Alessandra Narcisi, Vito Di Lernia, Maria Esposito, Vittorio Forte, Silvia Mariel Ferrucci, Lorenzo Gerratana, Pietro Morrone, Saverio Muscoli, Maddalena Napolitano, Michela Ortoncelli, Marina Talamonti
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引用次数: 0
Abstract
Guidelines recommend that patients with severe atopic dematitis (AD) be treated with Janus kinase inhibitors (JAKi). Recently, the safety of JAKi as a class was reviewed by the European Medicines Agency, leading to a modification of the Summaries of Product Characteristics. For upadacitinib, changes involve reduced posology and restriction of its use to patients with no other alternative amongst the elderly and those at an increased risk of major adverse cardiovascular events (MACE), cancer and venous thromboembolism (VTE). Risk assessment may be daunting and clarity regarding definitions and data is needed. An interdisciplinary workshop, termed the Multiple In-treatment Risk Assessment & Management, was conceived to provide dermatologists with a platform for multidisciplinary exchange on risk assessment in patients with MACE, cancer and VTE to correctly recognise patients with increased risk. In this review, we characterised common and less common patient profiles in order to assess the risk. With the cooperation of a cardiologist, oncologist, respiratory medicine specialist and haematologists, we identified the risk factors for MACE, cancer and VTE. The results show that taking a careful medical history is the basis of risk assessment and that a careful medical history should be performed regardless of the intended therapy in AD. We propose that risk levels be used in the general population as a benchmark to evaluate risk levels in patients with AD, and provide a checklist to support such risk assessments in routine clinical practice. Our work provides a clear framework for risk assessment to the community of dermatologists and, therefore, contributes to improving the standard of care in AD.
期刊介绍:
Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged.
Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers.
The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.