by patients with acne using topical treatments.

Objective: To assess the biological effects of the gel-matrix moisturizer on key epidermal proteins of skin barrier function, and clinical improvements in skin attributes and tolerability in adults with acne undergoing topical treatment.

Methods: Preclinical and clinical studies evaluated the tolerability of the gel-matrix moisturizer and its effects on filaggrin and aquaporin-3 protein levels (markers of barrier function), skin texture, appearance, and QoL in the study population.

Results: In skin explant studies, the gel-matrix moisturizer demonstrated significant increases in levels of filaggrin (+36%) and aquaporin-3 (+102%) versus untreated controls (both P<0.05). Clinically, at week 4 compared with baseline, the gel-matrix moisturizer demonstrated significant improvements in visual skin smoothness, roughness, clarity, radiance, pore issues, and overall skin appearance (all P<0.01), as well as significant decreases in skin itching (P<0.01) and tightness (P<0.002). Patients with acne also using topical over the counter and prescription treatments reported significant improvements in QoL at week 4 (P<0.001).

Conclusion: The gel-matrix moisturizer improved barrier function and skin attributes without exacerbating acne symptoms, offering suitable topical moisturization when used as an adjunctive moisturizer with acne treatments.  .

Warts have bothered people since the early Greek and Roman empires.5 For centuries, people have studied causes of and treatments for these irritating tumors. In recent history, treatments have stagnated. Warts are caused by non-enveloped, circular, double-stranded DNA human papillomavirus (HPV).6 Most infections are subclinical, but clinically relevant disease ranges from warts to invasive carcinoma.6 Two-thirds of warts resolve spontaneously within 2 years, meaning that the stakes for treatments are high.4 Successful therapies need to have high resolution, few side effects, and act fast. The lack of radical antiviral HPV treatment represents a significant care gap. Although common warts are generally due to low-risk HPV strains, coinfection with higher-risk variants is not uncommon.  .