Dermatology and Therapy最新文献

{"title":"A Real-World Approach to Trifarotene Treatment in Patients with Acne and Acne Sequelae Based on the Experience of the Italian Acne Board.","authors":"Maria Carmela Annunziata, Mauro Barbareschi, Vincenzo Bettoli, Federica Dall'Oglio, Giuseppe Micali, Giuseppe Monfrecola, Nevena Skroza, Matteo Tretti Clementoni, Stefano Veraldi","doi":"10.1007/s13555-024-01329-3","DOIUrl":"10.1007/s13555-024-01329-3","url":null,"abstract":"<p><p>Acne and acne sequelae can have an important impact on patients' quality of life, affecting interpersonal relationships and social functioning. Acne-induced scars (AIS) and acne-induced macular hyperpigmentation (AIH), in particular, are a major concern for patients with acne, as their management is challenging and often unsatisfactory. Retinoids are considered the mainstay of acne treatment because of their action on multiple pathogenetic factors, and there is increasing evidence that they can also improve AIS and AIH. Trifarotene, a topical retinoid with selectivity for retinoic acid receptor (RAR)-γ, has undergone an extensive clinical development programme, demonstrating its efficacy in treating facial and truncal acne and improving acne sequelae. In this article, we review the main evidence supporting the use of trifarotene in patients with acne and acne sequelae and provide place-in-therapy suggestions based on the experience of the Italian Acne Board with this drug in real-life practice. Trifarotene can be used successfully, as monotherapy or in association with other treatments, in most clinical settings of acne, but it plays an essential role in patients with existing AIS and AIH, those with a clinical or personal history of scarring and those who are predisposed to AIH. Owing to its long-term efficacy and tolerability, trifarotene is also a good option as a maintenance treatment. As with other topical retinoids, patients undergoing trifarotene therapy should be given advice on how to minimise local irritation when starting treatment.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"245-264"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deucravacitinib: Adverse Events of Interest Across Phase 3 Plaque Psoriasis Trials.","authors":"Joseph F Merola, Laura K Ferris, Jeffrey M Sobell, Howard Sofen, John Osborne, John Vaile, Ying-Ming Jou, Carolin Daamen, Julie Scotto, Thomas Scharnitz, Mark Lebwohl","doi":"10.1007/s13555-025-01337-x","DOIUrl":"10.1007/s13555-025-01337-x","url":null,"abstract":"<p><strong>Introduction: </strong>Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, is approved in multiple countries for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. The safety and efficacy of deucravacitinib in psoriasis has been demonstrated through 3 years in the phase 3 POETYK PSO-1, PSO-2, and long-term extension (LTE) trials enrolling adults with moderate to severe plaque psoriasis.</p><p><strong>Methods: </strong>To review the effect of deucravacitinib treatment on adverse events of interest (AEIs) over 3 years in POETYK PSO-1, PSO-2, and LTE, cumulative exposure-adjusted incidence rates (EAIRs) of AEIs were recorded through 3 years.</p><p><strong>Results: </strong>AEIs and 3-year EAIRs of select infections included serious infections (2.5/100 person-years [PY]), COVID-19 (1.6/100 PY), and herpes zoster (0.6/100 PY). Excluding COVID-19, the serious infections EAIR was 0.9/100 PY. Major adverse cardiovascular event (MACE) and venous thromboembolism EAIRs were 0.3/100 PY and 0.1/100 PY, respectively. The EAIRs for malignancies were 0.9/100 PY overall and 0.5/100 PY, excluding nonmelanoma skin cancer (NMSC). Cutaneous events included acne (EAIR, 1.3/100 PY) and folliculitis (EAIR, 1.1/100 PY). Three-year cumulative EAIRs generally remained stable or decreased relative to 1-year rates. EAIRs of non-COVID-19 serious infections, malignancies excluding NMSC, and MACE through 3 years were consistent with rates for other antipsoriatic agents from clinical trials, disease registries, and real-world claims data.</p><p><strong>Conclusion: </strong>In adults with plaque psoriasis treated with deucravacitinib, the cumulative incidence of AEIs remained comparable or decreased over 3 years of follow-up and aligned with comparison data for other antipsoriatic therapies.