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van Hal TW, van den Reek JMPA, Wenink MH, Otero ME, Ossenkoppele PM, Njoo MD, Oostveen A, Peters B, Tjioe M, Kop EN, Körver JEM, Dodemont SRP, Kleinpenning MM, Berends MAM, Veldkamp WR, van Doorn MBA, Mommers JM, Lindhout RJ, Kuijpers ALA, van Lümig PP, de Jonge CEJ, Tupker RA, Hendricksen J, Keijsers RR, van den Hoogen FHJ, Vriezekolk JE, de Jong EMGJ. Impairment in work and activities of daily life in patients with psoriasis: results of the prospective BioCAPTURE registry. J DERMATOL TREAT 2024; 35:2304025. [PMID: 38263716 DOI: 10.1080/09546634.2024.2304025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
Background: Little is known about the extent of impairments in work and activities of daily life (ADL) in patients with psoriasis, and the influence of contextual factors such as disease-related characteristics and treatment. Therefore, this study aimed to assess these impairments in patients with psoriasis who started using biologicals/small molecule inhibitors.Methods: Using data from the prospective BioCAPTURE registry, we collected patient, disease, and treatment parameters, as well as work/ADL impairments at baseline, 6 and 12 months. Changes in impairment parameters and correlations between impairment and patient/disease characteristics were assessed using generalized estimating equations.Results: We included 194 patients in our analysis. After biological initiation, disease activity decreased significantly (PASI 11.2 at baseline versus 3.9 at 12 months, p < 0.001). Work-for-pay in this cohort was lower than in the Dutch general population (53% versus 67%, p = 0.01). In patients who had work-for-pay, presenteeism improved over time (5% at baseline versus 0% at 12 months, p = 0.04). Up to half of the patients reported impairments in ADL, which did not change over time. Associations between impairments and contextual factors varied, but all impairments were associated with worse mental/physical general functioning.Conclusion: Patients with psoriasis using biologicals are less likely to have work-for-pay. Treatment improves the work productivity of employed patients, but we were unable to detect changes in ADL performance.
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Affiliation(s)
- Tamara W van Hal
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Juul M P A van den Reek
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mark H Wenink
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Marisol E Otero
- Department of Dermatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Paul M Ossenkoppele
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
| | - Marcellus D Njoo
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
| | - Annet Oostveen
- Department of Dermatology, Gelre Ziekenhuizen, Apeldoorn, the Netherlands
| | - Bas Peters
- Department of Dermatology, Ziekenhuis Rijnstate, Arnhem, the Netherlands
| | - Milan Tjioe
- Department of Dermatology/DermaTeam, Bravis Ziekenhuis, Bergen op Zoom, the Netherlands
| | - Else N Kop
- Department of Dermatology, Bernhoven Ziekenhuis, Uden, the Netherlands
| | - John E M Körver
- Department of Dermatology, Amphia Ziekenhuis, Breda, the Netherlands
| | | | | | - Maartje A M Berends
- Department of Dermatology, Slingeland Ziekenhuis, Doetinchem, the Netherlands
| | | | | | - Johannes M Mommers
- Department of Dermatology, St. Anna Ziekenhuis, Geldrop, the Netherlands
| | - Robert-Jan Lindhout
- Department of Dermatology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, the Netherlands
| | - Astrid L A Kuijpers
- Department of Dermatology, Maxima Medisch Centrum, Eindhoven, the Netherlands
| | - Paula P van Lümig
- Department of Dermatology, Maastricht UMC+, Maastricht, the Netherlands
| | - C Els J de Jonge
- Department of Dermatology, UMC Utrecht, Utrecht, the Netherlands
| | - Ron A Tupker
- Department of Dermatology, Sint Antoniusziekenhuis, Nieuwegein, the Netherlands
| | - Judith Hendricksen
- Department of Dermatology, Streekziekenhuis Koningin Beatrix, Winterswijk, the Netherlands
| | - Romy R Keijsers
- Department of Dermatology, Zuyderland Medisch Centrum, Sittard-Geleen, the Netherlands
| | | | - Johanna E Vriezekolk
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Department of Research & Innovation, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Elke M G J de Jong
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Dermatology, ZiekenhuisGroep Twente, Almelo/Hengelo, the Netherlands
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2
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Rousel J, Mergen C, Schoones JW, Niemeyer-van der Kolk T, van Doorn MBA, Bouwstra JA, van Smeden J, Rissmann R. Similar alterations of the stratum corneum ceramide profile in atopic dermatitis, psoriasis and ichthyosis: results from a systematic review and meta-analysis. J Invest Dermatol 2024:S0022-202X(24)00168-4. [PMID: 38447864 DOI: 10.1016/j.jid.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Jannik Rousel
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - Catherine Mergen
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - Jan W Schoones
- Directorate of Research Policy, Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, the Netherlands; Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Joke A Bouwstra
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - Jeroen van Smeden
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands; Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands; Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands; Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands.
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3
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Rousel J, Bergmans ME, van der Meulen LWJ, Pagan L, de Bruin DT, de Kam ML, Klarenbeek NB, Bouwstra JA, Seyger MMB, van den Reek JMPA, Niemeyer-van der Kolk T, Rissmann R, van Doorn MBA. Guselkumab induction therapy demonstrates long-lasting efficacy in patients with mild psoriasis, results from a randomized, placebo-controlled exploratory clinical trial. J Am Acad Dermatol 2024; 90:395-397. [PMID: 37804933 DOI: 10.1016/j.jaad.2023.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Jannik Rousel
- Centre for Human Drug Research, Leiden, The Netherlands; Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Menthe E Bergmans
- Centre for Human Drug Research, Leiden, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | - Laura W J van der Meulen
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lisa Pagan
- Centre for Human Drug Research, Leiden, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | - Digna T de Bruin
- Centre for Human Drug Research, Leiden, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Joke A Bouwstra
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Marieke M B Seyger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands; Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands; Leiden University Medical Center, Leiden, The Netherlands.
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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4
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Juch RNS, Bik L, Boeijink N, de Vos J, Dobbe IJGG, Bloemen PR, van Doorn MBA, Velthuis P, Aalders MCG, Wolkerstorfer A. Home-Use Hyaluronic Acid Jet Injectors: Unreliable and Unsafe. Dermatol Surg 2024; 50:62-68. [PMID: 37815475 DOI: 10.1097/dss.0000000000003971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
BACKGROUND Needle-free hyaluronic acid (HA) jet injectors are gaining popularity for rejuvenation treatment. The devices are widely available online and are used for self-injection or in beauty salons by nonphysicians. However, little is known about their performance and safety. OBJECTIVE To explore the injection efficiency and cutaneous biodistribution patterns administered with home-use compared with medical jet injectors and to assess safety aspects. MATERIALS AND METHODS The authors injected HA into ex vivo human skin with 4 home-use and 2 medical injectors. The intracutaneous dose of HA was calculated, and the cutaneous biodistribution of HA was assessed using a 3-dimensional Fluorescent Imaging Cryomicrotome System (3D-FICS). Safety aspects were evaluated based on the presence of a manual, CE (conformité européenne) mark, and sterility. RESULTS The intracutaneous dose delivered by the home-use injectors was markedly lower compared with the medical injectors. 3D imaging for home-use injectors showed superficial epidermal distribution with low distribution volumes. For medical injectors, volumes were substantially larger and mainly middermal. All evaluated safety aspects were lacking. CONCLUSION Results of this study suggest that the specific combinations of home-use injectors and HA used in this study are unreliable and unsafe, which casts doubts on the performance of these treatments in general.
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Affiliation(s)
- Rosalie N S Juch
- Dermatology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Liora Bik
- Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Neill Boeijink
- Dermatology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Judith de Vos
- Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Iwan J G G Dobbe
- Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health-Restoration and Development, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Paul R Bloemen
- Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | | | - Peter Velthuis
- Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Maurice C G Aalders
- Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Dermatology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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5
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Rousel J, Nădăban A, Saghari M, Pagan L, Zhuparris A, Theelen B, Gambrah T, van der Wall HEC, Vreeken RJ, Feiss GL, Niemeyer-van der Kolk T, Burggraaf J, van Doorn MBA, Bouwstra JA, Rissmann R. Lesional skin of seborrheic dermatitis patients is characterized by skin barrier dysfunction and correlating alterations in the stratum corneum ceramide composition. Exp Dermatol 2024; 33:e14952. [PMID: 37974545 DOI: 10.1111/exd.14952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 10/01/2023] [Indexed: 11/19/2023]
Abstract
Seborrheic dermatitis (SD) is a chronic inflammatory skin disease characterized by erythematous papulosquamous lesions in sebum rich areas such as the face and scalp. Its pathogenesis appears multifactorial with a disbalanced immune system, Malassezia driven microbial involvement and skin barrier perturbations. Microbial involvement has been well described in SD, but skin barrier involvement remains to be properly elucidated. To determine whether barrier impairment is a critical factor of inflammation in SD alongside microbial dysbiosis, a cross-sectional study was performed in 37 patients with mild-to-moderate facial SD. Their lesional and non-lesional skin was comprehensively and non-invasively assessed with standardized 2D-photography, optical coherence tomography (OCT), microbial profiling including Malassezia species identification, functional skin barrier assessments and ceramide profiling. The presence of inflammation was established through significant increases in erythema, epidermal thickness, vascularization and superficial roughness in lesional skin compared to non-lesional skin. Lesional skin showed a perturbed skin barrier with an underlying skewed ceramide subclass composition, impaired chain elongation and increased chain unsaturation. Changes in ceramide composition correlated with barrier impairment indicating interdependency of the functional barrier and ceramide composition. Lesional skin showed significantly increased Staphylococcus and decreased Cutibacterium abundances but similar Malassezia abundances and mycobial composition compared to non-lesional skin. Principal component analysis highlighted barrier properties as main discriminating features. To conclude, SD is associated with skin barrier dysfunction and changes in the ceramide composition. No significant differences in the abundance of Malassezia were observed. Restoring the cutaneous barrier might be a valid therapeutic approach in the treatment of facial SD.
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Affiliation(s)
- Jannik Rousel
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Andreea Nădăban
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Mahdi Saghari
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Lisa Pagan
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Ahnjili Zhuparris
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Tom Gambrah
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Rob J Vreeken
- Maastricht Multimodal Molecular Imaging Institute, Maastricht University, Maastricht, The Netherlands
| | | | | | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Joke A Bouwstra
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
- Leiden University Medical Center, Leiden, The Netherlands
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6
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Bik L, Elmzoon I, Wolkerstorfer A, Prens EP, van Doorn MBA. Needle-free electronically controlled jet injection with corticosteroids in recalcitrant keloid scars: a retrospective study and patient survey. Lasers Med Sci 2023; 38:250. [PMID: 37917309 PMCID: PMC10622365 DOI: 10.1007/s10103-023-03891-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/24/2023] [Indexed: 11/04/2023]
Abstract
First-line treatment of keloids consists of intralesional needle injections with corticosteroids, but generally entails multiple painful sessions, resulting in variable clinical outcomes. Novel needle-free jet injectors may facilitate more effective and patient-friendly dermal drug delivery. Here, we evaluated the effectiveness, tolerability and patient satisfaction of intralesional triamcinolone-acetonide (TCA) treatment in recalcitrant keloids using an electronically controlled pneumatic injector (EPI). A retrospective study was conducted in recalcitrant keloid patients with a history of severe pain during needle injections who received three sessions of EPI + TCA. Outcome measures included Patient and Observer Scar Assessment Scale (POSAS), Global Aesthetic Improvement Scale (GAIS), treatment-related pain (NRS), adverse effects, and patient satisfaction (survey). Ten patients with in total 283 keloids were included. The POSAS score significantly improved at follow-up and GAIS was reported as '(very) improved' for all patients. EPI + TCA was well-tolerated with a significantly lower NRS pain score compared to needle + TCA (pilot treatment). Only minor adverse effects occurred, and 90% of patients preferred EPI over needle treatment. EPI + TCA is an effective and tolerable treatment for patients with recalcitrant keloids. The minimal treatment-related pain and high patient satisfaction makes it a promising treatment for patients with needle-phobia and/or severe pain during needle injections.
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Affiliation(s)
- Liora Bik
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands.
| | - Ixora Elmzoon
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
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7
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Meertens MAJ, Luijf T, van Lindonk EAM, Soegiharto R, Assil S, Alizadeh Aghdam M, Kentie PA, Knulst AC, van Doorn MBA, Röckmann H. Age and fast initial response predict omalizumab retreatment in chronic urticaria. J Allergy Clin Immunol Pract 2023; 11:3556-3558.e1. [PMID: 37517795 DOI: 10.1016/j.jaip.2023.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Michelle A J Meertens
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Teddy Luijf
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Esmee A M van Lindonk
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Reineke Soegiharto
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Salma Assil
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mehran Alizadeh Aghdam
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Petra A Kentie
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Andre C Knulst
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Martijn B A van Doorn
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Heike Röckmann
- Urticaria Centre of Excellence and Reference (UCARE), Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
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8
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Kocatürk E, Salameh P, Sarac E, Vera Ayala CE, Thomsen SF, Zuberbier T, Ensina LF, Popov TA, van Doorn MBA, Giménez-Arnau AM, Asero R, Criado PR, Aarestrup FM, AbdulHameed Ansari Z, Al Abri S, Al-Ahmad M, Al Hinai B, Allenova A, Al-Nesf M, Altrichter S, Arnaout R, Bartosińska J, Bauer A, Bernstein JA, Bizjak M, Bonnekoh H, Bouillet L, Brzoza Z, Calvalcanti Dela Bianca Melo AC, Campinhos FL, Carne E, Purayil SC, Cherrez-Ojeda I, Chong-Neto HJ, Christoff G, Conlon N, Jardim Criado RF, Cvenkel K, Damadoglu E, Danilycheva I, Day C, de Montjoye L, Demir S, Ferucci SM, Fomina D, Fukunaga A, Garcia E, Gelincik A, Göbel JH, Godse K, Gonçalo M, Gotua M, Grattan C, Gugala A, Guillet C, Kalyoncu AF, Karakaya G, Kasperska-Zając A, Katelaris CH, Khoshkhui M, Kleinheinz A, Kolacinska-Flont M, Kolkhir P, Košnik M, Krasowska D, Kumaran MS, Kuprys-Lipinska I, Kurowski M, Kuznetsova EV, Larenas-Linnemann D, Lebedkina MS, Lee Y, Makris M, Gómez RM, Nasr I, Neisinger S, Oda Y, Kara RÖ, Palitot EB, Papapostolou N, Salvador Parisi CA, Pesque D, Peter J, Petkova E, Ridge K, Rudenko M, Rutkowski K, Saini SS, Salman A, Sanchez J, Şekerel B, Serdotetskova SA, Serpa FS, Dikicier BS, Sidiropoulos N, Sikora A, Sørensen JA, Soria A, Kucuk OS, Thalappil SR, Tomaszewska K, Tuncay G, Unal D, Valle S, van Lindonk E, Vestergaard C, Meshkova RY, Vitchuk A, Xepapadaki P, Ye YM, Zalewska-Janowska A, Zamlynski M, Maurer M. Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study. J Allergy Clin Immunol 2023; 152:1095-1106. [PMID: 37574079 DOI: 10.1016/j.jaci.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy. OBJECTIVE We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination. METHODS COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine. We evaluated CU exacerbations and severe allergic reactions as well as other adverse events associated with COVID-19 vaccinations and their association with various CU parameters. RESULTS Across 2769 COVID-19-vaccinated CU patients, most (90%) received at least 2 COVID-19 vaccine doses, and most patients received CU treatment and had well-controlled disease. The rate of COVID-19 vaccination-induced CU exacerbation was 9%. Of 223 patients with CU exacerbation after the first dose, 53.4% experienced recurrence of CU exacerbation after the second dose. CU exacerbation most often started <48 hours after vaccination (59.2%), lasted for a few weeks or less (70%), and was treated mainly with antihistamines (70.3%). Factors that increased the risk for COVID-19 vaccination-induced CU exacerbation included female sex, disease duration shorter than 24 months, having chronic spontaneous versus inducible urticaria, receipt of adenovirus viral vector vaccine, having nonsteroidal anti-inflammatory drug/aspirin intolerance, and having concerns about getting vaccinated; receiving omalizumab treatment and Latino/Hispanic ethnicity lowered the risk. First-dose vaccine-related adverse effects, most commonly local reactions, fever, fatigue, and muscle pain, were reported by 43.5% of CU patients. Seven patients reported severe allergic reactions. CONCLUSIONS COVID-19 vaccination leads to disease exacerbation in only a small number of CU patients and is generally well tolerated.
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Affiliation(s)
- Emek Kocatürk
- Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey; Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
| | - Pascale Salameh
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Department of Clinical Epidemiology, Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon; Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; School of Medicine, Lebanese American University, Beirut, Germany; Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Esra Sarac
- Department of Dermatology, Koc University School of Medicine, Istanbul, Turkey
| | - Carolina E Vera Ayala
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Simon Francis Thomsen
- Department of Dermatology, Department of Biomedical Sciences, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Luis Felipe Ensina
- Department of Dermatology, Federal University of São Paulo, São Paulo, Brazil
| | - Todor A Popov
- Department of Allergology, University Hospital Sv Ivan Rilski, Sofia, Bulgaria
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands
| | - Ana Maria Giménez-Arnau
- Department of Dermatology, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Paulo Ricardo Criado
- Alergoskin Alergia e Dermatologia, Centro Universitário Faculdade de Medicina do ABC, Santo André, Brazil
| | - Fernando M Aarestrup
- Department of Allergy and Immunology, Faculdade de Ciências, Médicas e da Saúde de Juiz de Fora (SUPREMA), Hospital Maternidade Therezinha de Jesus, Minas Gerais, Brazil
| | | | - Salma Al Abri
- Clinical Immunology and Allergy Unit, Royal Hospital, Muscat, Oman
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Bushra Al Hinai
- Clinical Immunology and Allergy Unit, Royal Hospital, Muscat, Oman
| | - Anastasiia Allenova
- Laboratory of Immune-Mediated Skin Diseases, Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; Medical Research and Education Center, M. V. Lomonosov Moscow State University, Moscow, Russia
| | - Maryam Al-Nesf
- Department of Medicine, Allergy and Immunology Division, Hamad Medical Corporation, Doha, Qatar
| | - Sabine Altrichter
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany; Department of Dermatology and Venereology, Kepler University Hospital, Linz, Austria
| | - Rand Arnaout
- Department of Dermatology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Joanna Bartosińska
- Department of Dermatology, Venereology, and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Andrea Bauer
- Department of Dermatology, Technical University Dresden, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Jonathan A Bernstein
- Department of Internal Medicine, Division of Rheumatology, Allergy, and Immunology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Mojca Bizjak
- Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Hanna Bonnekoh
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Laurence Bouillet
- National Reference Center for Angioedema, Grenoble University Hospital, Grenoble, France
| | - Zenon Brzoza
- Department of Internal Diseases with the Division of Allergology, Institute of Medical Sciences, University of Opole, Opole, Poland
| | | | - Fernanda L Campinhos
- Asthma Reference Center, UCARE Hospital Santa Casa de Misericórdia de Vitória, Esperito Santo, Brazil
| | - Emily Carne
- Department of Dermatology, University Hospital of Wales, Cardiff, United Kingdom
| | | | - Ivan Cherrez-Ojeda
- Research Department, Universidad Espiritu Santo, Samborondon, Ecuador; Department Allergy and Pulmonology, Respiralab Research Group, Guayaquil, Ecuador
| | - Herberto Jose Chong-Neto
- Departamento de Pediatria, Serviço de Alergia e Imunologia, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - George Christoff
- Faculty of Public Health, Medical University Sofia, Sofia, Bulgaria
| | - Niall Conlon
- School of Medicine, Trinity College Dublin, St James's Hospital Dublin, Dublin, Ireland
| | | | - Klara Cvenkel
- Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ebru Damadoglu
- Department of Chest Diseases, Division of Allergy and Immunology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Inna Danilycheva
- Department of Allergology, NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Cascia Day
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Laurence de Montjoye
- Department of Dermatology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Semra Demir
- Department of Internal Medicine, Division of Immunology and Allergy Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Silvia Mariel Ferucci
- Department of Dermatology, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico Milan, Milan, Italy
| | - Daria Fomina
- Moscow Healthcare Department, Moscow City Research and Practical Center of Allergoloy and Immunology, Moscow, Russia; Department of Clinical Immunology and Allergy, Sechenow First Moscow State Medical University, Moscow, Russia; Department of Pulmonology, Astana Medical University, Kazakhstan, Russia
| | - Atsushi Fukunaga
- Department of Dermatology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Elizabeth Garcia
- Faculty of Medicine, Universidad de los Andes-UNIMEQ ORL, Bogota, Colombia
| | - Asli Gelincik
- Department of Internal Medicine, Division of Immunology and Allergy Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Joe Hannah Göbel
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Kiran Godse
- Department of Dermatology, Dr D. Y. Patil Medical College & Hospital, Navi Mumbai, India
| | - Margarida Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maia Gotua
- Center of Allergy and Immunology, David Tvildiani Medical University, Tbilisi, Georgia
| | - Clive Grattan
- Department of Dermatology, St Thomas Hospital London, London, United Kingdom
| | - Agata Gugala
- Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland
| | - Carole Guillet
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Ali Fuat Kalyoncu
- Department of Chest Diseases, Division of Allergy and Immunology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Gul Karakaya
- Department of Chest Diseases, Division of Allergy and Immunology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Alicja Kasperska-Zając
- Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | | | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Marta Kolacinska-Flont
- Department of Internal Medicine, Asthma, and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Lodz, Poland
| | - Pavel Kolkhir
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Mitja Košnik
- Division of Allergy, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Dorota Krasowska
- Department of Dermatology, Venereology, and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Izabela Kuprys-Lipinska
- Department of Internal Medicine, Asthma, and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Lodz, Poland
| | - Marcin Kurowski
- Department of Immunology and Allergy, Medical University of Lodz, Lodz, Poland
| | - Elizaveta V Kuznetsova
- Department of Clinical Immunology and Allergy, Sechenow First Moscow State Medical University, Moscow, Russia
| | | | - Marina S Lebedkina
- Moscow Healthcare Department, Moscow City Research and Practical Center of Allergoloy and Immunology, Moscow, Russia
| | - Youngsoo Lee
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | | | - Iman Nasr
- Clinical Immunology and Allergy Unit, Royal Hospital, Muscat, Oman
| | - Sophia Neisinger
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Yoshiko Oda
- Department of Dermatology, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Rabia Öztaş Kara
- Department of Dermatology, University of Sakarya School of Medicine, Sakarya, Turkey
| | - Esther Bastos Palitot
- Federal University of Paraiba, Department of Infectious, Parasitic and Inflammatory Diseases, João Pessoa, Paraiba, Brazil; Lauro Wanderley University Hospital - Ebserh Network, João Pessoa, Brazil
| | - Niki Papapostolou
- Allergy Unit, 2nd Department of Dermatology and Venereology, University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | | | - David Pesque
- Department of Dermatology, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jonathan Peter
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Elena Petkova
- University Hospital "Alexandrovska", Clinic of Allergology, Sofia, Bulgaria
| | - Katie Ridge
- School of Medicine, Trinity College Dublin, St James's Hospital Dublin, Dublin, Ireland
| | - Michael Rudenko
- London Allergy & Immunology Centre, Department of Allergy and Immunology, London, United Kingdom
| | - Krzysztof Rutkowski
- Urticaria Clinic, St John's Institute of Dermatology, London, United Kingdom
| | - Sarbjit S Saini
- Department of Medicine, Division of Allergy and Clinical Immunology, Johns Hopkins Asthma and Allergy Center, Baltimore, Md
| | - Andac Salman
- Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey; Department of Dermatology, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Jorge Sanchez
- Group of Clinical and Experimental Allergy, Hospital "Alma Mater de Antioquia", University of Antioquia, Antioquia, Colombia
| | - Bülent Şekerel
- Pediatric Allergy Asthma Division, Hacettepe University, Ankara, Turkey
| | - Sofia A Serdotetskova
- Moscow Healthcare Department, Moscow City Research and Practical Center of Allergoloy and Immunology, Moscow, Russia
| | - Faradiba S Serpa
- Asthma Reference Center, UCARE Hospital Santa Casa de Misericórdia de Vitória, Esperito Santo, Brazil
| | | | - Nikitas Sidiropoulos
- Allergy Unit, 2nd Department of Dermatology and Venereology, University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Agnieszka Sikora
- Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | - Jennifer Astrup Sørensen
- Department of Dermatology, Department of Biomedical Sciences, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Angele Soria
- Department of Dermatology and Allergy, Tenon Hospital APHP, Sorbonne Université Paris, Paris, France
| | - Ozlem Su Kucuk
- Department of Dermatology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey
| | - Sherin Rahim Thalappil
- Department of Medicine, Allergy and Immunology Division, Hamad Medical Corporation, Doha, Qatar
| | | | - Gulseren Tuncay
- Department of Chest Diseases, Division of Allergy and Immunology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Derya Unal
- Department of Internal Medicine, Division of Immunology and Allergy Diseases, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Solange Valle
- Medicine Department, Immunology Service, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Esmee van Lindonk
- Department of Dermatology, Erasmus MC Rotterdam, Rotterdam, The Netherlands
| | | | - Raisa Y Meshkova
- Department of Clinical Immunology and Allergology, Smolensk State Medical University, Smolensk
| | - Aleksandr Vitchuk
- Department of Dermatology, Smolensk State Medical University, Smolensk, Russia
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | | | - Mateusz Zamlynski
- Department of Clinical Allergology and Urticaria, Medical University of Silesia, Silesia, Poland
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
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9
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Aarts P, van Huijstee JC, van der Zee HH, van Doorn MBA, van Straalen KR, Prens EP. Adalimumab in conjunction with surgery compared with adalimumab monotherapy for hidradenitis suppurativa: A Randomized Controlled Trial in a real-world setting. J Am Acad Dermatol 2023; 89:677-684. [PMID: 37116615 DOI: 10.1016/j.jaad.2023.04.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Adalimumab, the only biologic registered for hidradenitis suppurativa, shows clinical response in up to 60% of patients, leaving many patients in need for other treatment options such as surgery. OBJECTIVE To compare the clinical effectiveness of adalimumab combined with surgery vs adalimumab monotherapy in patients with moderate to severe hidradenitis suppurativa. METHODS A pragmatic Randomized Controlled Trial was performed from August 2018 to July 2022. Primary outcome was the difference in mean International Hidradenitis Suppurativa Severity Score System reduction after 12 months of treatment with the difference in mean Dermatology Life Quality Index reduction as a key secondary outcome. RESULTS Thirty-one patients were included per arm. The mean International Hidradenitis Suppurativa Severity Score System at baseline was 23.9 ± 10.7 in the surgery group and 20.9 ± 16.4, in the monotherapy group. After 12 months of treatment the surgery group had a significantly greater reduction in International Hidradenitis Suppurativa Severity Score System compared with the monotherapy group (-19.1 ± 11.3 vs -7.8 ± 11.8, P < .001). Moreover, the surgery group showed a greater reduction in Dermatology Life Quality Index after treatment compared with the monotherapy group (-8.2 ± 6.2 vs -4 ± 7.7, P = .02). LIMITATIONS The study follow-up was too short to assess surgical recurrence rates. DISCUSSION Combining adalimumab with surgery resulted in greater clinical effectiveness and improved quality of life after 12 months in patients with moderate to severe hidradenitis suppurativa.
