Background and objective: Brivudine has been used in herpes zoster (HZ) treatment for years, but the safety and efficacy of brivudine are inconclusive. Here we perform a meta-analysis to assess the efficacy, safety, incidence of postherpetic neuralgia of brivudine.
Methods: Data of randomized controlled Trials (RCTS) were obtained from the databases of both English (PubMed, Embase, and Cochrane Library) and Chinese (China National Knowledge Infrastructure, China Science Journal Database, and WanFang Database) literatures from inception to 12 September 2022. Meta-analyses of efficacy and safety of Brivudine for the treatment of herpes zoster for RCTS were conducted.
Results: The analyses included seven RCTS (2095 patients in experimental group and 2076 patients in control group) in the treatment of HZ with brivudine. It suggested that the brivudine group was superior to the control group in terms of efficacy (p = .0002) and incidence of postherpetic neuralgia (p = .04). But the incidence of adverse reactions has no significant difference between the brivudine and the control groups (p = .22). In addition, subgroup analysis of adverse events also showed that brivudine was about the same safety as other modalities in the treatment of HZ (p > .05).
Conclusions: Brivudine is effective for HZ. However, the evidence on the safety of brivudine is insufficient.
{"title":"Efficacy and safety of brivudine for the treatment of herpes zoster: a systematic review and meta-analysis.","authors":"Jiaxing Chen, Dongyun Lei, Peng Cao, Junchen He, Litao Zhang","doi":"10.1080/09546634.2024.2355256","DOIUrl":"https://doi.org/10.1080/09546634.2024.2355256","url":null,"abstract":"<p><strong>Background and objective: </strong>Brivudine has been used in herpes zoster (HZ) treatment for years, but the safety and efficacy of brivudine are inconclusive. Here we perform a meta-analysis to assess the efficacy, safety, incidence of postherpetic neuralgia of brivudine.</p><p><strong>Methods: </strong>Data of randomized controlled Trials (RCTS) were obtained from the databases of both English (PubMed, Embase, and Cochrane Library) and Chinese (China National Knowledge Infrastructure, China Science Journal Database, and WanFang Database) literatures from inception to 12 September 2022. Meta-analyses of efficacy and safety of Brivudine for the treatment of herpes zoster for RCTS were conducted.</p><p><strong>Results: </strong>The analyses included seven RCTS (2095 patients in experimental group and 2076 patients in control group) in the treatment of HZ with brivudine. It suggested that the brivudine group was superior to the control group in terms of efficacy (<i>p</i> = .0002) and incidence of postherpetic neuralgia (<i>p</i> = .04). But the incidence of adverse reactions has no significant difference between the brivudine and the control groups (<i>p</i> = .22). In addition, subgroup analysis of adverse events also showed that brivudine was about the same safety as other modalities in the treatment of HZ (<i>p</i> > .05).</p><p><strong>Conclusions: </strong>Brivudine is effective for HZ. However, the evidence on the safety of brivudine is insufficient.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: We aim to explore a potential treatment strategy for hair loss.
Materials and methods: A male 6-year-old child was diagnosed with hidrotic ectodermal dysplasia 2 (HED2) caused by GJB6 (p.G11R) mutations. He presented at our clinic with diffuse thinning and fine and brittle hair since birth. Additionally, the child exhibited abnormal development of teeth, fingernails, and toenails. The condition of the child's hair had not improved significantly with age. He was treated with botanical extracts combined with Minoxidil.
Results: After one and a half months of treatment, the patient showed remarkable hair growth.
Conclusions: Our team has previously used botanical extracts in combination for the treatment of autosomal recessive wooly hair in children. In the present case, treatment with botanical extract combined with minoxidil was found to be equally efficacious. This case report provides valuable information for future studies on the use of botanical extracts in treating hair loss, as well as a safe and effective potential treatment strategy for children with congenital alopecia.
