American Journal of Clinical Dermatology最新文献

{"title":"Relationship of Histopathologic Parameters and Gene Expression Profiling in Malignant Melanoma","authors":"Alexis G. Strahan,&nbsp;Ivan Švagelj,&nbsp;Drazen Jukic","doi":"10.1007/s40257-023-00815-2","DOIUrl":"10.1007/s40257-023-00815-2","url":null,"abstract":"<div><h3>Background</h3><p>Histopathologic characteristics (HC) are a mainstay in melanoma prognosis; gene expression profiling (GEP) has emerged as a potential additional independent value.</p><h3>Objective</h3><p>To elucidate HC predictive of groups obtained via GEP of malignant melanoma.</p><h3>Methods</h3><p>A retrospective study analyzing HC of 265 melanomas submitted for GEP over the course of 8 years. GEP was conducted as a part of regular clinicopathologic workup through Castle Biosciences Decision Dx^®.</p><h3>Results</h3><p>Of the 265 cases, the major HC found to have an association with reported gene expression profiles were melanoma histology subtype, depth of invasion, and presence of ulcer.</p><h3>Limitations</h3><p>This study is limited by its cross-sectional nature. Causation and long-term related outcomes of the use of GEP versus American Joint Committee on Cancer histopathologic staging cannot be ascertained by this design.</p><h3>Conclusions</h3><p>An association, but no definitive prediction, exists between histopathologic categories of depth of invasion, melanoma subtype, and presence or absence of ulcer and gene expression profiles. GEP adds valuable data to the evaluation of malignant melanomas that cannot be definitively predicted by conventional models. The findings add to needed groundwork for comparison of traditional markers and molecular genotyping and begins to build a robust predictive model for better outcomes in patients with malignant melanoma.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 1","pages":"119 - 126"},"PeriodicalIF":8.6,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507776","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}

{"title":"Interpreting the Relationship Among Itch, Sleep, and Work Productivity in Patients with Moderate-to-Severe Atopic Dermatitis: A Post Hoc Analysis of JADE MONO-2","authors":"Gil Yosipovitch,&nbsp;Melinda J. Gooderham,&nbsp;Sonja Ständer,&nbsp;Luz Fonacier,&nbsp;Jacek C. Szepietowski,&nbsp;Mette Deleuran,&nbsp;Giampiero Girolomoni,&nbsp;John C. Su,&nbsp;Andrew G. Bushmakin,&nbsp;Joseph C. Cappelleri,&nbsp;Claire Feeney,&nbsp;Gary Chan,&nbsp;Andrew J. Thorpe,&nbsp;Hernan Valdez,&nbsp;Pinaki Biswas,&nbsp;Ricardo Rojo,&nbsp;Marco DiBonaventura,&nbsp;Daniela E. Myers","doi":"10.1007/s40257-023-00810-7","DOIUrl":"10.1007/s40257-023-00810-7","url":null,"abstract":"<div><h3>Background</h3><p>Abrocitinib, an oral, once-daily Janus kinase 1-selective inhibitor, improved itch severity, sleep, and work productivity versus placebo in patients with moderate-to-severe atopic dermatitis.</p><h3>Objective</h3><p>The aim of this study was to investigate relationships among itch, sleep, and work productivity in the phase III JADE MONO-2 clinical trial.</p><h3>Methods</h3><p>A repeated-measures longitudinal model was used to examine relationships between itch (using the Peak Pruritus Numerical Rating Scale [PP-NRS] or Nighttime Itch Scale [NTIS]) and sleep disturbance/loss (using the Patient-Oriented Eczema Measure sleep item and SCORing AD Sleep Loss Visual Analog Scale) and, separately, between itch and work productivity (using the Work Productivity and Activity Impairment-Atopic Dermatitis Version 2.0 questionnaire). Mediation modelling was used to investigate the effect of treatment (abrocitinib vs placebo) on work impairment via improvements in itch and sleep.</p><h3>Results</h3><p>The relationships between itch/sleep and itch/work productivity were approximately linear. PP-NRS scores of 0, 4–6, and 10 were associated with 0 days, 3–4 days, and 7 days per week of disturbed sleep, respectively. PP-NRS or NTIS scores of 0–1, 4–5, and 10 were associated with 0–10%, 20–30%, and &gt;50% overall work impairment, respectively. Seventy-five percent of the effect of abrocitinib on reducing work impairment was indirectly mediated by improvement in itch, followed by sleep.</p><h3>Conclusion</h3><p>These results quantitatively demonstrate that reducing itch severity is associated with improvements in sleep and work productivity. Empirical evidence for the mechanism of action of abrocitinib showed that itch severity is improved, which reduces sleep loss/sleep disruption and, in turn, improves work productivity.</p><h3>Clinical Trial Registration</h3><p>NCT03575871</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"25 1","pages":"127 - 138"},"PeriodicalIF":8.6,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10068521","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}

