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Alavi A, Prens E, Kimball AB, Frew JW, Krueger JG, Mukhopadhyay S, Gao H, Ranganathan U, Ivanoff NB, Hernandez Daly AC, Zouboulis CC. Proof-of-concept study exploring the effect of spesolimab in patients with moderate-to-severe hidradenitis suppurativa: A randomized, double-blind, placebo-controlled clinical trial. Br J Dermatol 2024:ljae144. [PMID: 38576350 DOI: 10.1093/bjd/ljae144] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic inflammatory disease with a considerable disease burden. Existing treatment options are limited and often suboptimal; a high unmet need exists for effective targeted therapies. OBJECTIVE To explore the effects of spesolimab treatment in patients with HS. METHODS This randomized, double-blind, placebo-controlled, proof-of-clinical-concept study was conducted at 25 centers across 12 countries from May 3, 2021, to April 21, 2022. Patients had moderate-to-severe HS for ≥1 year before enrollment. Patients were randomized (2:1) to receive a loading dose of 3600 mg intravenous spesolimab (1200 mg at Weeks 0, 1, and 2) or matching placebo, followed by maintenance with either 1200 mg subcutaneous spesolimab every 2 weeks from Week 4-10 or matching placebo. The primary endpoint was the percentage change from baseline in total abscess and inflammatory nodule (AN) count at Week 12. Secondary endpoints were the absolute change from baseline in International Hidradenitis Suppurativa Severity Score System (IHS4), percentage change from baseline in draining tunnel (dT) count, the proportion of patients achieving a dT count of zero, absolute change from baseline in revised Hidradenitis Suppurativa Area and Severity Index (HASI-R), the proportion of patients achieving Hidradenitis Suppurativa Clinical Response (HiSCR50), the proportion of patients with ≥1 flare (all at Week 12), and patient-reported outcomes (PROs). RESULTS In this completed trial, randomized patients (N=52) received spesolimab (n=35) or placebo (n=17). The difference (95% confidence interval) versus placebo in least squares mean are reported. At Week 12, the percentage change in total AN count was similar between treatment arms: -4.1% (-31.7, 23.4). There was greater numerical improvement in the spesolimab arm, as measured by IHS4: -13.9 (-25.6, -2.3); percentage change from baseline in dT count: -96.6% (-154.5, -38.8); and the proportion of patients achieving a dT count of zero: 18.3% (-7.9, 37.5). Spesolimab treatment also improved HASI-R and HiSCR50 versus placebo. Spesolimab demonstrated a favorable safety profile, similar to that observed in trials in other diseases. CONCLUSIONS This exploratory proof-of-clinical-concept study supports the development of spesolimab as a new therapeutic option in HS. ClinicalTrials.gov identifier: NCT04762277.
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Affiliation(s)
- Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - John W Frew
- School of Clinical Medicine, UNSW Medicine and Health, Sydney, New South Wales, Australia
| | - James G Krueger
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | | | - Heli Gao
- Boehringer Ingelheim Shanghai Pharmaceuticals Co Ltd, Shanghai, China
| | - Usha Ranganathan
- Boehringer Ingelheim International GmbH, Ingelheim Am Rhein, Germany
| | | | | | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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2
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van Huizen A, Bank P, van der Kraaij G, Musters A, Busard C, Menting S, Rispens T, de Vries A, van Doorn M, Prens E, Lambert J, van den Reek J, de Jong E, Mathôt R, Spuls P. Quantifying the Effect of Methotrexate on Adalimumab Response in Psoriasis by Pharmacokinetic-Pharmacodynamic Modeling. J Invest Dermatol 2024; 144:794-801.e6. [PMID: 37992959 DOI: 10.1016/j.jid.2023.10.022] [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: 01/21/2023] [Revised: 10/07/2023] [Accepted: 10/23/2023] [Indexed: 11/24/2023]
Abstract
Previously, we showed that the combination of methotrexate and adalimumab treatment leads to less antidrug antibody development. In this study, we quantify the pharmacokinetics/pharmacodynamics (PK/PD) of adalimumab and evaluate the influence of methotrexate cotreatment. A population PK-PD model was developed using prospective data from 59 patients with psoriasis (baseline PASI = 12.6) receiving adalimumab over 49 weeks. Typical PK and PD parameters and their corresponding interpatient variability were estimated. We performed a covariate analysis to assess whether interpatient variability could be explained by addition of methotrexate and other covariates. In total, 330 PASIs, 252 adalimumab serum concentrations, and 247 antidrug antibody titers were available. Presence of antidrug antibodies (adalimumab group = 46.7%, adalimumab + methotrexate group = 38.7%; P = .031) was correlated with increased adalimumab apparent clearance (P < .001). In the PD model, the use of concomitant methotrexate was borderline to significantly correlated with a decreased half-maximal inhibitory concentration (adalimumab concentration for which clinical response score is reduced by half; P < .10). On the basis of our PK-PD model, concomitant use of methotrexate indirectly increases adalimumab concentration, partially through less antidrug antibodies formation, which may result in better efficacy.