{"title":"Botanical extract combined with minoxidil improve hidrotic ectodermal dysplasia caused by p.G11R mutations: a case report.","authors":"Shiyi Zhong, Chuhan Huang, Mingyue Zhuang, Qingwu Liu, Ziyuan Tian, Dingquan Yang","doi":"10.1080/09546634.2024.2378163","DOIUrl":"10.1080/09546634.2024.2378163","url":null,"abstract":"<p><strong>Purpose: </strong>We aim to explore a potential treatment strategy for hair loss.</p><p><strong>Materials and methods: </strong>A male 6-year-old child was diagnosed with hidrotic ectodermal dysplasia 2 (HED2) caused by <i>GJB6</i> (p.G11R) mutations. He presented at our clinic with diffuse thinning and fine and brittle hair since birth. Additionally, the child exhibited abnormal development of teeth, fingernails, and toenails. The condition of the child's hair had not improved significantly with age. He was treated with botanical extracts combined with Minoxidil.</p><p><strong>Results: </strong>After one and a half months of treatment, the patient showed remarkable hair growth.</p><p><strong>Conclusions: </strong>Our team has previously used botanical extracts in combination for the treatment of autosomal recessive wooly hair in children. In the present case, treatment with botanical extract combined with minoxidil was found to be equally efficacious. This case report provides valuable information for future studies on the use of botanical extracts in treating hair loss, as well as a safe and effective potential treatment strategy for children with congenital alopecia.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-05DOI: 10.1080/09546634.2024.2386973
Ahmad Alamer, Wejdan Alyazidi, Saad Aldosari, Fatimah Mobarki, Sarah Almakki, Abdullah Alahmari, Mukhtar Alomar, Ziyad Almalki, Tuqa Alkaff, Mohammad Fazel
Background: Biological therapies are effective for psoriasis, but patient responses vary, often requiring therapy switching or discontinuation.
Objectives: To identify physicians' prescribing patterns of biological therapies at a referral tertiary center in Saudi Arabia and assess the probability of biologic persistence following treatment initiation.
Methods: We conducted a retrospective study of biologic-naïve adult psoriasis patients who initiated therapy from October 2013 to July 2022 in Dammam. Descriptive statistics and a Kaplan-Meier analysis evaluated treatment persistence at 6, 12, 24, and 36 months.
Results: A total of 151 patients received adalimumab (n = 89), etanercept (n = 17), risankizumab (n = 30), ustekinumab (n = 14), and ixekizumab (n = 1). At 6 months, all therapies demonstrated 100% persistence. At 12 months, persistence was highest for ustekinumab (100%) and lowest for etanercept (88.2%). At 24 months, ustekinumab maintained 100% persistence, followed by risankizumab (96.6%), adalimumab (94.3%), and etanercept (76.4%). At 36 months, risankizumab had the highest persistence (96.6%), followed by adalimumab (83.1%), ustekinumab (78%), and etanercept (70.6%). The most common reasons for discontinuation were lack of effectiveness and intolerability.
Conclusion: This study shows changing psoriasis treatment patterns with new therapies. Risankizumab demonstrated high long-term persistence, while etanercept and ustekinumab showed declining persistence, suggesting evolving treatment considerations.
{"title":"Prescribing patterns and persistence of biological therapies for psoriasis management: a retrospective cohort study from Saudi Arabia.","authors":"Ahmad Alamer, Wejdan Alyazidi, Saad Aldosari, Fatimah Mobarki, Sarah Almakki, Abdullah Alahmari, Mukhtar Alomar, Ziyad Almalki, Tuqa Alkaff, Mohammad Fazel","doi":"10.1080/09546634.2024.2386973","DOIUrl":"https://doi.org/10.1080/09546634.2024.2386973","url":null,"abstract":"<p><strong>Background: </strong>Biological therapies are effective for psoriasis, but patient responses vary, often requiring therapy switching or discontinuation.</p><p><strong>Objectives: </strong>To identify physicians' prescribing patterns of biological therapies at a referral tertiary center in Saudi Arabia and assess the probability of biologic persistence following treatment initiation.</p><p><strong>Methods: </strong>We conducted a retrospective study of biologic-naïve adult psoriasis patients who initiated therapy from October 2013 to July 2022 in Dammam. Descriptive statistics and a Kaplan-Meier analysis evaluated treatment persistence at 6, 12, 24, and 36 months.</p><p><strong>Results: </strong>A total of 151 patients received adalimumab (<i>n</i> = 89), etanercept (<i>n</i> = 17), risankizumab (<i>n</i> = 30), ustekinumab (<i>n</i> = 14), and ixekizumab (<i>n</i> = 1). At 6 months, all therapies demonstrated 100% persistence. At 12 months, persistence was highest for ustekinumab (100%) and lowest for etanercept (88.2%). At 24 months, ustekinumab maintained 100% persistence, followed by risankizumab (96.6%), adalimumab (94.3%), and etanercept (76.4%). At 36 months, risankizumab had the highest persistence (96.6%), followed by adalimumab (83.1%), ustekinumab (78%), and etanercept (70.6%). The most common reasons for discontinuation were lack of effectiveness and intolerability.</p><p><strong>Conclusion: </strong>This study shows changing psoriasis treatment patterns with new therapies. Risankizumab demonstrated high long-term persistence, while etanercept and ustekinumab showed declining persistence, suggesting evolving treatment considerations.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-17DOI: 10.1080/09546634.2024.2302064
ChanXiu Li, Yue Hu, ZengYi Mu, Lei Shi, Xiao Sun, XinYue Wang, YaPing Wang, XinHong Li
Aim: This study aimed to compare the efficacy and safety of excimer laser (EL)-based combination regimens in improving repigmentation.