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Affiliation(s)
- Pim Aarts
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Johanna C van Huijstee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kelsey R van Straalen
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
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10
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Rousel J, Saghari M, Pagan L, Nădăban A, Gambrah T, Theelen B, de Kam ML, Haakman J, van der Wall HEC, Feiss GL, Niemeyer-van der Kolk T, Burggraaf J, Bouwstra JA, Rissmann R, van Doorn MBA. Treatment with the Topical Antimicrobial Peptide Omiganan in Mild-to-Moderate Facial Seborrheic Dermatitis versus Ketoconazole and Placebo: Results of a Randomized Controlled Proof-of-Concept Trial. Int J Mol Sci 2023; 24:14315. [PMID: 37762625 PMCID: PMC10531869 DOI: 10.3390/ijms241814315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Facial seborrheic dermatitis (SD) is an inflammatory skin disease characterized by erythematous and scaly lesions on the skin with high sebaceous gland activity. The yeast Malassezia is regarded as a key pathogenic driver in this disease, but increased Staphylococcus abundances and barrier dysfunction are implicated as well. Here, we evaluated the antimicrobial peptide omiganan as a treatment for SD since it has shown both antifungal and antibacterial activity. A randomized, patient- and evaluator-blinded trial was performed comparing the four-week, twice daily topical administration of omiganan 1.75%, the comparator ketoconazole 2.00%, and placebo in patients with mild-to-moderate facial SD. Safety was monitored, and efficacy was determined by clinical scoring complemented with imaging. Microbial profiling was performed, and barrier integrity was assessed by trans-epidermal water loss and ceramide lipidomics. Omiganan was safe and well tolerated but did not result in a significant clinical improvement of SD, nor did it affect other biomarkers, compared to the placebo. Ketoconazole significantly reduced the disease severity compared to the placebo, with reduced Malassezia abundances, increased microbial diversity, restored skin barrier function, and decreased short-chain ceramide Cer[NSc34]. No significant decreases in Staphylococcus abundances were observed compared to the placebo. Omiganan is well tolerated but not efficacious in the treatment of facial SD. Previously established antimicrobial and antifungal properties of omiganan could not be demonstrated. Our multimodal characterization of the response to ketoconazole has reaffirmed previous insights into its mechanism of action.
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Affiliation(s)
- Jannik Rousel
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | - Mahdi Saghari
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Leiden University Medical Center, Leiden University, 2333 ZA Leiden, The Netherlands
| | - Lisa Pagan
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Leiden University Medical Center, Leiden University, 2333 ZA Leiden, The Netherlands
| | - Andreea Nădăban
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | - Tom Gambrah
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
| | - Bart Theelen
- Westerdijk Fungal Biodiversity Institute, 3508 AD Utrecht, The Netherlands
| | | | - Jorine Haakman
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
| | | | | | | | - Jacobus Burggraaf
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
- Leiden University Medical Center, Leiden University, 2333 ZA Leiden, The Netherlands
| | - Joke A. Bouwstra
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden University, 2333 CC Leiden, The Netherlands
- Leiden University Medical Center, Leiden University, 2333 ZA Leiden, The Netherlands
| | - Martijn B. A. van Doorn
- Centre for Human Drug Research, 2333 CL Leiden, The Netherlands
- Department of Dermatology, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands
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11
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van Huizen AM, van der Kraaij GE, Busard CI, Ouwerkerk W, van den Reek JMPA, Menting SP, Prens EP, Rispens T, de Vries A, de Jong EMGJ, Lambert J, van Doorn MBA, Spuls PI. Adalimumab combined with methotrexate versus adalimumab monotherapy in psoriasis: Three-year follow-up data of a single-blind randomized controlled trial. J Eur Acad Dermatol Venereol 2023; 37:1815-1824. [PMID: 37014287 DOI: 10.1111/jdv.19089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Anti-drug antibodies (ADA) are formed in patients treated with adalimumab (ADL). This might increase clearance of ADL, potentially causing a (secondary) non-response. Combination therapy of ADL and methotrexate (MTX) reduces ADA levels and has a clinical benefit in rheumatologic diseases. In psoriasis however, the long-term effectiveness and safety have not been studied. OBJECTIVES To investigate the three-year follow-up data of ADL combined with MTX compared to ADL monotherapy in ADL-naive patients with moderate to severe plaque type psoriasis. METHODS We conducted a multicentre RCT in the Netherlands and Belgium. Randomization was performed by a centralized online randomization service. Patients were seen every 12 weeks until week 145. Outcome assessors were blinded. We collected data on drug survival, effectiveness, safety, pharmacokinetics and immunogenicity of patients that started ADL combined with MTX compared to ADL monotherapy. We present descriptive analysis and patients were analysed according to the group initially randomized to. Patients becoming non-adherent to the biologic were excluded from analyses. RESULTS Sixty-one patients were included and 37 patients (ADL group n = 17, ADL + MTX group n = 20) continued in the follow-up study after 1 year. After 109 weeks and 145 weeks, there was a trend towards longer drug survival in the ADL + MTX group compared to the ADL group (week 109: 54.8% vs. 41.4%; p = 0.326, week 145: 51.6% vs. 41.4%; p = 0.464). At week 145, 7/13 patients were treated with MTX. In the ADL group, 4/12 patients that completed the study developed ADA, and 3/13 in the ADL + MTX group. CONCLUSIONS In this small study, there was no significant difference in ADL overall drug survival when it was initially combined with MTX, compared to ADL alone. Discontinuation due to adverse events was common in the combination group. To secure accessible healthcare, combination treatment of ADL and MTX can be considered in individual patients.
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Affiliation(s)
- Astrid M van Huizen
- Department of Dermatology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Gayle E van der Kraaij
- Department of Dermatology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Celine I Busard
- Department of Dermatology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter Ouwerkerk
- Department of Clinical Epidemiology and Data Science, Biostatistics and Bioinformatics, Amsterdam UMC, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- National Heart Centre Singapore, Singapore City, Singapore
| | | | - Stef P Menting
- Department of Dermatology, OLVG, Amsterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - Theo Rispens
- Sanquin Research and Landsteiner Laboratory, Department of Blood Cell Research, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Annick de Vries
- Sanquin Pharma&Biotech Services, Sanquin, Amsterdam, The Netherlands
| | - Elke M G J de Jong
- Radboud UMC, Radboud University, Department of Dermatology, Nijmegen, The Netherlands
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
| | - Phyllis I Spuls
- Department of Dermatology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, The Netherlands
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12
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Assil S, Buters TP, Hameeteman PW, Hallard C, Treijtel N, Niemeyer – Van der Kolk T, de Kam ML, Florencia EFIII, Prens EP, van Doorn MBA, Rissmann R, Klarenbeek NB, Jansen MAA, Moerland M. Oral prednisolone suppresses skin inflammation in a healthy volunteer imiquimod challenge model. Front Immunol 2023; 14:1197650. [PMID: 37545524 PMCID: PMC10400434 DOI: 10.3389/fimmu.2023.1197650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023] Open
Abstract
Imiquimod (IMQ) is a topical agent that induces local inflammation via the Toll-like receptor 7 pathway. Recently, an IMQ-driven skin inflammation model was developed in healthy volunteers for proof-of-pharmacology trials. The aim of this study was to profile the cellular, biochemical, and clinical effects of the marketed anti-inflammatory compound prednisolone in an IMQ model. This randomized, double-blind, placebo-controlled study was conducted in 24 healthy volunteers. Oral prednisolone (0.25 mg/kg/dose) or placebo (1:1) was administered twice daily for 6 consecutive days. Two days after treatment initiation with prednisolone or placebo, 5 mg imiquimod (IMQ) once daily for two following days was applied under occlusion on the tape-stripped skin of the back for 48 h in healthy volunteers. Non-invasive (imaging and biophysical) and invasive (skin punch biopsies and blister induction) assessments were performed, as well as IMQ ex vivo stimulation of whole blood. Prednisolone reduced blood perfusion and skin erythema following 48 h of IMQ application (95% CI [-26.4%, -4.3%], p = 0.0111 and 95% CI [-7.96, -2.13], p = 0.0016). Oral prednisolone suppressed the IMQ-elevated total cell count (95% CI [-79.7%, -16.3%], p = 0.0165), NK and dendritic cells (95% CI [-68.7%, -5.2%], p = 0.0333, 95% CI [-76.9%, -13.9%], p = 0.0184), and classical monocytes (95% CI [-76.7%, -26.6%], p = 0.0043) in blister fluid. Notably, TNF, IL-6, IL-8, and Mx-A responses in blister exudate were also reduced by prednisolone compared to placebo. Oral prednisolone suppresses IMQ-induced skin inflammation, which underlines the value of this cutaneous challenge model in clinical pharmacology studies of novel anti-inflammatory compounds. In these studies, prednisolone can be used as a benchmark.
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Affiliation(s)
- Salma Assil
- Centre for Human Drug Research, Leiden, Netherlands
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands
| | - Thomas P. Buters
- Centre for Human Drug Research, Leiden, Netherlands
- Leiden University Medical Centre, Leiden, Netherlands
- Department of Dermatology Erasmus Medical Centre, Rotterdam, Netherlands
| | | | | | | | | | | | | | - Errol P. Prens
- Department of Dermatology Erasmus Medical Centre, Rotterdam, Netherlands
| | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, Netherlands
- Division of Biotherapeutics, Leiden Academic Centre for Drug Research, Leiden University, Leiden, Netherlands
- Leiden University Medical Centre, Leiden, Netherlands
| | - Naomi B. Klarenbeek
- Centre for Human Drug Research, Leiden, Netherlands
- Leiden University Medical Centre, Leiden, Netherlands
| | | | - Matthijs Moerland
- Centre for Human Drug Research, Leiden, Netherlands
- Leiden University Medical Centre, Leiden, Netherlands
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13
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Ten Voorde W, Saghari M, Boltjes J, de Kam ML, Zhuparris A, Feiss G, Buters TP, Prens EP, Damman J, Niemeyer-van der Kolk T, Moerland M, Burggraaf J, van Doorn MBA, Rissmann R. A multimodal, comprehensive characterization of a cutaneous wound model in healthy volunteers. Exp Dermatol 2023. [PMID: 37051698 DOI: 10.1111/exd.14808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023]
Abstract
Development of pharmacological interventions for wound treatment is challenging due to both poorly understood wound healing mechanisms and heterogeneous patient populations. A standardized and well-characterized wound healing model in healthy volunteers is needed to aid in-depth pharmacodynamic and efficacy assessments of novel compounds. The current study aims to objectively and comprehensively characterize skin punch biopsy-induced wounds in healthy volunteers with an integrated, multimodal test battery. Eighteen (18) healthy male and female volunteers received three biopsies on the lower back, which were left to heal without intervention. The wound healing process was characterized using a battery of multimodal, non-invasive methods as well as histology and qPCR analysis in re-excised skin punch biopsies. Biophysical and clinical imaging read-outs returned to baseline values in 28 days. Optical coherence tomography detected cutaneous differences throughout the wound healing progression. qPCR analysis showed involvement of proteins, quantified as mRNA fold increase, in one or more healing phases. All modalities used in the study were able to detect differences over time. Using multidimensional data visualization, we were able to create a distinction between wound healing phases. Clinical and histopathological scoring were concordant with non-invasive imaging read-outs. This well-characterized wound healing model in healthy volunteers will be a valuable tool for the standardized testing of novel wound healing treatments.
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Affiliation(s)
- Wouter Ten Voorde
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
| | - Mahdi Saghari
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
| | - Jiry Boltjes
- Centre for Human Drug Research, Leiden, the Netherlands
| | | | | | - Gary Feiss
- Cutanea Life Sciences, Wayne, Pennsylvania, USA
| | - Thomas P Buters
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
| | - Errol P Prens
- Department of Dermatology Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Jeffrey Damman
- Department of Pathology Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | | | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
- Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
| | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands
- Leiden University Medical Centre, Leiden, the Netherlands
- Leiden Academic Center for Drug Research, Leiden University, Leiden, the Netherlands
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14
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van Lint JA, Jessurun NT, Tas SW, Vonkeman HE, van Doorn MBA, Hoentjen F, Nurmohamed MT, van Puijenbroek EP, van den Bemt BJF. Recurring Fatigue After Biologic Administration: Patient-Reported Data from the Dutch Biologic Monitor. BioDrugs 2023:10.1007/s40259-023-00592-8. [PMID: 37010772 DOI: 10.1007/s40259-023-00592-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Fatigue is a common problem in immune-mediated inflammatory disease (IMID) patients, significantly impacting their quality of life. OBJECTIVES In this study, we describe the pattern and characteristics of fatigue as a patient-reported adverse drug reaction (ADR) of biologics, and compared patient and treatment characteristics with patients reporting other ADRs or no ADRs. METHODS In this cohort event monitoring study, the description and characteristics of fatigue reported as a possible ADR in the Dutch Biologic Monitor were assessed and analysed for commonly recurring themes or patterns. Baseline and treatment characteristics of patients with fatigue and patients reporting other ADRs or no ADRs were compared. RESULTS Of 1382 participating patients, 108 patients (8%) reported fatigue as an ADR of a biologic. Almost half of these patients (50 patients, 46%) described episodes of fatigue during or shortly after biologic injection, which often recurred following subsequent injections. Patients with fatigue were significantly younger than patients with other ADRs or patients without ADRs (median age for patients with fatigue, 52 years; median age for patients with other ADRs, 56 years; and median age for patients without ADRs, 58 years); significantly more often smoked (25% vs. 16% and 15%); used infliximab (22% vs. 9% and 13%), rituximab (9% vs. 3% and 1%) or vedolizumab (6% vs. 2% and 1%); and significantly more often had Crohn's disease (28% vs. 13% and 13%) and other comorbidities (31% vs. 20% and 15%). Patients with fatigue significantly less frequently used etanercept (12% vs. 29% and 34%) or had rheumatoid arthritis (30% vs. 45% and 43%). CONCLUSIONS IMID patients may experience fatigue as a postdosing effect of biologics.
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Affiliation(s)
- Jette A van Lint
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands.
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Naomi T Jessurun
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
| | - Sander W Tas
- Department of Rheumatology and Clinical Immunology, Amsterdam Infection and Immunity Institute and Amsterdam Rheumatology and Immunology Center (ARC), Amsterdam University Medical Center (AMC), Amsterdam, The Netherlands
| | - Harald E Vonkeman
- Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | | | - Frank Hoentjen
- Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands
- Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
| | - Michael T Nurmohamed
- Amsterdam Rheumatology Immunology Center, Location Reade, Amsterdam, The Netherlands
| | - Eugene P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH, 's-Hertogenbosch, The Netherlands
- Groningen Research Institute of Pharmacy, Unit of Pharmacotherapy, Epidemiology and Economics, University of Groningen, Groningen, The Netherlands
| | - Bart J F van den Bemt
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands
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15
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Giang J, van Doorn MBA, Diercks GFH, de Cordoba SR, van den Bosch TPP, Schreurs MWJ, Poppelaars F, Damman J. Successful pharmacological intervention at different levels of the complement system in an in vitro complement fixation model for bullous pemphigoid. Exp Dermatol 2023; 32:632-640. [PMID: 36704908 DOI: 10.1111/exd.14755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/12/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023]
Abstract
Bullous pemphigoid (BP) is characterized by deposition of immunoglobulins and complement along the epidermal basement membrane (BM). In humans, there is a lack of functional studies targeting the complement system (CS). This study investigates activation of all complement pathways in BP skin biopsies. Moreover, pharmacological inhibition at different levels of the CS was investigated using anti-complement compounds in a complement fixation BP assay. In this retrospective study, 21 frozen biopsies from BP patients were stained by direct immunofluorescence for C1q, MBL, ficolin-2, C4d, properdin, C3c and C5b-9. Sera from 10 patients were analysed in a complement fixation assay in the presence of C1 inhibitor, anti-factor B monoclonal antibody (mAb), anti-C3 mAb and anti-C5 mAb and compared with dexamethasone. The two readouts were the quantity of complement deposited along the BM and the release of sC5b-9 in the supernatant. Our results show classical and alternative complement pathway activation in BP skin biopsies, but could not demonstrate significant lectin pathway activation. In contrast to dexamethasone, complement deposition along the BM could be selectively inhibited by anti-C1 and anti- factor B. More downstream, selective intervention at the level of C3 and C5 could effectively reduce complement deposition along the BM and the release of sC5b-9 in the supernatant. This study shows that selective intervention in either the classical, alternative or terminal pathway prevented deposition of complement along the BM in an in vitro BP model. The results of our study greatly encourage the clinical development of complement inhibitors for the treatment of BP.
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Affiliation(s)
- Jenny Giang
- Department of Pathology, Maasstad Hospital, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Centre for Human Drug Research, Leiden, The Netherlands
| | - Gilles F H Diercks
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Santiago Rodriguez de Cordoba
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Madrid, Spain.,Centro de Investigación Biomédica en Enfermedades Raras, Madrid, Spain
| | | | - Marco W J Schreurs
- Department of Immunology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Felix Poppelaars
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jeffrey Damman
- Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
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16
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Gosselt HR, van Lint JA, Kosse LJ, Spuls PI, Vonkeman HE, Tas SW, Hoentjen F, Nurmohamed MT, van den Bemt BJF, van Doorn MBA, Jessurun NT. Sex differences in adverse drug reactions from Adalimumab and etanercept in patients with inflammatory rheumatic diseases. Expert Opin Drug Saf 2023; 22:501-507. [PMID: 36794307 DOI: 10.1080/14740338.2023.2181340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/16/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND We examine sex differences in relation to the nature, frequency, and burden of patient-reported adverse drug reactions (ADRs) in patients with inflammatory rheumatic diseases. RESEARCH DESIGN AND METHODS Rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis patients using etanercept or adalimumab from the Dutch Biologic Monitor were sent bimonthly questionnaires concerning experienced ADRs. Sex differences in the proportion and nature of reported ADRs were assessed. Additionally, 5-point Likert-type scales reported for the burden of ADRs, were compared between sexes. RESULTS In total 748 consecutive patients were included (59% female). From the women 55% reported ≥1 ADR, which was significantly higher than 38% of the men that reported ≥1 ADR (p < 0.001). A total of 882 ADRs were reported comprising 264 distinct ADRs. The nature of the reported ADRs differed significantly between both sexes (p = 0.02). Women in particular reported more injection site reactions than men. The burden of ADRs was similar between sexes. CONCLUSIONS Sex differences in the frequency and nature of ADRs, but not in ADR burden, exist during treatment with adalimumab and etanercept in patients with inflammatory rheumatic diseases. This should be taken into consideration when investigating and reporting results on ADRs and when counseling patients in daily clinical practice.
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Affiliation(s)
- Helen R Gosselt
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
| | - Jette A van Lint
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
| | - Leanne J Kosse
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Phyllis I Spuls
- Department of Dermatology, Public Health and Epidemiology, Immunity and Infections, Amsterdam UMC, location Academic Medical Center, Amsterdam, The Netherlands
| | - Harald E Vonkeman
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Sander W Tas
- Department of Rheumatology & Clinical Immunology, Amsterdam UMC, location AMC, University of Amsterdam and Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam, the Netherlands
| | - Frank Hoentjen
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Bart J F van den Bemt
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
| | - Naomi T Jessurun
- Netherlands Pharmacovigilance Centre Lareb,'s'-Hertogenbosch, Netherlands
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17
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de Boer M, Gosselt HR, Jansen J, van Doorn MBA, Hoentjen F, Nurmohamed MT, Spuls PI, Tas SW, Vonkeman HE, Jessurun NT. Analysis and visualization of the course and burden over time of adverse drug reactions (ADRs) attributed to TNFα-inhibitors in patients with inflammatory rheumatic diseases (IRDs). Expert Opin Drug Saf 2022; 22:195-202. [PMID: 35946722 DOI: 10.1080/14740338.2022.2110237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND We aimed to investigate course and burden over time of ADRs attributed to TNFα-inhibitors in IRD-patients, and whether Sankey diagrams and polar plots can visualize this. RESEARCH DESIGN AND METHODS Data on ADRs experienced during the Dutch Biologic Monitor (January 2017 till December 2022) were used in this study. We selected IRD-patients using a TNFα-inhibitor, reporting skin reactions/infections/injection site reactions and completing ≥3 questionnaires (i.e. the initial report and ≥2 follow-ups). Course was scored as worsening/improving/remaining stable/resolving and as (non-)recurrent. Patients scored burden from 1 (no burden) to 5 (very high burden). Sankey diagrams and polar plots visualized this. RESULTS 202 patients were included, reporting 353 ADRs. Most skin reactions were stable (25.0%). Most infections resolved (50.8%). Injection site reactions were mostly recurrent (72.3%). Skin reactions and infections tended to decrease in burden . Infections had highest burden at start, which mostly decreased over time. Injection site reactions had a low and stable burden. CONCLUSIONS Skin reactions attributed to TNFα-inhibitors by IRD-patients are stable with a slightly decreasing burden over time. Infections have highest burden at start but resolved mostly. Injection site reactions have a low and stable burden. Sankey diagrams and polar plots are suitable to visualize this.
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Affiliation(s)
- Merel de Boer
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Helen R Gosselt
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Jurriaan Jansen
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, Rotterdam, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Frank Hoentjen
- Radboud University Medical Center, Nijmegen, the Netherlands.,Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Phyllis I Spuls
- Department of Dermatology, Amsterdam Public Health/Infection and Immunology, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Sander W Tas
- Department of Rheumatology & Clinical Immunology, Amsterdam UMC, location AMC, University of Amsterdam and Amsterdam Rheumatology & Immunology Center (ARC), Amsterdam, the Netherlands
| | - Harald E Vonkeman
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, the Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands
| | - Naomi T Jessurun
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
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18
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Sleutjes JAM, Roeters van Lennep JE, Verploegh PJP, van Doorn MBA, Vis M, Kavousi M, van der Woude CJ, de Vries AC. Prevalence of ideal cardiovascular health and its correlates in patients with inflammatory bowel disease, psoriasis and spondylarthropathy. Eur J Prev Cardiol 2022; 29:e314-e318. [PMID: 35708713 DOI: 10.1093/eurjpc/zwac110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Jasmijn A M Sleutjes
- Dept. of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Pepijn J P Verploegh
- Dept. of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Marijn Vis
- Dept. of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Kavousi
- Dept. of Epidemiology of Cardiometabolic Disorders, Erasmus Medical Center, The Netherlands
| | - C Janneke van der Woude
- Dept. of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Annemarie C de Vries
- Dept. of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
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19
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Kasiem FR, Pasma A, Luime JJ, Tchetverikov I, Wervers K, Korswagen LA, Denissen N, Goekoop-Ruiterman YPM, van Oosterhout M, Fodili F, Hazes JMW, van Doorn MBA, Kok MR, Vis M. A practical guide for assessment of skin burden in patients with psoriatic arthritis. J Rheumatol 2022; 49:1117-1123. [PMID: 35649550 DOI: 10.3899/jrheum.210550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Rheumatologists play a pivotal role in the management of patients with Psoriatic Arthritis (PsA). Due to time constraints, the skin may not receive the attention that is needed for optimal patient outcome. Therefore, the aim of this study was to select a set of core questions that can help rheumatologists to identify PsA patients with a high skin burden in daily rheumatology clinical practice. METHODS Baseline data from patients included in the Dutch south west Psoriatic Arthritis cohort were used. Questions were derived from the Skindex-17 and Dermatology Life Quality Index (DLQI) questionnaires. Underlying clusters of questions were identified with an exploratory principal component analysis (PCA) with varimax rotation, after which a 2-parameter logistic model was fitted per cluster. Questions were selected based on their discrimination and difficulty. Subsequently, two flowcharts were made with categories of skin burden severity. Clinical consideration were specified per category. RESULTS In total, 413 patients were included. The PCA showed 2 underlying clusters; a psychosocial domain and a domain assessing physical symptoms. We selected these 2 domains. The psychosocial domain contains 3 questions and specifies 4 categories of skin burden severity. The physical symptoms domain contains 2 questions and categorizes patients in one out of 3 categories. CONCLUSION We have selected a set of maximum 5 questions which rheumatologists can easily implement in their consult to assess skin burden in PsA patients. This practical guide makes assessment of skin burden more accessible to rheumatologists and can aid in clinical decision making.