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Affiliation(s)
- Astrid van Huizen
- Amsterdam Public Health, Infection and Immunity, Department of Dermatology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - Paul Bank
- Department of Hospital Pharmacy & Clinical Pharmacology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Hospital Pharmacy, Northwest Clinics, Alkmaar, The Netherlands; Department of Hospital Pharmacy, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands
| | - Gayle van der Kraaij
- Amsterdam Public Health, Infection and Immunity, Department of Dermatology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Annelie Musters
- Amsterdam Public Health, Infection and Immunity, Department of Dermatology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Celine Busard
- Amsterdam Public Health, Infection and Immunity, Department of Dermatology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Stef Menting
- Department of Dermatology, OLVG, Amsterdam, The Netherlands
| | - Theo Rispens
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Annick de Vries
- Sanquin Diagnostic Services, Sanquin, Amsterdam, The Netherlands
| | - Martijn van Doorn
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands; Centre for Human Drug Research, Leiden, The Netherlands
| | - Errol Prens
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Juul van den Reek
- Department of Dermatology, Radboud UMC, Radboud University, Nijmegen, The Netherlands
| | - Elke de Jong
- Department of Dermatology, Radboud UMC, Radboud University, Nijmegen, The Netherlands
| | - Ron Mathôt
- Department of Hospital Pharmacy & Clinical Pharmacology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Phyllis Spuls
- Amsterdam Public Health, Infection and Immunity, Department of Dermatology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Wainman HE, Chandran NS, Frew JW, Garg A, Gibbons A, Gierbolini A, Horvath B, Jemec GB, Kirby B, Kirby J, Lowes MA, Martorell A, McGrath BM, Naik HB, Oon HH, Prens E, Sayed CJ, Thorlacius L, Van der Zee HH, Villumsen B, Ingram JR. Global consensus process to establish a core dataset for hidradenitis suppurativa registries. Br J Dermatol 2024; 190:510-518. [PMID: 37976235 DOI: 10.1093/bjd/ljad454] [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: 06/19/2023] [Revised: 11/01/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Several registries for hidradenitis suppurativa (HS) already exist in Europe and the USA. There is currently no global consensus on a core dataset (CDS) for these registries. Creating a global HS registry is challenging, owing to logistical and regulatory constraints, which could limit opportunities for global collaboration as a result of differences in the dataset collected. The solution is to encourage all HS registries to collect the same CDS of information, allowing registries to collaborate. OBJECTIVES To establish a core set of items to be collected by all HS registries globally. The core set will cover demographic details, comorbidities, clinical examination findings, patient-reported outcome measures and treatments. METHODS Beginning in September 2022, 20 participants - including both clinicians with expertise in HS and patient advocates - from eight countries across three continents participated in a Delphi process consisting of four rounds of voting, with all participants completing each round. A list of potential items for inclusion in the core set was generated from the relevant published literature, including systematic reviews of comorbidities in HS, clinical and examination findings, and epidemiology. For disease severity and progression items, the Hidradenitis SuppuraTiva Core outcome set International Collaboration (HiSTORIC) core set and other relevant instruments were considered for inclusion. This resulted in 47 initial items. Participants were invited to suggest additional items to include during the first round. Anonymous feedback was provided to inform each subsequent round of voting to encourage consensus. RESULTS The eDelphi process established a CDS of 48 items recommended for inclusion in all HS registries globally. CONCLUSIONS The routine adoption of this CDS in current and future HS registries should allow registries in different parts of the world to collaborate, enabling research requiring large numbers of participants.
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Affiliation(s)
- Hannah E Wainman
- Department of Dermatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Nisha S Chandran
- Division of Dermatology, Department of Medicine, National University Hospital, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - John W Frew
- Department of Dermatology, Liverpool Hospital, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | - Amit Garg
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, New Hyde Park, NY, USA
| | - Angela Gibbons
- Patient Representative, The HS Support Network UK and Ireland, UK
| | | | - Barbara Horvath
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Brian Kirby
- Charles Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Joselyn Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | | | | | | | - Haley B Naik
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Hazel H Oon
- Department of Dermatology, National Skin Centre, Singapore, Singapore
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Christopher J Sayed
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linnea Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Hessel H Van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Bente Villumsen
- Patient Representative, The Patients' Association HS Denmark, Denmark
| | - John R Ingram
- Department of Dermatology & Academic Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, UK
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4
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Krueger JG, Frew J, Jemec GBE, Kimball AB, Kirby B, Bechara FG, Navrazhina K, Prens E, Reich K, Cullen E, Wolk K. Hidradenitis suppurativa: new insights into disease mechanisms and an evolving treatment landscape. Br J Dermatol 2024; 190:149-162. [PMID: 37715694 DOI: 10.1093/bjd/ljad345] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic disabling and debilitating inflammatory disease with a high unmet medical need. The prevalence of HS reported in most studies is 1-2%, although it is likely to be under-reported and estimates vary globally owing to variance in data collection methods, ethnicity, geographical location and under-diagnosis. HS is characterized by persistent, painful cutaneous nodules, abscesses and draining tunnels commonly affecting the axillary, anogenital, inguinal and perianal/gluteal areas. Over time, chronic uncontrolled inflammation results in irreversible tissue destruction and scarring. Although the pathophysiology of HS has not been fully elucidated, the tumour necrosis factor (TNF)-α and interleukin (IL)-17 pathways have an important role, involving multiple cytokines. Currently, treatment options include topical medications; systemic therapies, including repeated and/or rotational courses of systemic antibiotics, retinoids and hormonal therapies; and various surgical procedures. The anti-TNF-α antibody adalimumab is currently the only biologic approved by both the US Food and Drug Administration and the European Medicines Agency for HS; however, its efficacy varies, with a clinical response reported in approximately 50% of patients in phase III trials. HS is a rapidly evolving field of discovery, with a diverse range of agents with distinct mechanisms of action currently being explored in clinical trials. Several other promising therapeutic targets have recently emerged, and agents targeting the IL-17 and Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathways are the most advanced in ongoing or completed phase III clinical trials. Alongside limited therapeutic options, significant challenges remain in terms of diagnosis and disease management, with a need for better treatment outcomes. Other unmet needs include significant diagnostic delays, thus missing the therapeutic 'window of opportunity'; the lack of standardized outcome measures in clinical trials; and the lack of established, well-defined disease phenotypes and biomarkers.