Methods: A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase on July 1, 2023, to include randomized controlled trials of EL combination treatments for vitiligo that met the criteria. The primary outcome measure was a repigmentation rate ≥ 75%, and the secondary outcome measures were a repigmentation rate of ≤ 25% and adverse events.
Results: Eleven studies involving 348 patients were included. Network Meta-Analysis showed that EL combined with antioxidants (SUCRA = 98.8%), EL combined with calcipotriol (SUCRA = 59.8%) and EL combined with tacalcitol (SUCRA = 59.6%) were the three optimal interventions achieving repigmentation rates ≥ 75%. EL alone (SUCRA = 77.6%), EL combined with tacalcitol (SUCRA = 61.7%) and EL combined with antioxidants (SUCRA = 57.2%) were the three interventions with the highest rates of treatment failure. Adverse events in all groups mainly included erythema, burning sensation and hyperpigmentation. Based on the results of the current study, EL combination therapies were safe with mild adverse events.
Conclusion: EL combined with antioxidants was the preferred regimen for vitiligo, whereas EL alone was the regimen with the highest rate of treatment failure in vitiligo.
目的:本研究旨在比较基于准分子激光(EL)的联合疗法在改善色素沉着方面的有效性和安全性:方法:于2023年7月1日在PubMed、Web of Science、Cochrane Library和Embase中进行了全面检索,以纳入符合标准的EL联合治疗白癜风的随机对照试验。主要结果指标是色素沉着率≥75%,次要结果指标是色素沉着率≤25%和不良事件:结果:共纳入 11 项研究,涉及 348 名患者。网络Meta分析显示,EL联合抗氧化剂(SUCRA=98.8%)、EL联合钙泊三醇(SUCRA=59.8%)和EL联合他卡西妥(SUCRA=59.6%)是三种最佳干预方法,再色素沉着率≥75%。单独使用 EL(SUCRA = 77.6%)、EL 联合他卡西妥(SUCRA = 61.7%)和 EL 联合抗氧化剂(SUCRA = 57.2%)是治疗失败率最高的三种干预措施。各组的不良反应主要包括红斑、烧灼感和色素沉着。根据目前的研究结果,EL联合疗法是安全的,不良反应轻微:结论:EL联合抗氧化剂是治疗白癜风的首选疗法,而单独使用EL是治疗白癜风失败率最高的疗法。
{"title":"Comparison of various excimer laser (EL) combination therapies for vitiligo: a systematic review and network meta-analysis.","authors":"ChanXiu Li, Yue Hu, ZengYi Mu, Lei Shi, Xiao Sun, XinYue Wang, YaPing Wang, XinHong Li","doi":"10.1080/09546634.2024.2302064","DOIUrl":"10.1080/09546634.2024.2302064","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to compare the efficacy and safety of excimer laser (EL)-based combination regimens in improving repigmentation.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Web of Science, Cochrane Library, and Embase on July 1, 2023, to include randomized controlled trials of EL combination treatments for vitiligo that met the criteria. The primary outcome measure was a repigmentation rate ≥ 75%, and the secondary outcome measures were a repigmentation rate of ≤ 25% and adverse events.</p><p><strong>Results: </strong>Eleven studies involving 348 patients were included. Network Meta-Analysis showed that EL combined with antioxidants (SUCRA = 98.8%), EL combined with calcipotriol (SUCRA = 59.8%) and EL combined with tacalcitol (SUCRA = 59.6%) were the three optimal interventions achieving repigmentation rates ≥ 75%. EL alone (SUCRA = 77.6%), EL combined with tacalcitol (SUCRA = 61.7%) and EL combined with antioxidants (SUCRA = 57.2%) were the three interventions with the highest rates of treatment failure. Adverse events in all groups mainly included erythema, burning sensation and hyperpigmentation. Based on the results of the current study, EL combination therapies were safe with mild adverse events.</p><p><strong>Conclusion: </strong>EL combined with antioxidants was the preferred regimen for vitiligo, whereas EL alone was the regimen with the highest rate of treatment failure in vitiligo.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-07-21DOI: 10.1080/09546634.2024.2381763
Yan Xue, Yuning Xia, Donghao Cheng, Taiyu Shi, Ping Mei, Sheng Hong
Background: Psoriasis is a common autoimmune disease in clinical practice, and previous observational studies have suggested that PPARG agonists such as Pioglitazone may be potential therapeutic agents. However, due to interference from various confounding factors, different observational studies have not reached a unified conclusion. We aim to evaluate the potential use of PPARG agonists for treating psoriasis from a new perspective through drug-targeted Mendelian randomization (MR) analysis.