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"453-462"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Risankizumab in Patients with Moderate-to-Severe Psoriasis: Interim Analysis from the VALUE Global Prospective Post-marketing Observational Study at 25 Months.","authors":"Diamant Thaçi, Mamitaro Ohtsuki, Julia-Tatjana Maul, Andrea Szegedi, Paula C Luna, Charles W Lynde, Ahmed M Soliman, Hongwei Wang, Christian Kaufmann, Doug G Ashley, Tshepiso Madihlaba, Simone Rubant, Kim A Papp","doi":"10.1007/s13555-025-01342-0","DOIUrl":"10.1007/s13555-025-01342-0","url":null,"abstract":"<p><strong>Introduction: </strong>Risankizumab is approved for treating moderate-to-severe psoriasis. This interim analysis at 25 months evaluated the effectiveness of risankizumab compared with other approved biologics (OtherBios) among patients with moderate-to-severe psoriasis in the 37-month VALUE post-marketing observational study.</p><p><strong>Methods: </strong>Patients diagnosed with psoriasis were enrolled in a 2:1 ratio to risankizumab or OtherBios, as prescribed by their physicians. A ≥ 90% improvement in Psoriasis Area Severity Index (PASI) 90 at months 4, 13, and 25 and the time to first treatment change at 25 months were evaluated. Additionally, PASI 100 and 75, static Physician Global Assessment (sPGA 0/1), Dermatology Life Quality Index (DLQI), and Treatment Satisfaction Questionnaire for Medication (TSQM) scores were evaluated. All patients treated with ≥ 1 dose of biological therapy with ≥ 1 post-baseline measurement were included in the analysis. Modified non-responder imputation was used to handle missing data, and propensity score matching accounted for imbalances between comparison groups.</p><p><strong>Results: </strong>Overall, 1765 patients received risankizumab and 874 received OtherBios. At baseline, the mean (SD) age of the overall population was 48.5 (14.7) years and mean (standard deviation [SD]) PASI scores were 15.0 (9.0) and 13.9 (8.8) in the risankizumab and OtherBios groups, respectively. At 25 months, 70.9% of those treated with risankizumab vs. 51.5% of those treated with OtherBios achieved PASI 90. The cumulative treatment change probability was 0.16 (95%, confidence interval [CI] 0.14, 0.18) in the risankizumab group and 0.29 (95% CI 0.26, 0.32) in the OtherBios group. At 25 months, a higher proportion of patients achieved PASI 100 (56.6% vs. 40.2%), PASI 75 (84.3% vs. 67.7%), sPGA 0/1 (82.6% vs. 66.2%), and DLQI 0/1 (70.0% vs. 52.9%) in the risankizumab vs. OtherBios group, respectively, and the change in mean TSQM global score was higher in the risankizumab group (86.0 vs. 79.4). All comparisons were nominally significant (P < 0.0001). No new safety signals were identified.</p><p><strong>Conclusions: </strong>In this prospective study, risankizumab demonstrated higher effectiveness, longer drug survival, and better improvement of patient-reported outcomes at 25 months compared with OtherBios.</p><p><strong>Clinical trials: </strong>ClinicalTrials.gov identifier: NCT03982394.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"381-394"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Predefined Safety Events Across Spesolimab Trials in Dermatological and Non-Dermatological Conditions.","authors":"Kenneth B Gordon, Yayoi Tada, Milan J Anadkat, Siew Eng Choon, Boni Elewski, Jonathan N Barker, Arash Mostaghimi, Kilian Eyerich, Ming Tang, Thomas Haeufel, Christian Thoma, Diamant Thaçi","doi":"10.1007/s13555-024-01325-7","DOIUrl":"10.1007/s13555-024-01325-7","url":null,"abstract":"<p><strong>Introduction: </strong>Spesolimab, a selective, humanised monoclonal antibody targeting the interleukin-36 receptor, is approved for the treatment of generalised pustular psoriasis (GPP). As a result of the limited patient numbers in GPP trials of spesolimab, analysing safety events across dermatological and non-dermatological diseases helps to further characterise the known safety profile of spesolimab. Here, we analyse predefined safety events from nine randomised, placebo-controlled spesolimab trials across dermatological (including GPP) and gastrointestinal conditions.</p><p><strong>Methods: </strong>Predefined safety events were based on the known safety profile of spesolimab across all diseases investigated to date and potential risks of biological therapeutics, and included serious/severe/opportunistic infections, hypersensitivity, malignancies and peripheral neuropathy.</p><p><strong>Results: </strong>Including placebo-controlled trials and open-label periods/trials, 589 patients received ≥ 1 dose of spesolimab (772.2 patient-years; mean exposure 1.31 patient-years). Overall, 452 patients had long-term exposure (≥ 6 months) to spesolimab, with 31 patients up to ≥ 3 years. In placebo-controlled periods, 445 patients had exposure to spesolimab (162.0 patient-years; mean exposure 0.36 patient-years). Severe/serious/opportunistic infections occurred in 0-3.2% of spesolimab-treated patients and 0-14.3% of placebo-treated patients. Malignancies occurred infrequently across trials (0-6.7% in spesolimab, 0-2.3% in placebo). Peripheral neuropathy events also occurred infrequently, with single events reported in the placebo arm of EFFISAYIL^® 2, and the spesolimab and placebo arms of palmoplantar pustulosis Study 2. Potential hypersensitivity events occurred in all trials, except for Crohn's disease, and were largely balanced between spesolimab (7.7-33.3%) and placebo (4.3-44.4%).