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Affiliation(s)
- James G Krueger
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - John Frew
- Laboratory of Translational Cutaneous Medicine, Ingham Institute for Applied Medical Research, Sydney, Australia
- Department of Dermatology, Liverpool Hospital, Sydney, Australia
- University of New South Wales, Sydney, Australia
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Alexa B Kimball
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Brian Kirby
- Charles Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Falk G Bechara
- Department of Dermatology, Venereology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Kristina Navrazhina
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, TheNetherlands
| | - Kristian Reich
- Translational Research in Inflammatory Skin Diseases, Institute for Health Care Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Germany
- MoonLake Immunotherapeutics AG, Zug, Switzerland
| | - Eva Cullen
- MoonLake Immunotherapeutics AG, Zug, Switzerland
| | - Kerstin Wolk
- Psoriasis Research and Treatment Centre, Department of Dermatology, Venereology and Allergology and Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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5
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Patrick MT, Sreeskandarajan S, Shefler A, Wasikowski R, Sarkar MK, Chen J, Qin T, Billi AC, Kahlenberg JM, Prens E, Hovnanian A, Weidinger S, Elder JT, Kuo CC, Gudjonsson JE, Tsoi LC. Large-scale functional inference for skin-expressing lncRNAs using expression and sequence information. JCI Insight 2023; 8:e172956. [PMID: 38131377 PMCID: PMC10807743 DOI: 10.1172/jci.insight.172956] [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: 06/08/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
Long noncoding RNAs (lncRNAs) regulate the expression of protein-coding genes and have been shown to play important roles in inflammatory skin diseases. However, we still have limited understanding of the functional impact of lncRNAs in skin, partly due to their tissue specificity and lower expression levels compared with protein-coding genes. We compiled a comprehensive list of 18,517 lncRNAs from different sources and studied their expression profiles in 834 RNA-Seq samples from multiple inflammatory skin conditions and cytokine-stimulated keratinocytes. Applying a balanced random forest to predict involvement in biological functions, we achieved a median AUROC of 0.79 in 10-fold cross-validation, identifying significant DNA binding domains (DBDs) for 39 lncRNAs. G18244, a skin-expressing lncRNA predicted for IL-4/IL-13 signaling in keratinocytes, was highly correlated in expression with F13A1, a protein-coding gene involved in macrophage regulation, and we further identified a significant DBD in F13A1 for G18244. Reflecting clinical implications, AC090198.1 (predicted for IL-17 pathway) and AC005332.6 (predicted for IFN-γ pathway) had significant negative correlation with the SCORAD metric for atopic dermatitis. We also utilized single-cell RNA and spatial sequencing data to validate cell type specificity. Our research demonstrates lncRNAs have important immunological roles and can help prioritize their impact on inflammatory skin diseases.
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Affiliation(s)
- Matthew T. Patrick
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Sutharzan Sreeskandarajan
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alanna Shefler
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachael Wasikowski
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Mrinal K. Sarkar
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jiahan Chen
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- College of Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Tingting Qin
- Department of Computational Medicine & Bioinformatics and
| | - Allison C. Billi
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - J. Michelle Kahlenberg
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alain Hovnanian
- Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - James T. Elder
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, USA
| | - Chao-Chung Kuo
- Institute for Computational Genomics, Joint Research Center for Computational Biomedicine, RWTH Aachen University, Aachen, Germany
| | - Johann E. Gudjonsson
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Lam C. Tsoi
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Computational Medicine & Bioinformatics and
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
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6
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Garg A, Rawal S, Akilov O, Alavi A, Ardon C, Bechara FG, Cohen AD, Cohen SR, Daveluy S, Del Marmol V, Delage M, Esmann S, Fisher S, Giamarellos-Bourboulis EJ, Glowaczewska A, