2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T782,Chronic obstructive pulmonary disease (COPD) is a leading cause of hospitalization and death, particularly among patients with chronic bronchitis and frequent exacerbations. Results of placebo-controlled clinical trials indicate that treatment escalation with either long-term oral roflumilast or azithromycin can reduce COPD exacerbations. However, head-to-head comparative data from clinical trials are lacking, so the relative harms and benefits of these treatments are unclear. The RELIANCE (RofLumilast or Azithromycin to preveNt COPD Exacerbations) study is an investigator-initiated, multicenter, randomized, pragmatic clinical trial embedded in clinical practice to evaluate the effectiveness of treatment escalation with long-term azithromycin versus roflumilast in patients with COPD and chronic bronchitis. We solicited preferences from patients, clinicians, and other stakeholders during the design and implementation phases of the study, including feedback that informed modifications related to the COVID-19 pandemic. Eligibility criteria did not require assessments outside of clinical practice, with exclusions principally for safety. The composite endpoint of first all-cause hospitalization or death served as the primary outcome. Enrollment was initially through university-affiliated Clinical Centers but was subsequently expanded to recruit patients in community-based practices who might not otherwise participate in research. We employed human-centered design principles to improve the usability of study activities from the perspective of participants, study staff, and treating clinicians. The final study design offered the option for patients with COPD and chronic bronchitis at high-risk of hospitalization or death to be remotely consented, prescribed a medication according to the randomized treatment allocation, and complete virtual follow-up study visits in a decentralized clinical trial.31:T926,Current topical treatments for scalp psoriasis are limited by formulation, efficacy, and/or safety. To assess safety and efficacy of roflumilast foam, 0.3%, in patients with psoriasis of the scalp and body. This was a phase 3 double-blinded, vehicle-controlled randomized clinical trial conducted between August 24, 2021, and June 3, 2022, at 49 sites in Canada and the US. Eligible participants were 12 years and older with plaque psoriasis affecting up to 25% of the scalp and body, at least 10% of the scalp, and up to 20% of nonscalp areas, with a minimum Scalp-Investigator Global Assessment (S-IGA) score of 3 (moderate), and minimum Body-IGA (B-IGA) score of 2 (mild). Data analyses were performed from September 9 to December 30, 2022. Once-daily roflumilast foam, 0.3%, or vehicle for 8 weeks. Coprimary end points were S-IGA and B-IGA success (clear [0] or almost clear [1] plus ≥2-grade improvement) at week 8. Secondary end points included S-IGA success at weeks 2 and 4, change in Scalp Itch-Numeric Rating Scale (SI-NRS), and SI-NRS and Worst Itch-NRS (WI-NRS) success (≥4-point improvement in patients with baseline score of ≥4). Safety and tolerability were also assessed. A total of 432 patients (mean [SD] age, 47.3 [14.8] years; 243 women [56.3%]) were randomized to roflumilast foam (n = 281) or vehicle (n = 151). At week 8, 66.4% of the roflumilast group achieved S-IGA success vs 27.8% of the vehicle group (P < .001); and 45.5% of the roflumilast group achieved B-IGA success compared with 20.1% of the vehicle group (P < .001). Rates for S-IGA success at week 2 and SI-NRS and WI-NRS success at weeks 2, 4, and 8 were significantly higher for roflumilast vs vehicle. Improvements in SI-NRS were greater for the roflumilast vs the vehicle group as early as the first assessment (24 hours after the first application). Both study groups had low rates of adverse events and favorable tolerability profiles. This randomized clinical trial found that roflumilast foam, 0.3%, improved signs and symptoms of psoriasis on the scalp and body, including pruritus, with low rates of adverse events in patients 12 years and older. These results demonstrate the potential of roflumilast foam, 0.3%, as monotherapy for patients with psoriasis of the scalp and body. ClinicalTrials.gov Identifier: NCT05028582.32:Tc8f,ImportanceCurrent topical treatments for scalp psoriasis are limited by formulation, efficacy, and/or safety.ObjectiveTo assess safety and efficacy of roflumilast foam, 0.3%, in patients with psoriasis of the scalp and body.Design, Setting, and ParticipantsThis was a phase 3 double-blinded, vehicle-controlled randomized clinical trial conducted between August 24, 2021, and June 3, 2022, at 49 sites in Canada and the US. Eligible participants were 12 years and older with plaque psoriasis affecting up to 25% of the scalp and body, at least 10% of the scalp, and up to 20% of nonscalp areas, with a minimum Scalp−Investigator Global Assessment (S-IGA) score of 3 (moderate), and minimum Body−IGA (B-IGA) score of 2 (mild). Data analyses were performed from September 9 to December 30, 2022.InterventionsOnce-daily roflumilast foam, 0.3%, or vehicle for 8 weeks.Main Outcomes and MeasuresCoprimary end points were S-IGA and B-IGA success (clear [0] or almost clear [1] plus ≥2-grade improvement) at week 8. Secondary end points included S-IGA success at weeks 2 and 4, change in Scalp Itch−Numeric Rating Scale (SI-NRS), and SI-NRS and Worst Itch−NRS (WI-NRS) success (≥4-point improvement in patients with baseline score of ≥4). Safety and tolerability were also assessed.ResultsA total of 432 patients (mean [SD] age, 47.3 [14.8] years; 243 women [56.3%]) were randomized to roflumilast foam (n = 281) or vehicle (n = 151). At week 8, 66.4% of the roflumilast group achieved S-IGA success vs 27.8% of the vehicle group (P &lt; .001); and 45.5% of the roflumilast group achieved B-IGA success compared with 20.1% of the vehicle group (P &lt; .001). Rates for S-IGA success at week 2 and SI-NRS and WI-NRS success at weeks 2, 4, and 8 were significantly higher for roflumilast vs vehicle. Improvements in SI-NRS were greater for the roflumilast vs the vehicle group as early as the first assessment (24 hours after the first application). Both study groups had low rates of adverse events and favorable tolerability profiles.Conclusions and RelevanceThis randomized clinical trial found that roflumilast foam, 0.3%, improved signs and symptoms of psoriasis on the scalp and body, including pruritus, with low rates of adverse events in patients 12 years and older. These results demonstrate the potential of roflumilast foam, 0.3%, as monotherapy for patients with psoriasis of the scalp and body.Trial RegistrationClinicalTrials.gov Identifier: NCT0502858233:T43f,A total of 122 308 patients with CISDs (median [IQR] age, 49 [38-58] years; 63 663 [52.1%] male) starting systemic immunomodulatory treatment in the US were included. Treatment for patients with CISDs comprised methotrexate (28 684), tumor necrosis factor α inhibitors (40 965), ustekinumab (12 841), IL-23i (6116), IL-17Ai (9799), dupilumab (7787), or apremilast (16 116). Complete blood cell count was the most common test, performed in 41% (3161/7787) to 69% (19 659/28 684) of individuals before initiation across treatments. Between 11% (889/7787) and 59% (3613/6116) of patients had tuberculosis screening within 6 months before treatment, and 3% (149/4577) to 26% (1559/6097) had updated tests 1 year later. Between 13% (1006/7787) and 41% (16 728/40 965) had hepatitis panels before treatment. Low pretreatment testing levels before apremilast (15% [2331/16 116] to 45% [7253/16 116]) persisted a year into treatment (9% [816/8496] to 36% [2999/8496]) and were similar to dupilumab (11% [850/7787] to 41% [3161/7787] vs 3% [149/4577] to 25% [1160/4577]).34:T98b,Laboratory testing for the presence of tuberculosis, hepatitis, and other conditions before starting most systemic immunomodulatory agents is recommended in patients with chronic inflammatory skin diseases (CISD) but current testing patterns in the US are unclear. To determine the prevalence of pretreatment testing that is recommended for patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis). This descriptive analysis of US commercial insurance claims databases from December 31, 2002, to December 31, 2020, included adult patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis) who started an immunomodulatory agent, including methotrexate, tumor necrosis factor α inhibitors, interleukin (IL)-17Ai, ustekinumab, IL-23i, dupilumab, or apremilast. The proportion of patients who underwent the screening tests as suggested by professional societies-including for tuberculosis, hepatitis, and liver function; complete blood cell counts; and lipid panels-were determined within 6 months before and during 2 years after treatment start. A total of 122 308 patients with CISDs (median [IQR] age, 49 [38-58] years; 63 663 [52.1%] male) starting systemic immunomodulatory treatment in the US were included. Treatment for patients with CISDs comprised methotrexate (28 684), tumor necrosis factor α inhibitors (40 965), ustekinumab (12 841), IL-23i (6116), IL-17Ai (9799), dupilumab (7787), or apremilast (16 116). Complete blood cell count was the most common test, performed in 41% (3161/7787) to 69% (19 659/28 684) of individuals before initiation across treatments. Between 11% (889/7787) and 59% (3613/6116) of patients had tuberculosis screening within 6 months before treatment, and 3% (149/4577) to 26% (1559/6097) had updated tests 1 year later. Between 13% (1006/7787) and 41% (16 728/40 965) had hepatitis panels before