</p><p><strong>Conclusions: </strong>Across placebo-controlled periods of spesolimab trials in dermatological and non-dermatological conditions, severe/serious/opportunistic infections, malignancies and peripheral neuropathy events were low, with no evidence for an increased risk with spesolimab versus placebo. Potential hypersensitivity events were similar between spesolimab and placebo. These results support the favourable safety profile of spesolimab observed in EFFISAYIL^® 2, the largest GPP trial conducted to date.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"395-411"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CDKN2A Mutation: A Patient's and Physician's Experience.","authors":"Yaelle Shaked, Alyssa Swearingen, Tracey N Liebman","doi":"10.1007/s13555-025-01354-w","DOIUrl":"10.1007/s13555-025-01354-w","url":null,"abstract":"<p><p>This article discusses both the patient's and physician's perspective on the CDKN2A mutation. After an intriguing interview with the patient, the author writes about the patient's feelings, thoughts, and overall experience when he was diagnosed with the CDKN2A mutation. The patient's story discusses what prompted the patient to get tested for the mutation and how the diagnosis later impacted his life and that of his family. The author describes the clinical relevance of the CDKN2A mutation and the current guidelines for testing. The author highlights the need to recognize patients with familial melanomas as high risk and educate the patient on the importance of routine dermatological surveillance.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"265-268"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety, and Cost-effectiveness of Zinc Oxide Nanoparticles in Whitfield's Spirit Solution for Treating Superficial Fungal Foot Infections: A Randomized Controlled Trial.","authors":"Charussri Leeyaphan, Primana Punnakitikashem, Bordeesuda Suiwongsa, Phojana Komesmuneeborirak, Piriyaporn Chongtrakool, Nattanichcha Kulthanachairojana, Pichaya Limphoka, Thrit Hutachoke, Phuwakorn Saengthong-Aram, Pantaree Kobkurkul, Supisara Wongdama, Bawonpak Pongkittilar, Lalita Matthapan, Chatisa Panyawong, Waranyoo Prasong, Akkarapong Plengpanich, Natsuda Kunwong, Kamonlatth Rodponthukwaji, Sumanas Bunyaratavej","doi":"10.1007/s13555-025-01340-2","DOIUrl":"10.1007/s13555-025-01340-2","url":null,"abstract":"<p><strong>Introduction: </strong>A novel antifungal formulation combining zinc oxide nanoparticles and Whitfield's spirit solution (ZnO-WFs) was developed to enhance the treatment of superficial fungal foot infections.</p><p><strong>Methods: </strong>This 8-week, randomized, double-blinded controlled trial compared the efficacy, safety, and cost-effectiveness of ZnO-WFs with those of Whitfield's spirit solution (WFs) alone and a zinc oxide nanoparticle solution (ZnOs). Seventy of the 84 enrolled patients completed the trial.</p><p><strong>Results: </strong>Patients treated with ZnO-WFs and WFs showed similar mycological cure rates, significantly outperforming ZnOs at the 4-week and 8-week evaluations (65.2% and 81.8% for ZnO-WFs and 66.7% and 83.3% for WFs, respectively, compared to 4.0% and 16.7% for ZnOs; P < 0.001). Particularly in nondermatophyte mold (NDM) infections, ZnO-WFs tended to have greater cure rates than WFs (90.0% vs 44.4% at 4 weeks, P = 0.057; 90.0% vs 55.6% at 8 weeks, P = 0.141). Patient satisfaction was equivalent across all groups. The cost-effectiveness analysis revealed that ZnO-WFs is a more economical option for managing NDM infections.</p><p><strong>Conclusion: </strong>This study confirmed that both ZnO-WFs and WFs effectively treat superficial fungal foot infections. However, ZnO-WFs demonstrates a trend toward increased efficacy and lower cost per patient in managing NDM infections, suggesting a potential advantage over WFs in these specific cases.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT05901961.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"351-365"},"PeriodicalIF":3.