Materials and methods: This study includes data on 8,876 individuals for acute myocardial infarction from GWAS, and LDL cholesterol data from 343,621 Europeans. FinnGen contributed psoriasis vulgaris data for 403,972 individuals. The DrugBank10 databases function to identify genes encoding protein products targeted by active constituents of lipid-modifying targets. A two-sample MR analysis and summary-data-based MR (SMR) analysis estimated the associations between expressions of drug target genes and symptoms of psoriasis vulgaris. A multivariable MR study was further conducted to examine if the observed association was direct association.
Results: SMR analysis revealed that enhanced PPARG gene expression in the blood (equivalent to a one standard deviation increase) was a protective factor for psoriasis vulgaris (beta = -0.2017, se = 0.0723, p = 0.0053). Besides, there exists an MR association between LDL mediated by PPARG and psoriasis vulgaris outcomes (beta = -3.9169, se = 0.5676, p = 5.17E-12). These results indicate that PPARG is a therapeutic target for psoriasis, suggesting that psoriasis may be a potential indication for PPARG agonists.
Conclusion: This study confirms that therapeutic activation of PPARG helps suppress the development of psoriasis. Psoriasis may be a new indication for PPARG agonists, such as Pioglitazone. In the future, new anti-psoriatic drugs could be developed targeting PPARG.
{"title":"Association between genetically proxied PPARG activation and psoriasis vulgaris: a Mendelian randomization study.","authors":"Yan Xue, Yuning Xia, Donghao Cheng, Taiyu Shi, Ping Mei, Sheng Hong","doi":"10.1080/09546634.2024.2381763","DOIUrl":"10.1080/09546634.2024.2381763","url":null,"abstract":"<p><strong>Background: </strong>Psoriasis is a common autoimmune disease in clinical practice, and previous observational studies have suggested that PPARG agonists such as Pioglitazone may be potential therapeutic agents. However, due to interference from various confounding factors, different observational studies have not reached a unified conclusion. We aim to evaluate the potential use of PPARG agonists for treating psoriasis from a new perspective through drug-targeted Mendelian randomization (MR) analysis.</p><p><strong>Materials and methods: </strong>This study includes data on 8,876 individuals for acute myocardial infarction from GWAS, and LDL cholesterol data from 343,621 Europeans. FinnGen contributed psoriasis vulgaris data for 403,972 individuals. The <i>DrugBank10</i> databases function to identify genes encoding protein products targeted by active constituents of lipid-modifying targets. A two-sample MR analysis and summary-data-based MR (SMR) analysis estimated the associations between expressions of drug target genes and symptoms of psoriasis vulgaris. A multivariable MR study was further conducted to examine if the observed association was direct association.</p><p><strong>Results: </strong>SMR analysis revealed that enhanced PPARG gene expression in the blood (equivalent to a one standard deviation increase) was a protective factor for psoriasis vulgaris (beta = -0.2017, se = 0.0723, <i>p</i> = 0.0053). Besides, there exists an MR association between LDL mediated by PPARG and psoriasis vulgaris outcomes (beta = -3.9169, se = 0.5676, <i>p</i> = 5.17E-12). These results indicate that PPARG is a therapeutic target for psoriasis, suggesting that psoriasis may be a potential indication for PPARG agonists.</p><p><strong>Conclusion: </strong>This study confirms that therapeutic activation of PPARG helps suppress the development of psoriasis. Psoriasis may be a new indication for PPARG agonists, such as Pioglitazone. In the future, new anti-psoriatic drugs could be developed targeting PPARG.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-20DOI: 10.1080/09546634.2024.2393376
