Clinical and Experimental Dermatology

<jats:title>Abstract</jats:title>
               <jats:p>This nationwide population-based cohort study investigates the incidence of cutaneous malignancies associated with the concomitant treatment of cyclosporine (CsA) and narrowband UV-B phototherapy (NBUVB) in patients with vitiligo, using the Korean National Health Insurance Service database. The concomitant CsA and NBUVB therapy may not significantly increase the incidence of cutaneous malignancies. Given the chronic autoimmune nature of vitiligo and the economic burden it imposes, these findings provide novel insights into the potential safety of these combination regimens.</jats:p>

This nationwide population-based cohort study investigates the incidence of cutaneous malignancies associated with the concomitant treatment of cyclosporine (CsA) and narrowband UV-B phototherapy (NBUVB) in patients with vitiligo, using the Korean National Health Insurance Service database. The concomitant CsA and NBUVB therapy may not significantly increase the incidence of cutaneous malignancies. Given the chronic autoimmune nature of vitiligo and the economic burden it imposes, these findings provide novel insights into the potential safety of these combination regimens.

Incidence of cutaneous malignancy following the concomitant use of cyclosporine and narrowband UV-B phototherapy in patients with vitiligo.

Incidence of cutaneous malignancy following the concomitant use of cyclosporine and narrowband UV-B phototherapy in patients with vitiligo

American Journal of Clinical Dermatology

ArticleHistory

accepted

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EthicsHeading

Ethics

Sanofi

Regeneron Pharmaceuticals

Dermatol Reports.

Allergol Immunopathol (Madr)

Ann Allergy Asthma Immunol

Expert Rev Clin Immunol

J Allergy Clin Immunol

PNAS USA

Nat Rev Drug Discov

Allergy

Lancet

J Am Acad Dermatol

BMJ Open

Br J Dermatol

J Cutan Med Surg

Dermatitis

Dermatol Ther (Heidelb).

Dermatol Ther (Heidelb)

Acta Derm Venereol

JAMA Dermatol

Atopic dermatitis (AD), a chronic systemic disease, can cause intense skin itching and negatively impact sleep, mood, and quality of life (QoL) for patients and families.
PEDISTAD is an ongoing, 10-year, observational registry describing disease characteristics, atopic comorbidities, and treatment patterns in pediatric patients (aged <12 years at enrollment) with moderate-to-severe AD. This 3-year interim analysis evaluates clinician-reported and caregiver-reported/patient-reported outcomes (Eczema Area and Severity Index [EASI], percent body surface area affected, worst itching/scratching, Children's Dermatology Life Quality Index, and Dermatitis Family Impact) in children treated with dupilumab, methotrexate, and/or cyclosporine. Outcomes were assessed as change from therapy start to last observation (either data cutoff date or treatment discontinuation).
Mean (±SE) EASI scores at the time of the last 3-year interim observation were consistent with mild disease in the dupilumab cohort and moderate disease in the methotrexate and cyclosporine cohorts. Improvements in pruritus were numerically greater in the dupilumab cohort relative to the methotrexate and cyclosporine cohorts, while improvements in QoL were similar in the dupilumab and methotrexate cohorts, with no significant change in the cyclosporine cohort. Rates of AD exacerbation were numerically lower with dupilumab treatment relative to methotrexate treatment which were numerically lower than cyclosporine treatment. Dupilumab discontinuation rates were numerically lower relative to methotrexate which were numerically lower than cyclosporine.
This PEDISTAD 3-year interim analysis of dupilumab, methotrexate, and cyclosporine treatment in children with AD demonstrates numerically greater improvements in AD signs, symptoms and QoL with dupilumab treatment relative to methotrexate and cyclosporine [Video abstract and graphical abstract available].
NCT03687359. Supplementary file1 (MP4 58163 KB).
Atopic dermatitis (AD) is a chronic inflammatory skin disease, often diagnosed before 5 years of age. AD causes intense itching and negatively impacts the sleep, mood, and quality of life of affected children and their families. Children may be treated with skin creams and ointments, which are often not enough to treat all AD signs (extent and severity of disease assessed by a clinician) and symptoms (burden of disease reported by a patient and/or caregiver). The drug dupilumab is approved for use in children as young as 6 months with moderate-to-severe AD and has shown improvements in signs and symptoms in clinical trials (sponsored by Regeneron Pharmaceuticals Inc., and Sanofi). We compared the use of dupilumab, methotrexate, and cyclosporine in routine clinical practice in children under the age of 12 years with moderate-to-severe AD using 3-year data from the PEDISTAD study. Compared with children treated with methotrexate and cyclosporine, children treated with dupilumab had greater improvements in the extent and severity of their AD, as assessed by their doctor. Children treated with dupilumab also showed greater improvements in how they described the severity of their symptoms, such as daytime/nighttime itching, and their quality of life. Fewer children using dupilumab stopped treatment and fewer reported side effects compared with those using methotrexate and cyclosporine. In summary, dupilumab-treated children had greater improvements in AD signs, AD symptoms, and quality of life, were more likely to continue treatment, and had fewer reported side effects than those given cyclosporine and methotrexate.

Systemic Treatments in Moderate-to-Severe Atopic Dermatitis in Pediatric Patients up to 12 Years of Age: Real-World Treatment Outcomes from the PEDISTAD Registry.

Systemic Treatments in Moderate-to-Severe Atopic Dermatitis in Pediatric Patients up to 12 Years of Age: Real-World Treatment Outcomes from the PEDISTAD Registry

Journal of the American Academy of Dermatology

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American Academy of Dermatology

Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies

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New evidence has emerged since the 2014 guidelines that further informs the management of atopic dermatitis (AD) with topical therapies. These guidelines update the 2014 recommendations for management of AD with topical therapies.
To provide evidence-based recommendations related to management of AD in adults using topical treatments.
A multidisciplinary workgroup conducted a systematic review and applied the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach for assessing the certainty of evidence and formulating and grading recommendations.
The workgroup developed 12 recommendations on the management of AD in adults with topical therapies, including nonprescription agents and prescription topical corticosteroids (TCS), calcineurin inhibitors (TCIs), Janus kinase (JAK) inhibitors, phosphodiesterase-4 inhibitors (PDE-4), antimicrobials, and antihistamines.
The pragmatic decision to limit the literature review to English-language randomized trials may have excluded data published in other languages and relevant long-term follow-up data.
Strong recommendations are made for the use of moisturizers, TCIs, TCS, and topical PDE-4 and JAK inhibitors. Conditional recommendations are made for the use of bathing and wet wrap therapy and against the use of topical antimicrobials, antiseptics, and antihistamines.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies.

Guidelines of care for the management of atopic dermatitis in adults with topical therapies

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