treatment. Low pretreatment testing levels before apremilast (15% [2331/16 116] to 45% [7253/16 116]) persisted a year into treatment (9% [816/8496] to 36% [2999/8496]) and were similar to dupilumab (11% [850/7787] to 41% [3161/7787] vs 3% [149/4577] to 25% [1160/4577]). In this descriptive analysis of patients with CISDs starting systemic immunomodulatory treatment in the US, less than 60% received the recommended pretreatment testing. Additional research is required to understand whether variations in testing affect patient outcomes.35:Tbec,ImportanceLaboratory testing for the presence of tuberculosis, hepatitis, and other conditions before starting most systemic immunomodulatory agents is recommended in patients with chronic inflammatory skin diseases (CISD) but current testing patterns in the US are unclear.ObjectiveTo determine the prevalence of pretreatment testing that is recommended for patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis).Design, Setting, and ParticipantsThis descriptive analysis of US commercial insurance claims databases from December 31, 2002, to December 31, 2020, included adult patients with CISD (psoriasis, hidradenitis suppurativa, or atopic dermatitis) who started an immunomodulatory agent, including methotrexate, tumor necrosis factor α inhibitors, interleukin (IL)–17Ai, ustekinumab, IL-23i, dupilumab, or apremilast.Main Outcomes and MeasuresThe proportion of patients who underwent the screening tests as suggested by professional societies—including for tuberculosis, hepatitis, and liver function; complete blood cell counts; and lipid panels—were determined within 6 months before and during 2 years after treatment start.ResultsA total of 122 308 patients with CISDs (median [IQR] age, 49 [38-58] years; 63 663 [52.1%] male) starting systemic immunomodulatory treatment in the US were included. Treatment for patients with CISDs comprised methotrexate (28 684), tumor necrosis factor α inhibitors (40 965), ustekinumab (12 841), IL-23i (6116), IL-17Ai (9799), dupilumab (7787), or apremilast (16 116). Complete blood cell count was the most common test, performed in 41% (3161/7787) to 69% (19 659/28 684) of individuals before initiation across treatments. Between 11% (889/7787) and 59% (3613/6116) of patients had tuberculosis screening within 6 months before treatment, and 3% (149/4577) to 26% (1559/6097) had updated tests 1 year later. Between 13% (1006/7787) and 41% (16 728/40 965) had hepatitis panels before treatment. Low pretreatment testing levels before apremilast (15% [2331/16 116] to 45% [7253/16 116]) persisted a year into treatment (9% [816/8496] to 36% [2999/8496]) and were similar to dupilumab (11% [850/7787] to 41% [3161/7787] vs 3% [149/4577] to 25% [1160/4577]).Conclusions and RelevanceIn this descriptive analysis of patients with CISDs starting systemic immunomodulatory treatment in the US, less than 60% received the recommended pretreatment testing. Additional research is required to understand whether variations in testing affect patient outcomes.36:T54d,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.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"PDE-4 Inhibitor: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on PDE-4 Inhibitor (modality). Clinician-written summaries and actionable practice insights. 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A.","family":"Sugar","sequence":"additional","affiliation":[]},{"given":"Richard","family":"Albert","sequence":"additional","affiliation":[]},{"given":"Steve","family":"Rennard","sequence":"additional","affiliation":[]},{"given":"Nina","family":"Bracken","sequence":"additional","affiliation":[]},{"given":"Jiaxian","family":"He","sequence":"additional","affiliation":[]},{"given":"Marie","family":"Bradley","sequence":"additional","affiliation":[]},{"given":"Kevin","family":"Coughlin","sequence":"additional","affiliation":[]},{"given":"Candace C.","family":"Fuller","sequence":"additional","affiliation":[]},{"given":"Bradley","family":"Hammill","sequence":"additional","affiliation":[]},{"given":"Elisha","family":"Malanga","sequence":"additional","affiliation":[]},{"given":"Vincent M.","family":"Malanga","sequence":"additional","affiliation":[]},{"given":"David","family":"Mannino","sequence":"additional","affiliation":[]},{"given":"Richard A.","family":"Mularski","sequence":"additional","affiliation":[]},{"given":"Hugh","family":"Musick","sequence":"additional","affiliation":[]},{"given":"Jean","family":"Rommes","sequence":"additional","affiliation":[]},{"given":"Julie","family":"DeLisa","sequence":"additional","affiliation":[]},{"given":"Sengwee","family":"Toh","sequence":"additional","affiliation":[]},{"given":"Robert