D Orsini, M Megna, C Assorgi, A Balato, R Balestri, N Bernardini, A Bettacchi, T Bianchelli, L Bianchi, G Buggiani, M Burlando, Amg Brunasso, G Caldarola, N Cameli, A Campanati, E Campione, A Carugno, K Chersi, A Conti, A Costanzo, E Cozzani, A Cuccia, D D'Amico, G Dal Bello, E G Dall'Olio, P Dapavo, C De Simone, E V Di Brizzi, A Di Cesare, V Dini, M Esposito, E Errichetti, M C Fargnoli, C S Fiorella, A Foti, Z Fratton, F M Gaiani, P Gisondi, R Giuffrida, A Giunta, C Guarneri, A Legori, F Loconsole, P Malagoli, A Narcisi, M Paolinelli, L Potestio, F Prignano, G Rech, A Rossi, N Skroza, F Trovato, M Venturini, A G Richetta, G Pellacani, A Dattola
Purpose of the article: The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices.
Materials and methods: A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation.
Results: The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks (p < 0.001), and 1.1 ± 1.7 after 16 week (p < 0.001). This level of improvement was maintained after 36 weeks (p < 0.001). PASI ≤2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not associated with baseline PASI, obesity, age, gender, previously naïve state, and presence of psoriatic arthritis. Patients naïve to biologics at baseline had similar response to bimekizumab as non-naïve subjects.
Conclusions: Bimekizumab is a suitable option for elder patients as it is effective, tolerated and has a convenient schedule.
文章目的这项多中心观察性研究旨在报告在年龄≥65岁的中重度斑块状银屑病患者中使用比美单抗的实际数据。老年患者在比美珠单抗治疗斑块状银屑病的临床试验中比例较低,因此真实世界的研究对于指导临床选择非常重要:在意大利的 33 家皮肤科门诊诊所开展了一项回顾性多中心研究。研究对象包括年龄≥ 65 岁、患有中度至重度斑块状银屑病并接受过 bimekizumab 治疗的患者。无排除标准。比美珠单抗按照意大利斑块状银屑病治疗指南和产品特性概要进行治疗,适用于接受全身治疗的成年患者。共有98名受试者接受了bimekizumab治疗,疗程持续到第36周。在开始使用bimekizumab治疗前收集了临床和人口统计学数据。在基线和每次皮肤检查(4、16 和 36 周)时,临床结果通过以下参数进行测量:(1) PASI 评分;(2) 特定部位(头皮、掌跖、生殖器、指甲)牛皮癣总体评估 (PGA)。在每次就诊时,记录任何不良事件(AEs)的发生情况,包括严重不良事件和导致停用比美珠单抗的不良事件:结果:基线时的平均 PASI 评分为 16.6 ± 9.4,4 周后明显降低至 4.3 ± 5.2(p p p 结论:Bimekizumab 的疗效显著:比美单抗疗效好、耐受性强、疗程方便,适合老年患者使用。
{"title":"Efficacy and Safety of bimekizumab in elderly patients: real-world multicenter retrospective study - IL PSO (Italian Landscape Psoriasis).","authors":"D Orsini, M Megna, C Assorgi, A Balato, R Balestri, N Bernardini, A Bettacchi, T Bianchelli, L Bianchi, G Buggiani, M Burlando, Amg Brunasso, G Caldarola, N Cameli, A Campanati, E Campione, A Carugno, K Chersi, A Conti, A Costanzo, E Cozzani, A Cuccia, D D'Amico, G Dal Bello, E G Dall'Olio, P Dapavo, C De Simone, E V Di Brizzi, A Di Cesare, V Dini, M Esposito, E Errichetti, M C Fargnoli, C S Fiorella, A Foti, Z Fratton, F M Gaiani, P Gisondi, R Giuffrida, A Giunta, C Guarneri, A Legori, F Loconsole, P Malagoli, A Narcisi, M Paolinelli, L Potestio, F Prignano, G Rech, A Rossi, N Skroza, F Trovato, M Venturini, A G Richetta, G Pellacani, A Dattola","doi":"10.1080/09546634.2024.2393376","DOIUrl":"https://doi.org/10.1080/09546634.2024.2393376","url":null,"abstract":"<p><p><b>Purpose of the article:</b> The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices.</p><p><p><b>Materials and methods:</b> A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation.</p><p><p><b>Results:</b> The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks (<i>p</i> < 0.001), and 1.1 ± 1.7 after 16 week (<i>p</i> < 0.001). This level of improvement was maintained after 36 weeks (<i>p</i> < 0.001). PASI ≤2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not associated with baseline PASI, obesity, age, gender, previously naïve state, and presence of psoriatic arthritis. Patients naïve to biologics at baseline had similar response to bimekizumab as non-naïve subjects.</p><p><p><b>Conclusions:</b> Bimekizumab is a suitable option for elder patients as it is effective, tolerated and has a convenient schedule.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-14DOI: 10.1080/09546634.2024.2304020