{"title":"Alopecia Areata: Current Treatments and New Directions","authors":"Dante Dahabreh,&nbsp;Seungyeon Jung,&nbsp;Yael Renert-Yuval,&nbsp;Jonathan Bar,&nbsp;Ester Del Duca,&nbsp;Emma Guttman-Yassky","doi":"10.1007/s40257-023-00808-1","DOIUrl":"10.1007/s40257-023-00808-1","url":null,"abstract":"<div><p>Alopecia areata is an autoimmune hair loss disease that is non-scarring and is characterized by chronic inflammation at the hair follicle level. Clinically, patients’ presentation varies from patchy, circumscribed scalp involvement to total body and scalp hair loss. Current management is guided by the degree of scalp and body involvement, with topical and intralesional steroid injections as primarily first-line for mild cases and broad immunosuppressants as the mainstay for more severe cases. Until recently, the limited number of blinded, randomized, placebo-controlled clinical trials for this disease had made establishing an evidence-based treatment paradigm challenging. However, growing insights into the pathogenesis of alopecia areata through blood and tissue analysis of human lesions have identified several promising targets for therapy. T-helper (Th) 1/interferon skewing has traditionally been described as the driver of disease; however, recent investigations suggest activation of additional immune mediators, including the Th2 pathway, interleukin (IL)-9, IL-23, and IL-32, as contributors to alopecia areata pathogenesis. The landscape of alopecia areata treatment has the potential to be transformed, as several novel targeted drugs are currently undergoing clinical trials. Given the recent US FDA approval of baricitinib and ritlecitinib, Janus kinase (JAK) inhibitors are a promising drug class for treating severe alopecia areata cases. This article will review the efficacy, safety, and tolerability of current treatments for alopecia areata, and will provide an overview of the emerging therapies that are leading the revolution in the management of this challenging disease.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"895 - 912"},"PeriodicalIF":7.3,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040552","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}

{"title":"The 25th World Congress of Dermatology, Singapore, 3–8 July, 2023: Research Highlights","authors":"Kathy A. Fraser","doi":"10.1007/s40257-023-00812-5","DOIUrl":"10.1007/s40257-023-00812-5","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 5","pages":"849 - 851"},"PeriodicalIF":7.3,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10434471","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}

{"title":"Correction to: Long-term Effectiveness and Safety of Upadacitinib for Atopic Dermatitis in a Real-world Setting: An Interim Analysis Through 48 Weeks of Observation","authors":"Andrea Chiricozzi,&nbsp;Michela Ortoncelli,&nbsp;Donatella Schena,&nbsp;Niccolò Gori,&nbsp;Silvia Mariel Ferrucci,&nbsp;Graziella Babino,&nbsp;Maddalena Napolitano,&nbsp;Maria Concetta Fargnoli,&nbsp;Luca Stingeni,&nbsp;Mariateresa Rossi,&nbsp;Marco Romanelli,&nbsp;Riccardo Balestri,&nbsp;Michele Pellegrino,&nbsp;Aurora Parodi,&nbsp;Alberto Maria Bertoldi,&nbsp;Giovanni Palazzo,&nbsp;Flaminia Antonelli,&nbsp;Annalisa Pitino,&nbsp;Giovanni Tripepi,&nbsp;Gabriella Fabbrocini,&nbsp;Anna Balato,&nbsp;Angelo Valerio Marzano,&nbsp;Giampiero Girolomoni,&nbsp;Simone Ribero,&nbsp;Ketty Peris","doi":"10.1007/s40257-023-00813-4","DOIUrl":"10.1007/s40257-023-00813-4","url":null,"abstract":"","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"963 - 964"},"PeriodicalIF":7.3,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/32/40257_2023_Article_813.PMC10570227.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10088405","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}