A.","family":"Wise","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026]]},"member":"6002","prefix":"10.15326","source":"Crossref","volume":null,"created":{"date-time":"2026-01-05T14:42:45Z","timestamp":1767624165000,"date-parts":[[2026,1,5]]},"indexed":{"date-time":"2026-01-05T18:30:00Z","timestamp":1767637800215,"date-parts":[[2026,1,5]]},"subject":[],"abstract":null,"relation":{},"resource":{"primary":{"URL":"https://journal.copdfoundation.org/Portals/0/JCOPDF/InPress/JCOPDF-2025-0669-InPress.pdf"}},"subtitle":[],"deposited":{"date-time":"2026-01-05T14:42:46Z","timestamp":1767624166000,"date-parts":[[2026,1,5]]},"issn-type":[{"type":"electronic","value":"2372-952X"}],"published":{"date-parts":[[2026]]},"publisher":"COPD Foundation","reference":null,"short-title":[],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026]]},"references-count":0,"short-container-title":["J COPD F"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.15326/jcopdf.2025.0669","is_oa":true,"title":"Rationale and Design of the Roflumilast or Azithromycin to Prevent COPD Exacerbations Clinical Trial","updated":"2026-01-10T04:46:20+00:00","published_date":"2026-01-01","best_oa_location":{"url":"https://doi.org/10.15326/jcopdf.2025.0669","pmh_id":null,"url_for_pdf":"https://doi.org/10.15326/jcopdf.2025.0669","url_for_landing_page":"https://doi.org/10.15326/jcopdf.2025.0669"}}},"created_at":"2026-01-14T18:30:49.575Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"condition","value":"Chronic Bronchitis","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"condition","value":"Chronic Obstructive Pulmonary Disease","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"generic","value":"azithromycin","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"generic","value":"roflumilast","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"modality","value":"Macrolide Antibiotic","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"modality","value":"PDE-4 Inhibitor","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"warning","value":"Abstract does not provide sample size or results.","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"warning","value":"Design classified as a pragmatic randomized controlled trial embedded in clinical practice.","value_numeric":null},{"paper_doi":"10.15326/jcopdf.2025.0669","tag_type":"warning","value":"Rationale/design article; no outcome data are reported.","value_numeric":null}],"summaries":{"what_studied":"A multicenter, randomized, pragmatic clinical trial embedded in routine care to compare long-term azithromycin versus roflumilast as treatment escalation for patients with COPD and chronic bronchitis at high risk of hospitalization or death. The primary outcome is time to first all-cause hospitalization or death; the design supports remote consent, prescribing per randomization, and virtual follow-up."}},{"doi":"10.1001/jamadermatol.2025.3986","pmid":"41160034","title":"Topical Anti-Inflammatory Treatments for Atopic Dermatitis","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-10-29T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.3986","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-10-30","doi":"10.1001/jamadermatol.2025.3986","days":"14","issn":"2168-6068","rank":"9","field":"Clinical Medicine","score":"7","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.3986","title":"Topical Anti-Inflammatory Treatments for Atopic Dermatitis.","journal":"JAMA dermatology","methods":"","results":"","abstract":"Which topical anti-inflammatory treatments are most effective and safe for managing atopic dermatitis?\nIn a network meta-analyses, very potent/potent topical corticosteroids; tacrolimus, 0.1%; and topical Janus kinase inhibitors were among the most effective treatments for short-term control of atopic dermatitis symptoms, while phosphodiesterase-4 inhibitors were among the least effective. Topical calcineurin inhibitors and crisaborole were associated with application-site irritation, and short-term topical steroid use was not associated with skin thinning. However, these findings were of low to moderate certainty, and longer-term data remain limited for many agents.","keywords":[],"pubmed_id":"41160034","conclusions":"","publication_date":"2025-10-29T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2025.3986","URL":"https://doi.org/10.1001/jamadermatol.2025.3986","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2840443/jamadermatology_zhang_2025_es_250001_1760625854.48381.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Topical Anti-Inflammatory Treatments for Atopic Dermatitis"],"author":[{"given":"Rachel","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"University of Arizona Phoenix School of Medicine, Phoenix"}]},{"given":"Joy","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}]}],"issued":{"date-parts":[[2025,10,29]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":null,"created":{"date-time":"2025-10-29T15:34:15Z","timestamp":1761752055000,"date-parts":[[2025,10,29]]},"indexed":{"date-time":"2025-10-29T15:38:55Z","timestamp":1761752335900,"date-parts":[[2025,10,29]]},"subject":[],"abstract":"\n Clinical Question\n Which topical anti-inflammatory treatments are most effective and safe for managing atopic dermatitis?\n \n \n Bottom Line\n In a network meta-analyses, very potent/potent topical corticosteroids; tacrolimus, 0.1%; and topical Janus kinase inhibitors were among the most effective treatments for short-term control of atopic dermatitis symptoms, while phosphodiesterase-4 inhibitors were among the least effective. Topical calcineurin inhibitors and crisaborole were associated with application-site irritation, and short-term topical steroid use was not associated with skin thinning. 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longer‑term outcomes remain unclear.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.3986","tag_type":"warning","value":"Short‑term timeframe was not specified and no absolute effect sizes or sample size were provided in the abstract.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.3986","tag_type":"warning","value":"The abstract references “network meta-analyses,” suggesting multiple analyses; details of included studies and comparators were not provided.","value_numeric":null}],"summaries":{"what_studied":"A network meta-analysis compared short‑term effectiveness and safety of topical anti‑inflammatory treatments for atopic dermatitis, including very potent/potent topical corticosteroids, tacrolimus 0.1%, topical JAK inhibitors, and PDE‑4 inhibitors (e.g., crisaborole).","key_result":"Very potent/potent steroids, tacrolimus 0.1%, and topical JAK inhibitors were among the most effective for short‑term symptom control; PDE‑4 inhibitors were among the least effective. Calcineurin inhibitors and crisaborole were associated with application‑site irritation, and short‑term steroid use was not associated with skin thinning.","limitations":"Certainty of the evidence was low to moderate. Longer‑term data were limited for many agents.","practice_takeaway":"For short‑term control of atopic dermatitis, consider very potent/potent topical steroids, tacrolimus 0.1%, or topical JAK inhibitors ahead of PDE‑4 inhibitors, and counsel about application‑site irritation with calcineurin inhibitors/crisaborole. Short courses of topical steroids did not show skin thinning in the included data."}},{"doi":"10.1001/jamadermatol.2025.1136","pmid":"40332898","title":"Roflumilast Foam, 0.3%, for Psoriasis of the Scalp and Body","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-05-07T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.1136","source_score":75,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-05-18","doi":"10.1001/jamadermatol.2025.1136","days":"30","issn":"2168-6068","rank":"4","field":"Clinical Medicine","score":"75","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.1136","title":"Roflumilast Foam, 0.3%, for Psoriasis of the Scalp and Body: The ARRECTOR Phase 3 Randomized Clinical Trial.","journal":"JAMA dermatology","methods":"","results":"A total of 432 patients (mean [SD] age, 47.3 [14.8] years; 243 women [56.3%]) were randomized to roflumilast foam (n = 281) or vehicle (n = 151). At week 8, 66.4% of the roflumilast group achieved S-IGA success vs 27.8% of the vehicle group (P < .001); and 45.5% of the roflumilast group achieved B-IGA success compared with 20.1% of the vehicle group (P < .001). Rates for S-IGA success at week 2 and SI-NRS and WI-NRS success at weeks 2, 4, and 8 were significantly higher for roflumilast vs vehicle. Improvements in SI-NRS were greater for the roflumilast vs the vehicle group as early as the first assessment (24 hours after the first application). 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trial at 49 sites (Canada/US) tested once-daily roflumilast foam 0.3% vs vehicle for 8 weeks in patients ≥12 years with plaque psoriasis of the scalp (≥10% involvement) and limited body involvement (≤20%). Coprimary outcomes were S-IGA and B-IGA success (clear/almost clear plus ≥2-grade improvement) at week 8.","key_result":"At week 8, S-IGA success was 66.4% with roflumilast vs 27.8% with vehicle, and B-IGA success was 45.5% vs 20.1% (both P<.001). Itch improvements favored roflumilast as early as 24 hours and at weeks 2, 4, and 8, with low adverse event rates reported in both groups.","limitations":"- Eight-week duration; durability of response and longer-term safety are not reported.\n- Enrollment required scalp involvement ≥10% and non-scalp involvement ≤20% with at most mild body disease, limiting generalizability to more extensive or severe psoriasis.","practice_takeaway":"Once-daily roflumilast foam 0.3% outperformed vehicle for scalp and limited body psoriasis over 8 weeks and reduced itch early, with low adverse event rates. 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Screening was measured within 6 months before and up to 2 years after treatment start.","key_result":"Before initiation, CBC testing occurred in 41% (3161/7787) to 69% (19,659/28,684); TB screening in 11% (889/7787) to 59% (3613/6116), with 1‑year retesting in 3% (149/4577) to 26% (1559/6097); hepatitis panels in 13% (1006/7787) to 41% (16,728/40,965). Apremilast and dupilumab showed low pretreatment testing (apremilast 15% [2331/16,116] to 45% [7253/16,116]; dupilumab 11% [850/7787] to 41% [3161/7787]) that persisted at 1 year (apremilast 9% [816/8496] to 36% [2999/8496]; dupilumab 3% [149/4577] to 25% [1160/4577]).","practice_takeaway":"Fewer than 60% of patients starting systemic immunomodulators received recommended baseline tests. 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They assessed nonprescription agents and prescription TCS, TCIs, topical JAK and PDE‑4 inhibitors, antimicrobials, and antihistamines.","key_result":"They issued 12 recommendations: strong for moisturizers, TCS, TCIs, and topical PDE‑4 and JAK inhibitors; conditional for bathing and wet wrap therapy; and conditional against topical antimicrobials, antiseptics, and antihistamines.","limitations":"The review was limited to English‑language randomized trials, which may exclude studies in other languages and long‑term follow‑up data.","practice_takeaway":"For adults with AD, prioritize moisturizers and appropriate TCS or TCIs, with topical PDE‑4 or JAK inhibitors as options. Use bathing and wet wraps selectively, and avoid topical antimicrobials, antiseptics, and antihistamines."}},{"doi":"10.1016/j.jaad.2022.08.068","pmid":"36623556","title":"Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies","journal_title":"Journal of the American Academy of Dermatology","journal_issn":"0190-9622","published_at":"2023-01-10T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaad.2022.08.068","source_score":354,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2023-02-03","doi":"10.1016/j.jaad.2022.08.068","days":"30","issn":"0190-9622","rank":"2","field":"Clinical Medicine","score":"354","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1016/j.jaad.2022.08.068","title":"Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies.","journal":"Journal of the American Academy of Dermatology","methods":"","results":"","abstract":"These guidelines update the 2014 recommendations for management of atopic dermatitis in adults with topical therapies. A multidisciplinary workgroup employed best practices for guideline development, including a systematic review of the evidence and application of the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading recommendations. The evidence on atopic dermatitis treatment supported strong recommendations for the use of nonprescription moisturizers, topical calcineurin inhibitors, topical corticosteroids, 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.","keywords":["JAK inhibitor","antihistamines","antimicrobials","atopic dermatitis","bathing","calcineurin inhibitors","corticosteroids","emollients","topicals","wet wraps"],"pubmed_id":"36623556","conclusions":"","publication_date":"2023-01-10T00:00:00"},"crossref":{"DOI":"10.1016/j.jaad.2022.08.068","URL":"https://doi.org/10.1016/j.jaad.2022.08.068","ISSN":["0190-9622"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0190962223000567?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0190962223000567?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"128-129","type":"journal-article","issue":"1","score":1,"title":["Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies"],"author":[{"given":"Robert","family":"Sidbury","sequence":"first","affiliation":[]},{"given":"Ali","family":"Alikhan","sequence":"additional","affiliation":[]},{"given":"Lionel","family":"Bercovitch","sequence":"additional","affiliation":[]},{"given":"David E.","family":"Cohen","sequence":"additional","affiliation":[]},{"given":"Jennifer M.","family":"Darr","sequence":"additional","affiliation":[]},{"given":"Aaron M.","family":"Drucker","sequence":"additional","affiliation":[]},{"given":"Lawrence F.","family":"Eichenfield","sequence":"additional","affiliation":[]},{"given":"Lindsy","family":"Frazer-Green","sequence":"additional","affiliation":[]},{"given":"Amy S.","family":"Paller","sequence":"additional","affiliation":[]},{"given":"Kathryn","family":"Schwarzenberger","sequence":"additional","affiliation":[]},{"given":"Jonathan I.","family":"Silverberg","sequence":"additional","affiliation":[]},{"given":"Anne Marie","family":"Singh","sequence":"additional","affiliation":[]},{"given":"Peggy A.","family":"Wu","sequence":"additional","affiliation":[]},{"given":"Dawn M.R.","family":"Davis","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/100001934","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100001934","name":"American Academy of Dermatology","doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2023,7]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":"89","created":{"date-time":"2023-01-07T01:16:02Z","timestamp":1673054162000,"date-parts":[[2023,1,7]]},"indexed":{"date-time":"2025-08-27T16:01:29Z","timestamp":1756310489308,"date-parts":[[2025,8,27]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000,"date-parts":[[2023,7,1]]},"delay-in-days":0,"content-version":"tdm"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S0190962223000567"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies"},{"name":"journaltitle","label":"Journal Title","value":"Journal of the American Academy of Dermatology"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.jaad.2022.08.068"},{"name":"associatedlink","label":"CrossRef DOI link to the associated document","value":"https://doi.org/10.1016/j.jaad.2022.12.029"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2023 by the American Academy of Dermatology, Inc."}],"deposited":{"date-time":"2023-12-09T08:46:23Z","timestamp":1702111583000,"date-parts":[[2023,12,9]]},"issn-type":[{"type":"print","value":"0190-9622"}],"published":{"date-parts":[[2023,7]]},"publisher":"Elsevier BV","reference":[{"DOI":"10.1016/j.jaad.2014.03.023","key":"10.1016/j.jaad.2022.08.068_bib1","year":"2014","issue":"1","author":"Eichenfield","volume":"71","first-page":"116","unstructured":null,"article-title":"Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies","journal-title":"J Am Acad Dermatol","doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,7]]}},"update-policy":"https://doi.org/10.1016/elsevier_cm_policy","alternative-id":["S0190962223000567"],"content-domain":{"domain":["clinicalkey.fr","jaad.org","clinicalkey.jp","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Journal of the American Academy of Dermatology"],"published-print":{"date-parts":[[2023,7]]},"reference-count":1,"published-online":null,"references-count":1,"short-container-title":["Journal of the American Academy of Dermatology"],"is-referenced-by-count":10},"unpaywall":{"doi":"10.1016/j.jaad.2022.08.068","is_oa":false,"title":"Executive summary: American Academy of Dermatology guidelines of care for the management of atopic dermatitis in adults with topical therapies","updated":"2025-05-22T18:42:22+00:00","published_date":"2023-01-07","best_oa_location":null}},"created_at":"2025-09-22T04:00:58.889Z","updated_at":"2025-09-22T14:20:55.574Z","tags":[{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Bathing","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Moisturizer","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"PDE-4 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Topical Antihistamine","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Topical Antimicrobial","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Topical Antiseptic","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Topical Calcineurin Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Topical Corticosteroid","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"modality","value":"Wet Wrap Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"study_design","value":"Guideline","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"warning","value":"Design is a guideline based on a systematic review rather than a primary comparative study.","value_numeric":null},{"paper_doi":"10.1016/j.jaad.2022.08.068","tag_type":"warning","value":"Only summary-level details were available; no numeric effect sizes or graded certainty levels are provided in the text.","value_numeric":null}],"summaries":{"what_studied":"Updated guidelines for managing atopic dermatitis in adults using topical therapies, based on a systematic review and GRADE methodology to assess evidence and make recommendations.","key_result":"Strong recommendations were made for nonprescription moisturizers, topical calcineurin inhibitors, topical corticosteroids, and topical PDE-4 and JAK inhibitors; conditional recommendations were made for bathing and wet wrap therapy and against topical antimicrobials, antiseptics, and antihistamines.","practice_takeaway":"For adult atopic dermatitis, prioritize moisturizers and guideline-supported topicals (corticosteroids, calcineurin inhibitors, PDE-4 and JAK inhibitors); consider bathing and wet wraps selectively, and avoid topical antimicrobials, antiseptics, and antihistamines."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"PDE-4 Inhibitor"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"PDE-4 Inhibitor"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"PDE-4 Inhibitor"}}}]]

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