Steven R Feldman, Jacob P Thyssen, Marco Boeri, Robert Gerber, Maureen P Neary, Amy Cha, Brett Hauber, Joseph C Cappelleri, Jason Xenakis, Colton Leach, Joshua Zeichner
Purpose: Topical treatments for mild-to-moderate (MM) atopic dermatitis (AD) include emollients, corticosteroids, calcineurin inhibitors, a Janus kinase inhibitor, and a phosphodiesterase 4 inhibitor, which differ in multiple ways. This study aimed to quantify the conditional relative importance (CRI) of attributes of topical treatments for MM AD among adult and adolescent patients and caregivers of children with MM AD.Materials and methods: A discrete-choice experiment (DCE) survey was administered to US adults and adolescents with MM AD and caregivers of children with MM AD. Each choice task comprised 2 hypothetical topical treatments characterized by efficacy, adverse events, vehicle, and application frequency. Data were analyzed using a random-parameters logit model to calculate the CRI of each attribute.Results and conclusions: 300 adults, 331 adolescents, and 330 caregivers completed the DCE. Avoiding changes in skin color (CRI 29.0) and time until itch improves (26.6) were most important to adults, followed by time until clear/almost clear skin (17.8). Application frequency (3.0) did not have a statistically significant impact on adults' choices. Adolescents were less concerned about changes in skin color than adults or caregivers; caregivers were less concerned about time until clear/almost clear skin than patients. Physicians should consider age-relevant aspects of preferences in treatment discussions with patients and caregivers.
{"title":"Adult, adolescent, and caregiver preferences for attributes of topical treatments for mild-to-moderate atopic dermatitis: a discrete-choice experiment.","authors":"Steven R Feldman, Jacob P Thyssen, Marco Boeri, Robert Gerber, Maureen P Neary, Amy Cha, Brett Hauber, Joseph C Cappelleri, Jason Xenakis, Colton Leach, Joshua Zeichner","doi":"10.1080/09546634.2024.2304020","DOIUrl":"10.1080/09546634.2024.2304020","url":null,"abstract":"<p><p><b>Purpose:</b> Topical treatments for mild-to-moderate (MM) atopic dermatitis (AD) include emollients, corticosteroids, calcineurin inhibitors, a Janus kinase inhibitor, and a phosphodiesterase 4 inhibitor, which differ in multiple ways. This study aimed to quantify the conditional relative importance (CRI) of attributes of topical treatments for MM AD among adult and adolescent patients and caregivers of children with MM AD.<b>Materials and methods:</b> A discrete-choice experiment (DCE) survey was administered to US adults and adolescents with MM AD and caregivers of children with MM AD. Each choice task comprised 2 hypothetical topical treatments characterized by efficacy, adverse events, vehicle, and application frequency. Data were analyzed using a random-parameters logit model to calculate the CRI of each attribute.<b>Results and conclusions:</b> 300 adults, 331 adolescents, and 330 caregivers completed the DCE. Avoiding changes in skin color (CRI 29.0) and time until itch improves (26.6) were most important to adults, followed by time until clear/almost clear skin (17.8). Application frequency (3.0) did not have a statistically significant impact on adults' choices. Adolescents were less concerned about changes in skin color than adults or caregivers; caregivers were less concerned about time until clear/almost clear skin than patients. Physicians should consider age-relevant aspects of preferences in treatment discussions with patients and caregivers.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Rituximab (RTX) is considered the first-line treatment for pemphigus vulgaris (PV), which is a B-cell-mediated acquired autoimmune disease. However, no consensus on the optimum dosage has been achieved.
Objectives: To investigate the efficacy and safety of low-dose RTX (a single infusion of 500 mg) for the treatment of PV, a cohort study was conducted for patients with PV, along with a 12-month follow-up following the administration of RTX.
Methods: Patients with moderate or severe PV were divided into group A (low-dose RTX combined with corticosteroids) and group B (corticosteroids alone). Data on complete remission (CR) rates, doses of corticosteroids, cumulative doses of corticosteroids at the third, sixth, and twelfth months, pemphigus disease area index and adverse effects (AEs) were collected.
Results: Forty-four patients with moderate or severe PV were enrolled in this study (19 in group A and 25 in group B). Patients treated with low-dose RTX had higher CR rates, lower doses of corticosteroids at the third, sixth, and twelfth months, lower cumulative doses of corticosteroids at the sixth and twelfth months, and fewer AEs than those who received corticosteroids alone.
Conclusions: This study indicated that low-dose RTX may be a beneficial and secure therapy option for patients with moderate to severe PV.
背景:利妥昔单抗(RTX)被认为是治疗寻常天疱疮(PV)的一线药物,寻常天疱疮是一种B细胞介导的获得性自身免疫性疾病。然而,目前尚未就最佳剂量达成共识:为了研究小剂量 RTX(单次输注 500 毫克)治疗寻常脓疱疮的有效性和安全性,我们对寻常脓疱疮患者进行了一项队列研究,并在使用 RTX 后进行了为期 12 个月的随访:方法:将中度或重度红斑狼疮患者分为 A 组(小剂量 RTX 联合皮质类固醇)和 B 组(仅使用皮质类固醇)。收集完全缓解(CR)率、皮质类固醇激素剂量、皮质类固醇激素在第三、第六和第十二个月的累积剂量、丘疹性荨麻疹病区指数和不良反应(AEs)等数据:44名中度或重度丘疹性荨麻疹患者参加了这项研究(A组19人,B组25人)。与单纯接受皮质类固醇治疗的患者相比,接受小剂量RTX治疗的患者CR率更高,在第三、第六和第十二个月使用皮质类固醇的剂量更低,在第六和第十二个月使用皮质类固醇的累积剂量更低,AEs更少:这项研究表明,低剂量 RTX 可能是中度至重度 PV 患者的一种有益而安全的治疗选择。
{"title":"The efficacy and safety of low-dose rituximab in the treatment of pemphigus vulgaris: a cohort study.","authors":"Xingli Zhou, Tongying Zhan, Xiaoxi Xu, Tianjiao Lan, Hongxiang Hu, Yuxi Zhou, Dengmei Xia, Jinqiu Wang, Yiyi Wang, Yue Xiao, Wei Li","doi":"10.1080/09546634.2024.2302071","DOIUrl":"10.1080/09546634.2024.2302071","url":null,"abstract":"<p><strong>Background: </strong>Rituximab (RTX) is considered the first-line treatment for pemphigus vulgaris (PV), which is a B-cell-mediated acquired autoimmune disease. However, no consensus on the optimum dosage has been achieved.</p><p><strong>Objectives: </strong>To investigate the efficacy and safety of low-dose RTX (a single infusion of 500 mg) for the treatment of PV, a cohort study was conducted for patients with PV, along with a 12-month follow-up following the administration of RTX.</p><p><strong>Methods: </strong>Patients with moderate or severe PV were divided into group A (low-dose RTX combined with corticosteroids) and group B (corticosteroids alone). Data on complete remission (CR) rates, doses of corticosteroids, cumulative doses of corticosteroids at the third, sixth, and twelfth months, pemphigus disease area index and adverse effects (AEs) were collected.</p><p><strong>Results: </strong>Forty-four patients with moderate or severe PV were enrolled in this study (19 in group A and 25 in group B). Patients treated with low-dose RTX had higher CR rates, lower doses of corticosteroids at the third, sixth, and twelfth months, lower cumulative doses of corticosteroids at the sixth and twelfth months, and fewer AEs than those who received corticosteroids alone.</p><p><strong>Conclusions: </strong>This study indicated that low-dose RTX may be a beneficial and secure therapy option for patients with moderate to severe PV.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-23DOI: 10.1080/09546634.2024.2302394
Fangying Su, Tai Wang, Qunshi Qin, Zhi Xie