{"title":"Antifungal Resistance, Susceptibility Testing and Treatment of Recalcitrant Dermatophytosis Caused by Trichophyton indotineae: A North American Perspective on Management","authors":"Aditya K. Gupta,&nbsp;Shruthi Polla Ravi,&nbsp;Tong Wang,&nbsp;Elizabeth A. Cooper,&nbsp;Sara A. Lincoln,&nbsp;Hui-Chen Foreman,&nbsp;Wayne L. Bakotic","doi":"10.1007/s40257-023-00811-6","DOIUrl":"10.1007/s40257-023-00811-6","url":null,"abstract":"<div><p>There is an ongoing epidemic of chronic, relapsing dermatophytoses caused by <i>Trichophyton indotineae</i> that are unresponsive to one or multiple antifungal agents. Although this new species may have originated from the Indian subcontinent, there has been a notable increase of its reporting in other countries. Based on current literature, antifungal susceptibility testing (AFST) showed a large variation of terbinafine minimum inhibitory concentrations (MICs) (0.04 to ≥ 32 µg/ml). Elevated terbinafine MICs can be attributed to mutations in the squalene epoxidase gene (single mutations: Leu393Phe, Leu393Ser, Phe397Leu, and double mutations: Leu393Phe/Ala448Thr, Phe397Leu/Ala448Thr). Itraconazole MICs had a lower range when compared with that of terbinafine (0.008–16 µg/ml, with most MICs falling between 0.008 µg/ml and &lt; 1 µg/ml). The interpretation of AFST results remains challenging due to protocol variations and a lack of established breakpoints. Adoption of molecular methods for resistance detection, coupled with AFST, may provide a better evaluation of the in vitro resistance status of <i>T. indotineae</i>. There is limited information on treatment options for patients with confirmed <i>T. indotineae</i> infections by molecular diagnosis; preliminary evidence generated from case reports and case series points to itraconazole as an effective treatment modality, while terbinafine and griseofulvin are generally not effective. For physicians working outside of endemic regions, there is currently an unmet need for standardized clinical trials to establish treatment guidelines; in particular, combination therapy of oral and topical agents (e.g., itraconazole and ciclopirox), as well as with other azoles (i.e., fluconazole, voriconazole, ketoconazole), warrants further investigation as multidrug resistance is a possibility for <i>T. indotineae</i>.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"927 - 938"},"PeriodicalIF":7.3,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9957424","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}

{"title":"Comorbid Conditions Associated with Alopecia Areata: A Systematic Review and Meta-analysis","authors":"Sophia Ly,&nbsp;Priya Manjaly,&nbsp;Kanika Kamal,&nbsp;Ali Shields,&nbsp;Bruna Wafae,&nbsp;Najiba Afzal,&nbsp;Lara Drake,&nbsp;Katherine Sanchez,&nbsp;Samantha Gregoire,&nbsp;Guohai Zhou,&nbsp;Carol Mita,&nbsp;Arash Mostaghimi","doi":"10.1007/s40257-023-00805-4","DOIUrl":"10.1007/s40257-023-00805-4","url":null,"abstract":"<div><h3>Background</h3><p>Alopecia areata (AA) is a complex autoimmune condition resulting in nonscarring hair loss. In recent years, many studies have provided new evidence on comorbid diseases present in patients with AA. However, some studies have conflicting results, and analyses conducting a comprehensive approach are lacking.</p><h3>Objective</h3><p>The aim of our study was to provide an updated systematic review and meta-analysis of medical comorbidities associated with AA.</p><h3>Methods</h3><p>We searched PubMed, Embase, and Web of Science for case-control, cross-sectional, and cohort studies investigating medical comorbidities in AA published from inception through 1 February 2023.</p><h3>Results</h3><p>We screened 3428 abstracts and titles and reviewed 345 full text articles for eligibility. Ultimately, 102 studies were analyzed, comprising 680,823 patients with AA and 72,011,041 healthy controls. Almost all included studies (100 of 102 studies) were of satisfactory to high quality (Newcastle–Ottawa scale score ≥ 4). Among patients with AA, comorbidities with the highest odds ratios (OR) compared with healthy controls and data available from more than one study included vitamin D deficiency (OR 10.13, 95% CI 4.24–24.20), systemic lupus erythematous (OR 5.53, 95% CI 3.31–9.23), vitiligo (OR 5.30, 95% CI 1.86–15.10), metabolic syndrome (OR 5.03, 95% CI 4.18–6.06), and Hashimoto’s thyroiditis (OR 4.31, 95% CI 2.51–7.40). AA may be a protective factor for certain disorders, for which the AA group had lower odds compared with healthy controls, such as irritable bowel syndrome (OR 0.38, 95% CI 0.14–0.99) and colorectal cancer (OR 0.61, 95% CI 0.42–0.89).</p><h3>Conclusion</h3><p>These findings corroborate and contextualize the risks across comorbidities for patients with AA. Further work should be done to identify the underlying pathophysiology and understand appropriate screening criteria.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"875 - 893"},"PeriodicalIF":7.3,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10190060","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}