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Affiliation(s)
- Fazira R Kasiem
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Annelieke Pasma
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Jolanda J Luime
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Ilja Tchetverikov
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Kim Wervers
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Lindy-Anne Korswagen
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Natasja Denissen
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Yvonne P M Goekoop-Ruiterman
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Maikel van Oosterhout
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Faouzia Fodili
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Johanna M W Hazes
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Martijn B A van Doorn
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
| | - Marc R Kok
- Erasmus Medical Center, dep. of Rheumatology, Albert Schweitzer Hospital, dep. of Rheumatology, Franciscus Gasthuis & Vlietland, dep. of Rheumatology, Amphia Hospital, dep. of Rheumatology, Haga Hospital, dep. of Rheumatology, Groene Hart Ziekenhuis dep. of Rheumatology, Reumazorg Zuid West Nederland, dep. of Rheumatology, Erasmus Medical Center, dep. of Dermatology, Maasstad Hospital, dep. of Rheumatology and clinical immunology. Statement of ethics and consent: This study was approved by the local medical research ethics committee of the University Medical Center Rotterdam (MEC-2012-549) and written informed consent was obtained for all study participants according to the Declaration of Helsinki. Address correspondence to Fazira. R. Kasiem, MD; Doctor Molewaterplein 40, 3015 GD Rotterdam. Email address:
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20
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Hermans MAW, Pasmans SGMA, Arends NJT, van den Bosch TPP, van Daele PLA, van Doorn MBA, Huisman EJ, Mooyaart AL, Damman J. Histopathological characteristics are instrumental to distinguish monomorphic from polymorphic maculopapular cutaneous mastocytosis in children. Clin Exp Dermatol 2022; 47:1694-1702. [PMID: 35596520 PMCID: PMC9544455 DOI: 10.1111/ced.15262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
Background Mastocytosis is characterized by the accumulation of mast cells (MCs) in the skin or other organs, and can manifest at any age. A significant number of paediatric mastocytosis cases persist after puberty. In particular, monomorphic maculopapular cutaneous mastocytosis (mMPCM) is often persistent and associated with systemic mastocytosis. However, clinical differentiation of MPCM from polymorphic (p)MPCM can be difficult. Aim To identify histopathological features that can help to distinguish mMPCM from other subtypes of paediatric mastocytosis. Methods This was a retrospective study using skin biopsies from patients with any subtype of mastocytosis. The localization and density of the MC infiltrate, MC morphology and expression of aberrant markers were evaluated and correlated with clinical characteristics. Results In total, 33 biopsies were available for evaluation from 26 children [(10 with mMPCM, 5 with mastocytoma, 3 with diffuse cutaneous mastocytosis (DCM), 8 with pMPCM)] and 7 adults with MPCM. The MC number was increased in all patients, but was higher in children than adults (P < 0.01). The presence of mMPCM was associated with sparing of the papillary dermis from MC infiltration, whereas MC density in the papillary dermis was highest in pMPCM and DCM (P < 0.01). The positive predictive value of the presence of a reticular MC infiltrate for mMPCM was 72.7% (95% CI 51.4–87.0), and the negative predictive value was 83.3% (95% CI 42.2–97.2). There were no relevant differences in the expression of CD2, CD25 or CD30 between the different subtypes. Conclusion Skin histopathology might enhance the phenotypical differentiation of mMPCM from other subtypes in children, thereby increasing the accuracy of one's prognosis.
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Affiliation(s)
- Maud A W Hermans
- Department of internal medicine, section of allergy & clinical immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzanne G M A Pasmans
- Department of dermatology, Erasmus University MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nicolette J T Arends
- Department of pediatric medicine, section of allergy, Erasmus University MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Paul L A van Daele
- Department of internal medicine, section of allergy & clinical immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of pediatric hematology, Erasmus University MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of dermatology, Erasmus University MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Elise J Huisman
- Department of pediatric hematology, Erasmus University MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Antien L Mooyaart
- Department of immunology, Erasmus University MC, Rotterdam, The Netherlands
| | - Jeffrey Damman
- Department of pathology, Erasmus University MC, Rotterdam, The Netherlands
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21
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Geeven IPAC, Jessurun NT, Wasylewicz ATM, Drent M, Spuls PI, Hoentjen F, van Puijenbroek EP, Vonkeman HE, Grootens KP, van Doorn MBA, van Den Bemt BJF, Bekkers CL. Barriers and facilitators for systematically registering adverse drug reactions in electronic health records: a qualitative study with Dutch healthcare professionals. Expert Opin Drug Saf 2022; 21:699-706. [DOI: 10.1080/14740338.2022.2020756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Isa P. A. C. Geeven
- Research Department, Pharmacovigilance Centre Lareb, ’s-Hertogenbosch, The Netherlands
| | - Naomi T. Jessurun
- Research Department, Pharmacovigilance Centre Lareb, ’s-Hertogenbosch, The Netherlands
- Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands
| | | | - Marjolein Drent
- Department of Pulmonology, St Antonius Hospital, Interstitial Lung Diseases (ILD) Center of Excellence, Nieuwegein, The Netherlands
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht, The Netherlands
- ild Care Foundation Research Team, Ede, The Netherlands
| | - Phyllis I. Spuls
- Department of Dermatology, Amsterdam University Medical Centers, Amsterdam Public Health and Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Frank Hoentjen
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eugène P. van Puijenbroek
- Research Department, Pharmacovigilance Centre Lareb, ’s-Hertogenbosch, The Netherlands
- Reinier van Arkel Mental health Institution, Department of Geriatric and Hospital Psychiatry, ‘s-Hertogenbosch, The Netherlands
| | - Harald E. Vonkeman
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherland
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Koen P. Grootens
- Renier van Arkel Mental Health Insitutute ‘S Hertogenbosch, The Netherlands
| | | | - Bart J. F. van Den Bemt
- Department of Pharmacy, Sint Maartenskliniek, Ubbergen, The Netherlands
- Department of Pharmacy, Research Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Charlotte L. Bekkers
- Department of Pharmacy, Research Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
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22
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Bik L, van Doorn MBA, Boeijink N, Wennekers M, Meesters AA, Bloemen P, Haedersdal M, Wolkerstorfer A. Clinical endpoints of needle-free jet injector treatment: An in depth understanding of immediate skin responses. Lasers Surg Med 2022; 54:693-701. [PMID: 35067934 PMCID: PMC9303610 DOI: 10.1002/lsm.23521] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 12/13/2022]
Abstract
Objectives Needle‐free jet injectors have been used in dermatological practice for many years. However, predefined clinical endpoints that guide physicians to choose optimal device settings have not been clearly defined. Here, we evaluate immediate skin responses as clinical endpoints for needle‐free jet injector treatments. Methods We injected methylene blue in ex vivo human skin using an electronically‐controllable pneumatic injector (EPI; 3–6 bar, 50–130 µl; n = 63), and a spring‐loaded jet injector (SLI) with fixed settings (100 µl; n = 9). We measured the immediate skin papule (3D‐camera), residual surface fluid (pipette), dermal dye distribution by estimating depth and width, and subcutaneous dye deposition. Results EPI with 4 bar and 100 µl resulted in the largest skin papule of 48.7 mm3 (35.4–62.6 mm3) and widest dermal distribution of 8.0 mm (5.5–9.0 mm) compared to EPI with 6 bar and 100 µl (p < 0.001, p = 0.018, respectively). The skin papule volume showed a significant moderate to high positive correlation with the width and depth of dye distribution in the dermis (rs = 0.63, rs = 0.58, respectively; p < 0.001 for both correlations). SLI showed high variability for all outcome measures. Finally, a trend was observed that a small skin papule (≤7 mm) and little residual surface fluid (≤10% of injection volume) were warning signs for subcutaneous deposition. Conclusions The immediate skin papule and residual surface fluid correspond with dermal drug deposition and are relevant clinical endpoints for needle‐free jet injector treatments in dermatological practice.
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Affiliation(s)
- Liora Bik
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Neill Boeijink
- Department of Dermatology, Amsterdam UMC Medical Center, Amsterdam, The Netherlands
| | - Medelyn Wennekers
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Arne A Meesters
- Department of Dermatology, Amsterdam UMC Medical Center, Amsterdam, The Netherlands
| | - Peter Bloemen
- Department of Biomedical Engineering, Amsterdam UMC Medical Center, Amsterdam, The Netherlands
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam UMC Medical Center, Amsterdam, The Netherlands
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23
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Bik L, Wolkerstorfer A, Bekkers V, Prens EP, Haedersdal M, Bonn D, van Doorn MBA. Needle-free jet injection-induced small-droplet aerosol formation during intralesional bleomycin therapy. Lasers Surg Med 2021; 54:572-579. [PMID: 34931319 PMCID: PMC9303553 DOI: 10.1002/lsm.23512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/14/2021] [Accepted: 12/04/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Needle-free jet injectors are frequently used in dermatological practice. Injection-generated small-droplet aerosols could be harmful upon inhalation when chemotherapeutics, like bleomycin, are used. Here, we aim to explore jet injector-induced small-droplet aerosol formation of bleomycin in relation to air ventilation and to provide safety measures for clinical practice. MATERIALS AND METHODS With a professional particle sensor, we measured airborne aerosol particles (0.2-10.0 µm) after electronic pneumatic injection (EPI), spring-loaded jet injection (SLI), and needle injection (NI) of bleomycin and saline (100 μl) on ex vivo human skin. Three levels of air ventilation were explored: no ventilation, room ventilation, and room ventilation with an additional smoke evacuator. RESULTS EPI and SLI induced significant small-droplet aerosol formation compared with none after NI (0.2-1.0 µm; no ventilation). The largest bleomycin aerosol generation was observed for the smallest particles (0.2-1.0 µm) with 673.170 (528.802-789.453) aerosol particles/liter air (EPI; no ventilation). Room ventilation and smoke evacuation led to a reduction of ≥99% and 100% of measured aerosols, respectively. CONCLUSION Jet injectors generate a high number of small-droplet aerosols, potentially introducing harmful effects to patients and healthcare personnel. Room ventilation and smoke evacuation are effective safety measures when chemotherapeutics are used in clinical practice.
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Affiliation(s)
- Liora Bik
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Wolkerstorfer
- Department of Dermatology, Amsterdam UMC Medical Center, Amsterdam, The Netherlands
| | - Vazula Bekkers
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg hospital, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Bonn
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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24
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van Lint JA, van Hunsel FPAM, Tas SW, Vonkeman HE, Hoentjen F, van Doorn MBA, Hebing RCF, Nurmohamed MT, van den Bemt BJF, van Puijenbroek EP, Jessurun NT. Hypoglycaemia following JAK inhibitor treatment in patients with diabetes. Ann Rheum Dis 2021; 81:597-599. [PMID: 34916208 DOI: 10.1136/annrheumdis-2021-221840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/07/2021] [Indexed: 01/20/2023]
Affiliation(s)
- Jette A van Lint
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
| | | | - Sander W Tas
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, location AMC, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Harald E Vonkeman
- Department of Rheumatology & Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Frank Hoentjen
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Renske C F Hebing
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center
- Reade, Amsterdam, The Netherlands
| | - Michael T Nurmohamed
- Department of Rheumatology, Amsterdam Rheumatology and Immunology Center
- Reade, Amsterdam, The Netherlands.,Rheumatology, Amsterdam University Medical Centres, Location VUmc, Amsterdam, The Netherlands
| | - Bart J F van den Bemt
- Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands.,Pharmacy, Radboudumc, Nijmegen, The Netherlands
| | - Eugene P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.,Pharmacotherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Naomi T Jessurun
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands
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25
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Stroet LC, Hermans MAW, Maurer M, van Doorn MBA. Cold-induced urticaria associated with type I cryoglobulinemia, successfully treated with rituximab. JAAD Case Rep 2021; 19:18-20. [PMID: 34901362 PMCID: PMC8640162 DOI: 10.1016/j.jdcr.2021.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Leonie C Stroet
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maud A W Hermans
- Department of Internal Medicine, Section of Allergy & Immunology, Urticaria Center of Reference and Excellence (UCARE), Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Maurer
- Dermatological Allergology; Department of Dermatology and Allergy, Charité, Urticaria Center of Reference and Excellence (UCARE), Universitätsmedizin, Berlin, Germany.,Department of Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
| | - Martijn B A van Doorn
- Department of Dermatology, Urticaria Center of Reference and Excellence (UCARE), Erasmus Medical Center, Rotterdam, The Netherlands
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26
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Hendel K, Hansen ACN, Bik L, Bagger C, van Doorn MBA, Janfelt C, Olesen UH, Haedersdal M, Lerche CM. Bleomycin administered by laser-assisted drug delivery or intradermal needle-injection results in distinct biodistribution patterns in skin: in vivo investigations with mass spectrometry imaging. Drug Deliv 2021; 28:1141-1149. [PMID: 34121567 PMCID: PMC8205002 DOI: 10.1080/10717544.2021.1933649] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Bleomycin (BLM) is being repositioned in dermato-oncology for intralesional and intra-tumoural use. Although conventionally administered by local needle injections (NIs), ablative fractional lasers (AFLs) can facilitate topical BLM delivery. Adding local electroporation (EP) can augment intracellular uptake in the target tissue. Here, we characterize and compare BLM biodistribution patterns, cutaneous pharmacokinetic profiles, and tolerability in an in vivo pig model following fractional laser-assisted topical drug delivery and intradermal NI, with and without subsequent EP. In vivo pig skin was treated with AFL and topical BLM or NI with BLM, alone or with additional EP, and followed for 1, 2 and 4 h and eventually up to 9 d. BLM biodistribution was assessed by spatiotemporal mass spectrometry imaging. Cutaneous pharmacokinetics were assessed by mass spectrometry quantification and temporal imaging. Tolerability was evaluated by local skin reactions (LSRs) and skin integrity measurements. AFL and NI resulted in distinct BLM biodistributions: AFL resulted in a horizontal belt-shaped BLM distribution along the skin surface, and NI resulted in BLM radiating from the injection site. Cutaneous pharmacokinetic analyses and temporal imaging showed a substantial reduction in BLM concentration within the first few hours following administration. LSRs were tolerable overall, and all interventions permitted almost complete recovery of skin integrity within 9 d. In conclusion, AFL and NI result in distinct cutaneous biodistribution patterns and pharmacokinetic profiles for BLM applied to in vivo skin. Evaluation of LSRs showed that both methods were similarly tolerable, and each method has potential for individualized approaches in a clinical setting.