Both bullous pemphigoid (BP) and psoriasis are common immune-related dermatological conditions in clinical practice, but the co-occurrence of these two diseases is rare. Currently, there is no consensus on the long-term safe and effective treatment for patients with both BP and psoriasis. JAK inhibitors are emerging as targeted therapeutic drugs that act by inhibiting Janus kinase activity, regulating the JAK/STAT pathway, blocking the transduction pathway of key proinflammatory cytokines, and influencing T-cell differentiation. These cytokines upstream of the JAK/STAT pathway play a pivotal role in the pathogenesis of numerous inflammatory and autoimmune disorders. Upadacitinib, a second-generation JAK inhibitor with high selectivity, demonstrates promising potential.This case report aims to provide a description of the successful treatment of bullous pemphigoid (BP) and psoriasis vulgaris by using upadacitinib, highlighting significant clinical outcomes. Additionally, we aim to analyze the underlying mechanism of upadacitinib in treating these two comorbidities by reviewing relevant literature from both domestic and international sources. Based on our clinical observations, upadacitinib appears to be a promising and well-tolerated therapeutic option for patients with concurrent BP and psoriasis, offering valuable insights for developing appropriate treatment strategies in clinical practice.
在临床实践中,大疱性类天疱疮(BP)和银屑病都是常见的免疫相关皮肤病,但这两种疾病同时出现的情况却很少见。目前,对于同时患有脓疱性丘疹和银屑病的患者的长期安全有效治疗还没有达成共识。JAK 抑制剂是新兴的靶向治疗药物,它通过抑制 Janus 激酶活性、调节 JAK/STAT 通路、阻断关键促炎细胞因子的转导途径以及影响 T 细胞分化发挥作用。JAK/STAT 通路上游的这些细胞因子在许多炎症和自身免疫性疾病的发病机制中起着关键作用。本病例报告旨在介绍使用乌达替尼成功治疗大疱性类天疱疮(BP)和寻常型银屑病的病例,并重点介绍其显著的临床疗效。此外,我们还通过回顾国内外相关文献,分析了达达替尼治疗这两种合并症的内在机制。根据我们的临床观察,奥达帕替尼似乎是一种很有前景且耐受性良好的治疗方案,可用于治疗同时患有血压和银屑病的患者,为在临床实践中制定适当的治疗策略提供有价值的见解。
{"title":"Upadacitinib for the management of bullous pemphigoid coexisting with psoriasis vulgaris: a case report and literature review.","authors":"Fangying Su, Tai Wang, Qunshi Qin, Zhi Xie","doi":"10.1080/09546634.2024.2302394","DOIUrl":"10.1080/09546634.2024.2302394","url":null,"abstract":"<p><p>Both bullous pemphigoid (BP) and psoriasis are common immune-related dermatological conditions in clinical practice, but the co-occurrence of these two diseases is rare. Currently, there is no consensus on the long-term safe and effective treatment for patients with both BP and psoriasis. JAK inhibitors are emerging as targeted therapeutic drugs that act by inhibiting Janus kinase activity, regulating the JAK/STAT pathway, blocking the transduction pathway of key proinflammatory cytokines, and influencing T-cell differentiation. These cytokines upstream of the JAK/STAT pathway play a pivotal role in the pathogenesis of numerous inflammatory and autoimmune disorders. Upadacitinib, a second-generation JAK inhibitor with high selectivity, demonstrates promising potential.This case report aims to provide a description of the successful treatment of bullous pemphigoid (BP) and psoriasis vulgaris by using upadacitinib, highlighting significant clinical outcomes. Additionally, we aim to analyze the underlying mechanism of upadacitinib in treating these two comorbidities by reviewing relevant literature from both domestic and international sources. Based on our clinical observations, upadacitinib appears to be a promising and well-tolerated therapeutic option for patients with concurrent BP and psoriasis, offering valuable insights for developing appropriate treatment strategies in clinical practice.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}