{"title":"Diagnosis and Management of Dermatologic Adverse Events from Systemic Melanoma Therapies","authors":"Christopher J. Fay,&nbsp;Samantha Jakuboski,&nbsp;Beth Mclellan,&nbsp;Blair S. Allais,&nbsp;Yevgeniy Semenov,&nbsp;Cecilia A. Larocca,&nbsp;Nicole R. LeBoeuf","doi":"10.1007/s40257-023-00790-8","DOIUrl":"10.1007/s40257-023-00790-8","url":null,"abstract":"<div><p>The advent of protein kinase inhibitors and immunotherapy has profoundly improved the management of advanced melanoma. However, with these therapeutic advancements also come drug-related toxicities that have the potential to affect various organ systems. We review dermatologic adverse events from targeted (including BRAF and MEK inhibitor-related) and less commonly used melanoma treatments, with a focus on diagnosis and management. As immunotherapy-related toxicities have been extensively reviewed, herein, we discuss injectable talimogene laherparepvec and touch on recent breakthroughs in the immunotherapy space. Dermatologic adverse events may severely impact quality of life and are associated with response and survival. It is therefore essential that clinicians are aware of their diverse presentations and management strategies.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 5","pages":"765 - 785"},"PeriodicalIF":7.3,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10187756","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}

{"title":"Characteristics and Burdens of Disease in Patients from Beijing with Generalized Pustular Psoriasis and Palmoplantar Pustulosis: Multicenter Retrospective Cohort Study Using a Regional Database","authors":"Hai-Meng Wang,&nbsp;Jia-Ming Xu,&nbsp;Hong-Zhong Jin","doi":"10.1007/s40257-023-00807-2","DOIUrl":"10.1007/s40257-023-00807-2","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Objective&lt;/h3&gt;&lt;p&gt;Pustular psoriasis is a chronic and recurrent autoimmune disease, although little is known about the disease burden of pustular psoriasis in China. We analyzed the characteristics and disease burdens of patients from Beijing who had generalized pustular psoriasis (GPP) or palmoplantar pustulosis (PPP).&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This multicenter retrospective cohort study used a regional electronic health database that covered 30 public hospitals in Beijing. From June 2016 to June 2021, all patients with a diagnosis of GPP, PPP, or psoriasis vulgaris (PV) were identified by International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes. The GPP and PPP cohorts were separately matched with patients with PV in a 3:1 ratio for comparisons. Demographic data, clinical characteristics, healthcare resource utilization, and costs were collected. Descriptive and comparative analyses were used to compare the cohorts.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;There were 744 patients with GPP (46.8% men; age 42.14 ± 21.47 years) and 4808 patients with PPP (35.5% men; age 51.65 ± 16.12 years); 14.5% of patients with GPP had concomitant PV and 7.5% of patients with PPP had concomitant PV. Relative to matched patients with PV, patients with GPP had a higher prevalence of erythrodermic psoriasis (5.9% vs 0.4%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), psoriatic arthritis (3.1% vs 1.5%, &lt;i&gt;p&lt;/i&gt; = 0.007), and organ failure (1.1% vs 0.2%, &lt;i&gt;p&lt;/i&gt; = 0.002). Relative to matched patients with PV, patients with PPP had a higher prevalence of cerebrovascular disease (4.7% vs 1.2%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), thyroid dysfunction (3.9% vs 3.3%, &lt;i&gt;p&lt;/i&gt; = 0.035), and type 2 diabetes mellitus (6.8% vs 5.9%, &lt;i&gt;p&lt;/i&gt; = 0.030). More patients with GPP than patients with PV received systemic non-biological agents (27.9% vs 3.3%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and biologic agents (4.8% vs 2.0%, &lt;i&gt;p&lt;/i&gt; = 0.010). More patients with PPP than patients with PV received topical agents (50.9% vs 34.7%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and systemic non-biological agents (17.8% vs 2.7%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). More patients with GPP than patients with PV required inpatient hospitalization (22.0% vs 7.8%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Hospitalization stay was longer in patients with GPP than patients with PV (11.72 ± 0.45 vs 10.38 ± 0.45 days, &lt;i&gt;p&lt;/i&gt; = 0.022). More patients with PPP than patients with PV had emergency visits (16.3% vs 12.8%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). The GPP and PPP cohorts and their matched PV cohorts had no significant differences in costs. However, patients with PPP had lower outpatient costs than patients with PV (368.20 ± 8.19 vs 445.38 ± 5.90 Chinese Yuan per patient per month, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001).&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Patients from Beijing with GPP and PPP had higher disease burdens than matched PV cohorts, including the prevalence of comorbidities, healthcare resource utilization, and medication burden. However, the economic burden of pustular psoria","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"991 - 1002"},"PeriodicalIF":7.3,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699138","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}