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frontal Fibrosing Alopecia: A Comprehensive Guide for Cosmetic Dermatologists.","authors":"Marina Landau, Sofia M Perez, Antonella Tosti","doi":"10.1007/s13555-024-01311-z","DOIUrl":"10.1007/s13555-024-01311-z","url":null,"abstract":"<p><p>Frontal fibrosing alopecia (FFA) is an inflammatory, scarring hair loss that commonly affects postmenopausal women and presents as frontal hairline recession, facial papules, loss of eyebrows, and facial hyperpigmentation. Because of the chronic, progressive nature of this disease and its important impact on aesthetic appearance, patients often consult dermatologists to improve unwanted FFA symptoms. Cosmetic practices including the use of non-ablative lasers, autologous fat injections, and oral isotretinoin can improve FFA-associated facial vein prominence, atrophic indentations, and facial papules, respectively. On the other hand, while exact etiology underlying FFA development remains unclear, some procedures including deep chemical peels and ablative laser therapies have been shown to induce facial scarring and are contraindicated in patients with FFA. In the same way, some cosmetic ingredients can possibly be a triggering or worsening factor for FFA as well. Therefore, it is essential for dermatologists to be aware of both the benefits and risks of cosmetic treatments in patients with diagnosed or suspected FFA. This comprehensive review aims to outline the key cosmetic products and procedures that may be useful in patients with FFA and those which should be considered contraindicated.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"15-29"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic Therapy and Cardiometabolic Risk in Psoriasis: A Retrospective Review.","authors":"Annika Smith, Aidin Karahasan, Deborah Yi, Sanjay Yapabandara, James Elhindi, Pablo Fernandez-Penas, Clara Chow, Sarah Zaman","doi":"10.1007/s13555-024-01327-5","DOIUrl":"10.1007/s13555-024-01327-5","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a systemic inflammatory disease with increased cardiometabolic risk including dyslipidaemia and diabetes. Biologic therapy effectively treats the cutaneous inflammatory burden of psoriasis and evolving evidence suggests potential to reduce systemic inflammatory sequalae that can elevate cardiovascular risk. This study aimed to assess the change in cardiometabolic risk markers in a cohort of patients with psoriasis treated with 1 year of continuous biologic treatment.</p><p><strong>Methods: </strong>A retrospective review was conducted of patients receiving biologic therapy for chronic plaque psoriasis in a single dermatology centre at a major tertiary hospital in Sydney, Australia. The effect of biologic therapy on psoriasis was assessed using the psoriasis area severity index (PASI). Cardiometabolic risk markers assessed included lipid profile (total cholesterol [TC], low-density lipoprotein [LDL] cholesterol, high-density lipoprotein [HDL] cholesterol and triglycerides [TG]) and haemoglobin A1c (HbA1c). Measurements at baseline and 1 year were compared using paired t tests for analysis of the parameters which approximated normal distribution (TC, LDL, HDL) and Wilcoxon signed-rank test for analysis of those which did not (TG, HbA1c, PASI). Two-tailed P values < 0.05 were considered significant.</p><p><strong>Results: </strong>A total of 200 patients were reviewed, of which 39 had complete data sets. The participants' ages ranged from 21 to 85 years (mean 51, SD 16.9). Of the 39 participants, 31 (79.5%) were male, 8 (20.5%) were female; 26 (67%) were biologic experienced (BE) and 13 (33%) were biologic naïve (BN). The mean PASI at baseline (for BN + BE) was 13.4 (SD 9.8). The biologic agents used, according to frequency, included risankizumab, with 14 participants (35.9%), secukinumab by 7 (17.9%), ustekinumab by 6 (15.4%), ixekizumab by 6 (15.4%), guselkumab by 3 (7.7%), infliximab by 2 (5.1%), and adalimumab by 1 (2.6%). After 12 months, significant skin improvement was seen [PASI reduced from 13.43 (SD 9.8) to 1.1 (SD 2.1), p < 0.001]. There was no significant change in lipid profile, including TC (mean difference - 0.1 mmol/L, p = 0.532), LDL-C (mean difference = - 0.1 mmol/L, p = 0.476), HDL (mean difference = - 0.1 mmol/L, p = 0.125), triglycerides (mean difference = 0.0 mmol/l, p = 0.748) or HbA1c (mean difference 0.38%, p = 0.468).</p><p><strong>Conclusion: </strong>Markers of cardiometabolic risk (lipid profile and HbA1c) did not significantly improve after 1 year of biologic therapy despite significant reduction in psoriasis skin severity. Further research in larger cohorts is needed to elucidate the benefits, if any, of biologic therapy on cardiometabolic parameters in individuals with psoriasis, in order to optimise care for this vulnerable cohort.