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Affiliation(s)
- Kristoffer Hendel
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Anders C N Hansen
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Liora Bik
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Charlotte Bagger
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Christian Janfelt
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
| | - Uffe H Olesen
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Catharina M Lerche
- Department of Dermatology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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27
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van Lint JA, Jessurun NT, Tas SW, van den Bemt BJF, Nurmohamed MT, van Doorn MBA, Spuls PI, van Tubergen AM, Ten Klooster PM, van Puijenbroek EP, Hoentjen F, Vonkeman HE. Gastrointestinal Adverse Drug Reaction Profile of Etanercept: Real-world Data From Patients and Healthcare Professionals. J Rheumatol 2021; 48:1388-1394. [PMID: 33993115 DOI: 10.3899/jrheum.201373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to describe the nature and frequency of gastrointestinal adverse drug reactions (GI-ADRs) of etanercept (ETN) using patient-reported and healthcare professional (HCP)-registered data and compared this frequency with the GI-ADR frequency of the widely used tumor necrosis factor-α inhibitor adalimumab (ADA). METHODS Reported GI-ADRs of ETN for rheumatic diseases were collected from the Dutch Biologic Monitor and DREAM registries. We described the clinical course of GI-ADRs and compared the frequency with ADA in both data sources using Fisher exact test. RESULTS Out of 416 patients using ETN for inflammatory rheumatic diseases in the Dutch Biologic Monitor, 25 (6%) patients reported 36 GI-ADRs. In the DREAM registries 11 GI-ADRs were registered for 9 patients (2.3%), out of 399 patients using ETN, with an incidence of 7.1 per 1000 patient-years. Most GI-ADRs consisted of diarrhea, nausea, and abdominal pain. GI-ADRs led to ETN discontinuation in 1 patient (4%) and dose adjustment in 4 (16%) in the Dutch Biologic Monitor. Eight GI-ADRs (73%) led to ETN discontinuation in the DREAM registries. The frequency of GI-ADRs of ETN did not significantly differ from GI-ADRs of ADA in both data sources (Dutch Biologic Monitor: ETN 8.7% vs ADA 5.3%, P = 0.07; DREAM: ETN 2.8% vs ADA 4.7%, P = 0.16). CONCLUSION Most GI-ADRs associated with ETN concerned gastrointestinal symptoms. These ADRs may lead to dose adjustment or ETN discontinuation. The frequency of ETN-associated GI-ADRs was comparable to the frequency of ADA-associated GI-ADRs. Knowledge about these previously unknown ADRs can facilitate early recognition and improve patient communication.
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Affiliation(s)
- Jette A van Lint
- J.A. van Lint, PharmD, N.T. Jessurun, PharmD, Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch;
| | - Naomi T Jessurun
- J.A. van Lint, PharmD, N.T. Jessurun, PharmD, Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch
| | - Sander W Tas
- S.W. Tas, MD, PhD, Department of Rheumatology & Clinical Immunology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Infection & Immunity Institute and Amsterdam Rheumatology & immunology Center (ARC), Amsterdam
| | - Bart J F van den Bemt
- B.J.F. van den Bemt, PharmD, Prof. Dr., Department of Pharmacy, Sint Maartenskliniek, and Department of Pharmacy, Radboud University Medical Center, Nijmegen
| | - Michael T Nurmohamed
- M.T. Nurmohamed, MD, Prof. Dr., Amsterdam Rheumatology & immunology Center (ARC), Reade, and Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam
| | - Martijn B A van Doorn
- M.B. van Doorn, MD, PhD, Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam
| | - Phyllis I Spuls
- P.I. Spuls, MD, Prof. Dr., Department of Dermatology, Public Health and Epidemiology, Immunity and Infections, Amsterdam UMC, location Academic Medical Center, Amsterdam
| | - Astrid M van Tubergen
- A.M. van Tubergen, MD, Prof. Dr., Department of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht
| | - Peter M Ten Klooster
- P.M. ten Klooster, PhD, Transparency in Healthcare BV, Hengelo, and Department of Psychology, Health & Technology, University of Twente, Enschede
| | - Eugene P van Puijenbroek
- E.P. van Puijenbroek, MD, Prof. Dr., Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, and Department of Pharmacotherapy, Epidemiology & Economics, University of Groningen, Groningen
| | - Frank Hoentjen
- F. Hoentjen, MD, PhD, Department of Gastroenterology, Radboud University Medical Center, Nijmegen
| | - Harald E Vonkeman
- H.E. Vonkeman, MD, PhD, Department of Psychology, Health & Technology, University of Twente, and Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, the Netherlands
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28
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Buters TP, van der Velden WAC, Abdisalaam I, van Maaren MS, van Doorn MBA. Effectiveness and tolerability of personalized omalizumab treatment in patients with chronic inducible urticaria. J Allergy Clin Immunol Pract 2021; 9:3227-3229. [PMID: 33915307 DOI: 10.1016/j.jaip.2021.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas P Buters
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands
| | - Willemijn A C van der Velden
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ismahaan Abdisalaam
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands
| | - Maurits S van Maaren
- Department of Allergology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands.
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Saghari M, Gal P, Ziagkos D, Burggraaf J, Powell JF, Brennan N, Rissmann R, van Doorn MBA, Moerland M. A randomized controlled trial with a delayed-type hypersensitivity model using keyhole limpet haemocyanin to evaluate adaptive immune responses in man. Br J Clin Pharmacol 2020; 87:1953-1962. [PMID: 33025648 PMCID: PMC8056735 DOI: 10.1111/bcp.14588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 01/12/2023] Open
Abstract
AIMS Keyhole limpet haemocyanin (KLH) immunization is a clinical model for the evaluation of human antibody responses. The current study evaluated the anti-KLH antibody response after KLH immunization and the delayed-type hypersensitivity response following intradermal KLH administration, using objective imaging techniques. METHODS Healthy male subjects aged 24.5 ± 5.4 years were randomized to intramuscular immunization with 100 μg KLH (n = 12) or placebo (n = 3). Anti-KLH antibody (Ig) M and IgG titres were determined before and every 7 days after KLH immunization for a total of 28 days. Twenty-one days after the immunization, all subjects received 1 μg KLH intradermally. Prior to and 2 days after intradermal KLH administration, skin blood perfusion, erythema and oedema were quantified using noninvasive imaging tools. Repeated measures ANCOVAs were used to analyse data. RESULTS Anti-KLH IgM and IgG titres increased after KLH immunization compared to placebo (estimated difference [ED]: 37%, 95% confidence interval [CI]: 19-51% and ED: 68%, 95% CI: 56-76% respectively). Upon intradermal KLH administration an increase in skin blood perfusion (ED: 10.9 arbitrary units (AU), 95% CI: 1.4-20.4 AU) and erythema (ED: 0.3 AU, 95% CI: 0.1-0.5 AU) was observed in KLH-immunized subjects compared to placebo. CONCLUSION KLH immunization followed by intradermal KLH administration resulted in increased anti-KLH IgM and IgG titres and a delayed-type hypersensitivity response quantified by an increase in skin blood perfusion and erythema. Using noninvasive imaging tools the KLH model has the potential to serve as an objective tool to study the pharmacodynamics of T-cell-directed immunomodulatory drugs.
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Affiliation(s)
- Mahdi Saghari
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Centre, Leiden, the Netherlands
| | - Pim Gal
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Centre, Leiden, the Netherlands
| | | | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Centre, Leiden, the Netherlands.,Leiden Academic Centre for Drug Research, Leiden, the Netherlands
| | | | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Centre, Leiden, the Netherlands.,Leiden Academic Centre for Drug Research, Leiden, the Netherlands
| | | | - Matthijs Moerland
- Centre for Human Drug Research, Leiden, the Netherlands.,Leiden University Medical Centre, Leiden, the Netherlands
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30
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Perez-Garcia LF, Dolhain R, Te Winkel B, Carrizales JP, Bramer WM, Vorstenbosch S, van Puijenbroek E, Hazes M, van Doorn MBA. Male Sexual Health and Reproduction in Cutaneous Immune-Mediated Diseases: A Systematic Review. Sex Med Rev 2020; 9:423-433. [PMID: 32883623 DOI: 10.1016/j.sxmr.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Information about the possible effects of cutaneous immune-mediated diseases (cIMDs) on male sexual function and reproduction is scarce. Factors known to impair sexual health and reproduction, such as inflammation, medication use, and hypogonadism, can be present in a significant proportion of male patients with cIMD. OBJECTIVES To systematically review the literature for the influence of paternal cIMD on many aspects of male sexual and reproductive health, such as sexual function, reproductive hormones, fertility, and pregnancy and offspring outcomes. METHODS A systematic literature search was performed. The searches combined keywords regarding male sexual function and fertility, pregnancy outcomes, and offspring's health with a list of cIMDs. RESULTS The majority of the identified studies included patients with psoriasis (22 of 27), and sexual function was the most common outcome of interest (20 of 27). For patients diagnosed with psoriasis, the prevalence of male sexual dysfunction reported in these studies ranged from 34 to 81%. Hypogonadism in patients with psoriasis was reported in 2 of 3 studies. Sperm analysis abnormalities in patients with psoriasis were reported in 3 of 4 studies. No information about the effect of paternal disease on pregnancy and offspring outcomes was identified. CONCLUSIONS Disease activity in psoriasis might play an important role in the development of sexual dysfunction, hypogonadism, and abnormal sperm quality. For the other cIMD included in this review, there is insufficient information regarding male sexual and reproductive health to draw firm conclusions. More research is needed to understand the association between cIMD and impaired male sexual and reproductive health. Perez-Garcia LF, Dolhain R, te Winkel B, et al. Male Sexual Health and Reproduction in Cutaneous Immune-Mediated Diseases: A Systematic Review. Sex Med Rev 2021;9:423-433.
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Affiliation(s)
- Luis F Perez-Garcia
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Radboud Dolhain
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Bernke Te Winkel
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Juan P Carrizales
- Servicio de Reumatología, Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Mexico
| | - Wichor M Bramer
- Medical Library, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Saskia Vorstenbosch
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands
| | - Eugene van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, the Netherlands; Research Institute of Pharmacy, PharmacoTherapy, Epidemiology and Economics, University of Groningen, Groningen, the Netherlands
| | - Mieke Hazes
- Department of Rheumatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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31
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Bik L, van Doorn MBA, Biskup E, Ortner VK, Haedersdal M, Olesen UH. Electronic Pneumatic Injection-Assisted Dermal Drug Delivery Visualized by Ex Vivo Confocal Microscopy. Lasers Surg Med 2020; 53:141-147. [PMID: 32515075 PMCID: PMC7891353 DOI: 10.1002/lsm.23279] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/05/2020] [Accepted: 05/23/2020] [Indexed: 12/14/2022]
Abstract
Background and Objectives Electronic pneumatic injection (EPI) is a technique for dermal drug delivery, which is increasingly being used in clinical practice. However, only few studies have been reported on cutaneous drug distribution and related clinical endpoints. We aimed to visualize the immediate cutaneous drug distribution, changes in skin architecture, and related clinical endpoint of EPI. Study Design/Materials and Methods Acridine orange (AO) solution was administered to ex vivo porcine skin by EPI at pressure levels from 4 to 6 bar with a fixed injection volume of 50 µl and nozzle size of 200 µm. Immediate cutaneous distribution was visualized using ex vivo confocal microscopy (EVCM). Changes in skin architecture were visualized using both EVCM and hematoxylin and eosin‐stained cryosections. Results The defined immediate endpoint was a clinically visible papule formation on the skin. The pressure threshold to consistently induce a papule was 4 bar, achieving delivery of AO to the deep dermis (2319 µm axial and 5944 µm lateral distribution). Increasing the pressure level to 6 bar did not lead to significant differences in axial and lateral dispersion (P = 0.842, P = 0.905; respectively). A distinctively hemispherical distribution pattern was identified. Disruption of skin architecture occurred independently of pressure level, and consisted of subepidermal clefts, dermal vacuoles, and fragmented collagen. Conclusions This is the first study to relate a reproducible clinical endpoint to EPI‐assisted immediate drug delivery using EVCM. An EPI‐induced skin papule indicates dermal drug delivery throughout all layers of the dermis, independent of pressure level settings. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC
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Affiliation(s)
- Liora Bik
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark.,Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Doctor Molewaterplein 40, Rotterdam, 3015 GD, The Netherlands
| | - Edyta Biskup
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Vinzent K Ortner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
| | - Uffe H Olesen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark
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32
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Niemeyer-van der Kolk T, van der Wall H, Hogendoorn GK, Rijneveld R, Luijten S, van Alewijk DCJG, van den Munckhof EHA, de Kam ML, Feiss GL, Prens EP, Burggraaf J, Rissmann R, van Doorn MBA. Pharmacodynamic Effects of Topical Omiganan in Patients With Mild to Moderate Atopic Dermatitis in a Randomized, Placebo-Controlled, Phase II Trial. Clin Transl Sci 2020; 13:994-1003. [PMID: 32315497 PMCID: PMC7485951 DOI: 10.1111/cts.12792] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/17/2020] [Indexed: 12/29/2022] Open
Abstract
Omiganan is an indolicidin analog with antimicrobial properties that could be beneficial for patients with atopic dermatitis. In this randomized, double‐blind, placebo‐controlled, phase II trial we explored the efficacy, pharmacodynamics, and safety of topical omiganan once daily in 36 patients with mild to moderate atomic dermatitis. Patients were randomized to apply topical omiganan 1%, omiganan 2.5%, or vehicle gel to one target lesion once daily for 28 consecutive days. Small but significant improvements in local objective SCORing Atopic Dematitis index and morning itch were observed in the omiganan 2.5% group compared with the vehicle gel group (−18.5%; 95% confidence interval, −32.9 to −1.0; P = 0.04; and −8.2; 95% confidence interval, −16.3 to −0.2; P = 0.05, respectively). A shift from lesional to nonlesional skin microbiota was observed in both omiganan treatment groups, in contrast to the vehicle group. Thus, treatment with topical omiganan improved dysbiosis in patients with mild to moderate atopic dermatitis, and small but statistically significant improvements in clinical scores were detected. Our findings warrant further exploration in future clinical trials.
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Affiliation(s)
- Tessa Niemeyer-van der Kolk
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Hein van der Wall
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden Academic Center for Drug Research, Leiden, The Netherlands
| | | | | | | | | | | | | | | | - Errol P Prens
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands.,Leiden Academic Center for Drug Research, Leiden, The Netherlands
| | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands.,Leiden Academic Center for Drug Research, Leiden, The Netherlands
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands.,Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
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33
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Niemeyer-van der Kolk T, Assil S, Buters TP, Rijsbergen M, Klaassen ES, Feiss G, Florencia E, Prens EP, Burggraaf J, van Doorn MBA, Rissmann R, Moerland M. Omiganan Enhances Imiquimod-Induced Inflammatory Responses in Skin of Healthy Volunteers. Clin Transl Sci 2020; 13:573-579. [PMID: 32043302 PMCID: PMC7214655 DOI: 10.1111/cts.12741] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/04/2019] [Accepted: 11/04/2019] [Indexed: 12/01/2022] Open
Abstract
Omiganan (OMN; a synthetic cationic peptide) and imiquimod (IMQ; a TLR7 agonist) have synergistic effects on interferon responses in vitro. The objective of this study was to translate this to a human model for proof‐of‐concept, and to explore the potential of OMN add‐on treatment for viral skin diseases. Sixteen healthy volunteers received topical IMQ, OMN, or a combination of both for up to 4 days on tape‐stripped skin. Skin inflammation was quantified by laser speckle contrast imaging and 2D photography, and molecular and cellular responses were analyzed in biopsies. IMQ treatment induced an inflammatory response of the skin. Co‐treatment with OMN enhanced this inflammatory response to IMQ, with increases in perfusion (+17.1%; 95% confidence interval (CI) 5.6%–30%; P < 0.01) and erythema (+1.5; 95% CI 0.25%–2.83; P = 0.02). Interferon regulatory factor‐driven and NFκB‐driven responses following TLR7 stimulation were enhanced by OMN (increases in IL‐6, IL‐10, MXA, and IFNɣ), and more immune cell infiltration was observed (in particular CD4+, CD8+, and CD14+ cells). These findings are in line with the earlier mechanistic in vitro data, and support evaluation of imiquimod/OMN combination therapy in human papillomavirus‐induced skin diseases.
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Affiliation(s)
| | - Salma Assil
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | | | - Gary Feiss
- Cutanea Life Science, Wayne, Pennsylvania, USA
| | - Edwin Florencia
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Jacobus Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden Academic Center for Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | | | - Robert Rissmann
- Centre for Human Drug Research, Leiden, The Netherlands.,Leiden Academic Center for Drug Research, Leiden, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
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34
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van den Munckhof EHA, Niemeyer-van der Kolk T, van der Wall H, van Alewijk DCJG, van Doorn MBA, Burggraaf J, Buters TP, Becker MJ, Feiss GL, Quint WGV, van Doorn LJ, Knetsch CW, Rissmann R. Inter- and Intra-patient Variability Over Time of Lesional Skin Microbiota in Adult Patients with Atopic Dermatitis. Acta Derm Venereol 2020; 100:adv00018. [PMID: 31742645 PMCID: PMC9128996 DOI: 10.2340/00015555-3373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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35
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Edwards G, Diercks GFH, Seelen MAJ, Horvath B, van Doorn MBA, Damman J. Complement Activation in Autoimmune Bullous Dermatoses: A Comprehensive Review. Front Immunol 2019; 10:1477. [PMID: 31293600 PMCID: PMC6606728 DOI: 10.3389/fimmu.2019.01477] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022] Open
Abstract
Autoimmune bullous dermatoses (AIBD) are characterized by circulating autoantibodies that are either directed against epidermal antigens or deposited as immune complexes in the basement membrane zone (BMZ). The complement system (CS) can be activated by autoantibodies, thereby triggering activation of specific complement pathways. Local complement activation induces a pathogenic inflammatory response that eventually results in the formation of a sub- or intraepidermal blister. Deposition of complement components is routinely used as a diagnostic marker for AIBD. Knowledge from different animal models mimicking AIBD and deposition of complement components in human skin biopsies provides more insight into the role of complement in the pathogenesis of the different AIBD. This review outlines the role of the CS in several AIBD including bullous pemphigoid, epidermolysis bullosa acquisita, mucous membrane pemphigoid (MMP), pemphigus, linear IgA-disease, and dermatitis herpetiformis. We also discuss potential therapeutic approaches targeting key complement components, pathways and pathogenic complement-mediated events.
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Affiliation(s)
- Gareth Edwards
- Department of Dermatology, University Medical Center Groningen, Groningen, Netherlands
| | - Gilles F H Diercks
- Department of Pathology, University Medical Center Groningen, Groningen, Netherlands
| | - Marc A J Seelen
- Department of Nephrology, University Medical Center Groningen, Groningen, Netherlands
| | - Barbara Horvath
- Department of Dermatology, University Medical Center Groningen, Groningen, Netherlands
| | | | - Jeffrey Damman
- Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
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36
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de Wit J, Totté JEE, van Mierlo MMF, van Veldhuizen J, van Doorn MBA, Schuren FHJ, Willemsen SP, Pardo LM, Pasmans SGMA. Endolysin treatment against Staphylococcus aureus in adults with atopic dermatitis: A randomized controlled trial. J Allergy Clin Immunol 2019; 144:860-863. [PMID: 31145938 DOI: 10.1016/j.jaci.2019.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/08/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Jill de Wit
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Joan E E Totté
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Minke M F van Mierlo
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Joyce van Veldhuizen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Sten P Willemsen
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Suzanne G M A Pasmans
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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37
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Niemeyer-van der Kolk T, van Maaren MS, van Doorn MBA. Personalized omalizumab treatment improves clinical benefit in patients with chronic spontaneous urticaria. J Allergy Clin Immunol 2018; 142:1992-1994. [PMID: 30144475 DOI: 10.1016/j.jaci.2018.07.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/26/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Tessa Niemeyer-van der Kolk
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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38
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van den Reek JMPA, van Vugt LJ, van Doorn MBA, van der Kraaij GE, de Kort WJA, Lucker GPH, Horvath B, Njoo MD, Bovenschen HJ, Ossenkoppele PM, De Bruin-Weller MS, de Groot M, Mommers R, Prevoo RLMA, van de Kerkhof PCM, Spuls PI, Kievit W, de Jong EMGJ. Initial Results of Secukinumab Drug Survival in Patients with Psoriasis: A Multicentre Daily Practice Cohort Study. Acta Derm Venereol 2018; 98:648-654. [PMID: 29405245 DOI: 10.2340/00015555-2900] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interleukin 17-antagonist secukinumab demonstrated high efficacy for treatment of psoriasis in randomized controlled trials. However, performance in daily practice may differ from trials. Drug survival is a comprehensive outcome covering effectiveness and safety, suitable for analyses of daily practice. The aim of this study was to evaluate drug survival of secukinumab in a daily practice psoriasis cohort. Data were collected from 13 hospitals. Drug survival was analysed using Kaplan-Meier survival curves, split for reason of discontinuation. In total, 196 patients were included (83% biologic experienced). Overall, 12 and 18 months drug survival of secukinumab was 76% and 67%, respectively, and was mostly determined by ineffectiveness. There was a trend towards shorter drug survival in women and in biologic experienced patients. Thirteen percent of patients experienced at least one episode of fungal infection. This is one of the first studies of drug survival of secukinumab in patients with psoriasis treated in daily practice.
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Affiliation(s)
- Juul M P A van den Reek
- Department of Dermatology, Radboud University Medical Centre, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands.
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39
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Vossen ARJV, van der Zee HH, Terian M, van Doorn MBA, Prens EP. Laser-Haarentfernung verändert den Krankheitsverlauf bei leichter Hidradenitis suppurativa. J Dtsch Dermatol Ges 2018; 16:901-903. [PMID: 29989379 DOI: 10.1111/ddg.13563_g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Allard R J V Vossen
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Niederlande
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Niederlande
| | - Marinka Terian
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Niederlande
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Niederlande
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Niederlande
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40
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Vossen ARJV, van Doorn MBA, van der Zee HH, Prens EP. Apremilast for moderate hidradenitis suppurativa: Results of a randomized controlled trial. J Am Acad Dermatol 2018; 80:80-88. [PMID: 30482392 DOI: 10.1016/j.jaad.2018.06.046] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Effective anti-inflammatory treatments for hidradenitis suppurativa (HS) are limited. OBJECTIVE To evaluate the efficacy and short-term safety of apremilast in patients with moderate HS. METHODS A total of 20 patients with moderate HS were randomized in a 3:1 ratio to receive blinded treatment with apremilast, 30 mg twice daily, or placebo for 16 weeks. The primary outcome was the Hidradenitis Suppurativa Clinical Response at week 16. Linear mixed effects modeling (analysis of covariance) was used to assess secondary clinical outcomes between treatment groups. RESULTS The HS clinical response was met in 8 of 15 patients in the apremilast group (53.3%) and none of 5 patients in the placebo group (0%) (P = .055) at week 16. Moreover, the apremilast-treated patients showed a significantly lower abscess and nodule count (mean difference, -2.6; 95% confidence interval, -6.0 to -0.9; P = .011), NRS for pain (mean difference, -2.7; 95% -4.5 to -0.9; P = .009), and itch (mean difference, -2.8; 95% confidence interval, -5.0 to -0.6; P = .015) over 16 weeks compared with the placebo-treated patients. There was no significant difference in the Dermatology Life Quality Index over time between the 2 treatment groups (mean difference, -3.4; 95% confidence interval, -9.0 to 2.3; P = .230). The most frequently reported adverse events in the apremilast-treated patients were mild-to-moderate headache and gastrointestinal symptoms, which did not result in dropouts. LIMITATIONS Small number of patients, relatively short study duration. CONCLUSION Apremilast, at a dose of 30 mg twice daily, demonstrated clinically meaningful efficacy and was generally well tolerated in patients with moderate HS.
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Affiliation(s)
- Allard R J V Vossen
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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41
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van der Kolk T, Assil S, Rijneveld R, Klaassen ES, Feiss G, Florencia E, Prens EP, Burggraaf J, Moerland M, Rissmann R, van Doorn MBA. Comprehensive, Multimodal Characterization of an Imiquimod-Induced Human Skin Inflammation Model for Drug Development. Clin Transl Sci 2018; 11:607-615. [PMID: 29768709 PMCID: PMC6226121 DOI: 10.1111/cts.12563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 04/19/2018] [Indexed: 12/22/2022] Open
Abstract
Imiquimod (IMQ) is often used as a topical challenge agent to provoke local skin inflammation. The objective of this study was to develop and refine a rapid, temporary, and reversible human skin inflammation model with IMQ for application in clinical drug development. A randomized, vehicle‐controlled, open‐label, dose‐ranging study was conducted in 16 healthy male subjects. IMQ (5 mg) was applied once daily for 72 hours under occlusion to intact skin (n = 8) or tape stripped (TS) skin (n = 8). Although IMQ alone induced limited effects, TS+IMQ treatment showed larger responses in several domains, including erythema and perfusion (P < 0.0001), mRNA expression of inflammatory markers (P < 0.01), and inflammatory cell influx compared with vehicle. In conclusion, a rapid, human IMQ skin inflammation challenge model was successfully developed with a clear benefit of TS prior to IMQ application. Future interaction studies will enable proof‐of‐pharmacology of novel compounds targeting the innate immune system.
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Affiliation(s)
| | - Salma Assil
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | | | - Gary Feiss
- Cutanea Life Science, Inc., Wayne, Pennsylvania, USA
| | - Edwin Florencia
- Department of Dermatology Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology Erasmus Medical Centre, Rotterdam, The Netherlands
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Vossen ARJV, van der Zee HH, Terian M, van Doorn MBA, Prens EP. Laser hair removal alters the disease course in mild hidradenitis suppurativa. J Dtsch Dermatol Ges 2018; 16:901-903. [DOI: 10.1111/ddg.13563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Hessel H. van der Zee
- Department of Dermatology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - Marinka Terian
- Department of Dermatology; Erasmus University Medical Center; Rotterdam The Netherlands
| | | | - Errol P. Prens
- Department of Dermatology; Erasmus University Medical Center; Rotterdam The Netherlands
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Giang J, Seelen MAJ, van Doorn MBA, Rissmann R, Prens EP, Damman J. Complement Activation in Inflammatory Skin Diseases. Front Immunol 2018; 9:639. [PMID: 29713318 PMCID: PMC5911619 DOI: 10.3389/fimmu.2018.00639] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/14/2018] [Indexed: 01/02/2023] Open
Abstract
The complement system is a fundamental part of the innate immune system, playing a crucial role in host defense against various pathogens, such as bacteria, viruses, and fungi. Activation of complement results in production of several molecules mediating chemotaxis, opsonization, and mast cell degranulation, which can contribute to the elimination of pathogenic organisms and inflammation. Furthermore, the complement system also has regulating properties in inflammatory and immune responses. Complement activity in diseases is rather complex and may involve both aberrant expression of complement and genetic deficiencies of complement components or regulators. The skin represents an active immune organ with complex interactions between cellular components and various mediators. Complement involvement has been associated with several skin diseases, such as psoriasis, lupus erythematosus, cutaneous vasculitis, urticaria, and bullous dermatoses. Several triggers including auto-antibodies and micro-organisms can activate complement, while on the other hand complement deficiencies can contribute to impaired immune complex clearance, leading to disease. This review provides an overview of the role of complement in inflammatory skin diseases and discusses complement factors as potential new targets for therapeutic intervention.
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Affiliation(s)
- Jenny Giang
- Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Marc A J Seelen
- Department of Nephrology, University Medical Center Groningen, Groningen, Netherlands
| | | | | | - Errol P Prens
- Department of Dermatology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jeffrey Damman
- Department of Pathology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
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Greveling K, Kunkeler ACM, Prens EP, van Doorn MBA. Allergic contact dermatitis caused by topical sirolimus used as an adjuvant for laser treatment of port wine stains. Contact Dermatitis 2017; 75:184-5. [PMID: 27480514 DOI: 10.1111/cod.12589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 03/07/2016] [Accepted: 03/07/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Karin Greveling
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Amalia C M Kunkeler
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Erasmus MC, University Medical Centre Rotterdam, 3000 CA, Rotterdam, The Netherlands
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van Bezooijen JS, Balak DMW, van Doorn MBA, Looman CWN, Schreurs MWJ, Koch BCP, van Gelder T, Prens EP. Combination Therapy of Etanercept and Fumarates versus Etanercept Monotherapy in Psoriasis: A Randomized Exploratory Study. Dermatology 2016; 232:407-14. [PMID: 27576483 DOI: 10.1159/000448135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Biologics are a safe and efficacious therapy for psoriasis. The drug survival of biologics may be disappointing, primarily due to loss of efficacy. Therefore, safe combination treatments are sought to improve their clinical response. OBJECTIVE To assess the efficacy, safety and tolerability of the combination therapy of etanercept with fumarates versus etanercept monotherapy. METHODS Thirty-three patients with psoriasis were randomized 1:1 to receive etanercept combined with fumarates or etanercept monotherapy. The primary outcome measure was the difference in PASI-75 response after 24 weeks; additionally, a longitudinal analysis was performed. An important secondary outcome measure was the proportion of patients with a Physician Global Assessment (PGA) of clear or almost clear. Adverse events were collected throughout the study. RESULTS In the combination therapy group, 78% (14 out of 18 patients) reached PASI-75 at week 24 versus 57% (8 out of 14 patients) in the monotherapy group (p = 0.27). The longitudinal analysis showed a PASI reduction of 5.97% per week for the combination therapy group and of 4.76% for the monotherapy group (p = 0.11). In the combination therapy group, 94% (17 out of 18 patients) of patients had a PGA of clear/almost clear versus 64% (9 out of 14 patients) in the monotherapy group (p = 0.064). The incidence of mild gastrointestinal complaints was higher in the combination group than in the monotherapy group. CONCLUSION Using the PGA, combination therapy showed a trend towards faster improvement in the first 24 weeks. The difference in the PASI score between the two groups was not statistically significant. Addition of fumarates to etanercept for 48 weeks appeared safe with an acceptable tolerability.
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van Meer L, Moerland M, Gallagher J, van Doorn MBA, Prens EP, Cohen AF, Rissmann R, Burggraaf J. Injection site reactions after subcutaneous oligonucleotide therapy. Br J Clin Pharmacol 2016; 82:340-51. [PMID: 27061947 DOI: 10.1111/bcp.12961] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 12/22/2022] Open
Abstract
Oligonucleotides (ONs) are short fragments of nucleic acids, currently being investigated as therapeutic agents. When administered subcutaneously (sc), ONs cause a specific local reaction originating around the injection site, such as erythema, itching, discomfort and pain, including more severe manifestations such as ulceration or necrosis. These injection site reactions (ISRs) are common, but rather poorly described in the literature. With this review, we aim to provide an overview on the extent of the problem of ISRs, based on reported incidence. A structured literature search was performed to identify reported incidence and clinical features of ISRs which yielded 70 manuscripts that contained information regarding ISRs. The data from literature was combined with data on file available at our institution. All sc administered ONs described in the literature lead to the occurrence of ISRs. The percentage of trial subjects that developed ISRs ranged from 22 to 100% depending on ON. The majority of ONs caused ISRs in more than 70% of the trial subjects. The severity of the observed reactions varied between different ONs. Occurrence rate as well as severity of ISRs increases with higher doses. For chemistry and target of the compounds, no clear association regarding ISR incidence or severity was identified. All ONs developed to date are associated with ISRs. Overcoming the problem of ISRs might add greatly to the potential success of sc-administered ONs. Knowledge of these skin reactions and their specific immunostimulatory properties should be increased in order to obtain ONs that are more suitable for long-term use and clinically applicable in a broader patient population.
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Affiliation(s)
| | | | | | | | - Errol P Prens
- Department of Dermatology Erasmus MC, University Medical Center Rotterdam
| | - Adam F Cohen
- Centre for Human Drug Research, Leiden, the Netherlands
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Prens SP, de Vries K, van Doorn MBA, Prens EP. [Medical indications for laser therapy in dermatology]. Ned Tijdschr Geneeskd 2013; 157:A6662. [PMID: 24168850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Laser therapy in dermatology is often associated with cosmetic procedures. However, nowadays laser therapy has become a treatment modality for many dermatological diseases. We present three cases of patients with different dermatological diseases that are highly therapy-resistant. The first case is a 19-year-old man with multiple angiofibromas in the face, who was treated with ablative laser therapy. We also administered ablative laser therapy to a 64-year-old man with a big tumourous nose due to granuloma faciale, who had already tried multiple treatment options without result. Finally, a 69-year-old woman with extensive neurofibromas in the face, which had been considered untreatable, was successfully treated with ablative laser therapy. We would like to show the extensive therapeutical options of laser therapy for difficult-to-treat dermatological diseases.
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Starink TM, Houweling AC, van Doorn MBA, Leter EM, Jaspars EH, van Moorselaar RJA, Postmus PE, Johannesma PC, van Waesberghe JH, Ploeger MH, Kramer MT, Gille JJP, Waisfisz Q, Menko FH. Familial multiple discoid fibromas: a look-alike of Birt-Hogg-Dubé syndrome not linked to the FLCN locus. J Am Acad Dermatol 2011; 66:259.e1-9. [PMID: 21794948 DOI: 10.1016/j.jaad.2010.11.039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 11/02/2010] [Accepted: 11/06/2010] [Indexed: 10/17/2022]
Abstract
BACKGROUND Previously, we proposed that familial multiple trichodiscomas (OMIM 190340) is distinct from Birt-Hogg-Dubé syndrome (BHD) (OMIM #135150). BHD is characterized by multiple fibrofolliculomas/trichodiscomas, lung cysts, pneumothorax, and renal cell cancer. Germline FLCN mutations can be detected in most but not all BHD families. OBJECTIVE We sought to evaluate familial multiple trichodiscomas at a clinical and genetic level. We now renamed this condition "familial multiple discoid fibromas" (FMDF) to emphasize the distinction from BHD. METHODS In 8 additional families with an autosomal dominant pattern of multiple discoid fibromas we assessed the clinical findings and the histopathological features of skin lesions. FLCN germline mutation analysis was completed in 7 families. In two of these families segregation analysis was performed using polymorphic DNA markers in and around the FLCN locus. RESULTS The clinical findings in FMDF are different from those in BHD with early onset of skin lesions, prominent involvement of the pinnae, and discoid fibromas without the follicular epithelial component characteristic of the fibrofolliculoma/trichodiscoma spectrum of BHD. In addition, there were no evident pulmonary or renal complications. In none of the families were pathogenic FLCN germline mutations identified. Using segregation analysis we could exclude involvement of the FLCN locus in the two kindreds tested. LIMITATIONS The prevalence of FMDF is presently unknown. The underlying gene defect has not yet been identified. CONCLUSIONS FMDF is clinically distinct from BHD and is not linked to the FLCN locus.
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Affiliation(s)
- Theo M Starink
- Birt-Hogg-Dubé Working Group, Department of Dermatology, VU University Medical Centre, Amsterdam, The Netherlands.
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Lecluse LLA, Driessen RJB, Spuls PI, de Jong EMGJ, Stapel SO, van Doorn MBA, Bos JD, Wolbink GJ. Extent and clinical consequences of antibody formation against adalimumab in patients with plaque psoriasis. ACTA ACUST UNITED AC 2010; 146:127-32. [PMID: 20157022 DOI: 10.1001/archdermatol.2009.347] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To investigate the extent antibodies to adalimumab are formed in patients with plaque psoriasis and whether these antibodies have clinical consequences. Also, to examine the relationship between antibodies to adalimumab and adalimumab trough titers. DESIGN Prospective observational cohort study. SETTING Two Dutch dermatology departments in university hospitals. PATIENTS All consecutive patients starting a regimen of adalimumab for chronic plaque psoriasis. Patients were screened and fulfilled the Dutch reimbursement criteria for adalimumab to treat psoriasis. INTERVENTION Adalimumab treatment (per label). MAIN OUTCOME MEASURES The titer of antibodies to adalimumab, the adalimumab trough concentration, and the Psoriasis Area and Severity Index at weeks 12 and 24. RESULTS Antibodies to adalimumab were detected in 13 of 29 patients (45%) during 24 weeks of treatment. Differences in response rates among patients with low, high, and no titers of antibodies to adalimumab were significant at weeks 12 and 24 (P = .04 and P < .001, respectively). The median adalimumab trough concentrations varied significantly among patients with low, high, and no titers of antibodies to adalimumab (1.30 [range, 0.01-5.50], 0.0 [range, 0.0-0.0], and 9.6 [range, 0.0-22.6] mg/L, respectively; P < .001). At week 24, the median adalimumab trough concentrations also differed significantly among good responders, moderate responders, and nonresponders (9.7 [range, 0.0-22.6], 8.9 [range, 3.2-12.6], and 0.0 [range, 0.0-13.3] mg/L, respectively; P = .01). CONCLUSION Antibodies to adalimumab are associated with lower serum adalimumab trough concentrations and with nonresponse or loss of response to adalimumab in patients with plaque psoriasis.
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Affiliation(s)
- Lidian L A Lecluse
- Department of Dermatology, Academic Medical Center, University of Amsterdam, Room A0-252, PO Box 22700, 1100 DE Amsterdam, the Netherlands.
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van Doorn MBA, Espirito Santo SM, Meijer P, Kamerling IM, Schoemaker RC, Dirsch V, Vollmar A, Haffner T, Gebhardt R, Cohen AF, Princen HM, Burggraaf J. Effect of garlic powder on C-reactive protein and plasma lipids in overweight and smoking subjects. Am J Clin Nutr 2006; 84:1324-9. [PMID: 17158412 DOI: 10.1093/ajcn/84.6.1324] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epidemiologic studies suggest that garlic may have beneficial effects on risk factors associated with cardiovascular disease (CVD). However, these findings are not unambiguously supported by randomized placebo-controlled clinical trials. OBJECTIVE We sought to investigate the effects of a chemically well-characterized garlic preparation on biomarkers for inflammation, endothelial function, and lipid metabolism in subjects with risk factors for CVD. DESIGN This was a double-blind, randomized, placebo-controlled trial in 90 overweight [body mass index (in kg/m2) > 24.5] subjects aged 40-75 y who smoked >10 cigarettes/d. The subjects were randomly assigned to 3 parallel treatment groups: garlic powder (2.1 g/d), atorvastatin (40 mg/d), or placebo. Duplicate measurements were performed at baseline and after 1 and 3 mo of treatment. Treatments were compared with analysis of covariance with baseline as the covariate, and differences between the treatments were reported as mean percentage difference and corresponding 97.5% CI. RESULTS None of the variables showed significant differences between the garlic-treated and the placebo groups. In contrast, compared with the placebo group, atorvastatin treatment resulted in significantly lower plasma concentrations of C-reactive protein (20.2%; 1.7%, 35.3%), total cholesterol (37.2%; 33.1%, 41.1%), LDL cholesterol (52.7%; 47.9%, 57.1%), triacylglycerols (31.9%; 20.8%, 41.5%), and tumor necrosis factor alpha (TNF-alpha; 41.9%; 19.0%, 58.3%) and increased the ratio of ex vivo whole blood lipopolysaccharide-stimulated to nonstimulated TNF-alpha concentrations (109.7%; 37.9%, 218.9%). CONCLUSION We conclude that a chemically well-characterized garlic preparation has no significant effect on inflammatory biomarkers, endothelial function, or lipid profile in normolipidemic subjects with risk factors for CVD.
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