{"title":"Disease Burden and Treatment Patterns Among US Patients with Hidradenitis Suppurativa: A Retrospective Cohort Study","authors":"Amit Garg,&nbsp;Yvonne Geissbühler,&nbsp;Emma Houchen,&nbsp;Nilesh Choudhary,&nbsp;Disha Arora,&nbsp;Varun Vellanki,&nbsp;Abhishek Srivastava,&nbsp; Priyanka,&nbsp;John Darcy II,&nbsp;Craig Richardson,&nbsp;Alexa B. Kimball","doi":"10.1007/s40257-023-00796-2","DOIUrl":"10.1007/s40257-023-00796-2","url":null,"abstract":"<div><h3>Introduction</h3><p>Hidradenitis suppurativa (HS) is a chronic, autoinflammatory skin disease associated with many comorbidities. One biologic (adalimumab) is approved for HS. This study assessed the sociodemographic characteristics, comorbidities, treatment patterns, healthcare resource utilization (HCRU) and associated costs of patients with HS following biologic approval.</p><h3>Methods</h3><p>This non-interventional, retrospective cohort study involved adult (≥ 18 years) and adolescent (12–17 years) patients diagnosed with HS in the United States (US) using Optum’s de-identified Clinformatics^® Data Mart Database during the period 1 January 2016 to 31 December 2018.</p><h3>Results</h3><p>Of 42,843 identified patients, 10,909 met the incident HS patient criteria (10,230 adults, 628 adolescents, 51 patients aged &lt;12 years). Patients were mostly diagnosed by a general practitioner/pediatrician (adults: 41.6%; adolescents: 39.6%) or dermatologist (adults: 22.1%; adolescents: 30.6%). Commonly reported Charlson comorbidities at pre-index in adult patients were diabetes without complications (20.4%), chronic pulmonary disease (16.4%) and diabetes with complications (9.0%), and the most frequent Elixhauser comorbidities were uncomplicated hypertension (38.3%), obesity (22.5%), uncomplicated diabetes (19.0%) and depression (17.4%). The burden of comorbidities generally increased over time after diagnosis in both adults and adolescents. HS-related surgical procedures were uncommon in the 2-years post-index period: an incision and drainage procedure was reported in 7.6% of adults and 6.4% of adolescents. Patients were predominantly treated with both topical and systemic antibiotic treatments (adults: 25.0% and 65.1%, respectively; adolescents: 41.7% and 74.5%, respectively). Biologic prescription was higher in adults than adolescents (3.5% vs. 1.8%). Total healthcare costs for adult and adolescent patients in the 2-years post-index period were US$42,143 and US$16,057, respectively, with outpatient costs accounting for the majority of these costs (US$20,980 and US$8408, respectively).</p><h3>Conclusion</h3><p>In adult and adolescent patients with HS, comorbidity burden continues to increase after diagnosis. All-cause and HS-specific HCRU and costs are high in adults and adolescents with HS. These findings support the need for a multidisciplinary comprehensive care strategy for patients with HS.</p></div>","PeriodicalId":7706,"journal":{"name":"American Journal of Clinical Dermatology","volume":"24 6","pages":"977 - 990"},"PeriodicalIF":7.3,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/f0/40257_2023_Article_796.PMC10570206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9692623","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}