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"201-212"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlormethine Gel for Treatment of Patients with Mycosis Fungoides: Best Practices and Guidance to Clinicians.","authors":"Larisa Geskin, Christiane Querfeld, Emmilia Hodak, Neda Nikbakht, Evangelia Papadavid, Marco Ardigò, Ulrike Wehkamp, Martine Bagot","doi":"10.1007/s13555-024-01305-x","DOIUrl":"10.1007/s13555-024-01305-x","url":null,"abstract":"<p><strong>Background: </strong>Mycosis fungoides (MF) is the most common form of cutaneous T cell lymphoma. While multiple guidelines provide treatment recommendations, there are currently no clear treatment algorithms for MF. Chlormethine gel is recommended by major treatment guidelines as a first-line option for stage IA-IIA disease, and, on the basis of these guidelines, used in combination with other therapies in patients with advanced-stage MF in clinical practice.</p><p><strong>Objectives: </strong>To provide guidance regarding the use of chlormethine gel for patients with all stages of MF, based on clinical expertise.</p><p><strong>Methods: </strong>Opinions on best practices regarding the use of chlormethine gel were collected through discussions that involved eight clinicians with extensive experience in treating patients with MF.</p><p><strong>Results: </strong>Chlormethine gel can be used as monotherapy in first- or second-line treatment of early-stage MF. In first-line, chlormethine gel monotherapy is prescribed for stage IA MF, and is particularly convenient for patients unable/unwilling to travel for hospital-based phototherapy, patients with thick plaques or palmoplantar involvement, when ultraviolet treatment is contraindicated, and for sanctuary sites. Chlormethine gel is also an appropriate first-line monotherapy for patients with stage IB or IIA MF; it may be used as part of combination regimens in these patients as well. For patients with late-stage MF, skin-directed treatments such as chlormethine gel should be combined with systemic therapies.</p><p><strong>Conclusions: </strong>Chlormethine gel is a safe and effective treatment option that can be used in all stages of MF, either as monotherapy or in combination, depending on disease stage and patient characteristics and needs.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"61-73"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Achievement of Demanding Outcomes in Upadacitinib-Treated Atopic Dermatitis Patients: A Real-World, 96-Week Single-Centre Study.","authors":"Stamatios Gregoriou, Ioannis-Alexios Koumprentziotis, Ileana Afroditi Kleidona, Michail Bakakis, Eleni Hatzidimitriou, Theodora Douvali, Aikaterini Tsiogka, Styliani Mastraftsi, Aristeidis Vaiopoulos, Alexander Stratigos","doi":"10.1007/s13555-024-01334-6","DOIUrl":"10.1007/s13555-024-01334-6","url":null,"abstract":"<p><strong>Introduction: </strong>Results from randomized controlled trials of upadacitinib, a Janus kinase (JAK) inhibitor, have led to its approval for the treatment of moderate-to-severe atopic dermatitis (AD) in patients aged ≥ 12 years. The aim of this study was to report the effectiveness and safety of upadacitinib in real-world settings over a period of 96 weeks.</p><p><strong>Methods: </strong>This retrospective study included all patients treated with upadacitinib at our centre between April 2022 and September 2024. Clinical and patient-reported outcomes were recorded and assessed at each follow-up visit and included the eczema area severity index (EASI), investigator global assessment (IGA), scoring atopic dermatitis (SCORAD), dermatology life quality index (DLQI) and the worst pruritus numerical scale score (WP-NRS). All drug-related adverse events (AEs) were documented.</p><p><strong>Results: </strong>In total, 36 patients (44.4% female) were retrospectively included. After 4 weeks of treatment, the mean EASI was reduced from 29.97 to 3.72 with 83.3/52.8/19.4% achieving EASI75/90/100 respectively. Similar reductions were observed in the DLQI, which was reduced from 20.78 to 2.92, and in the WP-NRS, from 7.78 to 1.31. Further improvements were observed at week 16, with a mean EASI of 0.75 and 96.4% of the patients achieving EASI75 and EASI90. At week 48 of treatment, EASI75/90/100 were achieved by 100/93.8/81.3% along with a mean DLQI and pruritus NRS of 0.81. All nine patients that reached the 72- and 96-week timepoints had clear skin with no pruritus. Six (16.7%) patients experienced AEs with four of them discontinuing medication; no patient discontinued because of upadacitinib inefficacy.</p><p><strong>Conclusion: </strong>This long-term real-world study of patients with moderate-to-severe AD receiving upadacitinib demonstrated that treatment success (EASI75/90/100) can be achieved in a high proportion of patients by week 16 and can be maintained for up to 96 weeks along with substantial improvements in pruritus and quality of life.</p>","PeriodicalId":11186,"journal":{"name":"Dermatology and Therapy","volume":" ","pages":"227-235"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11785836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}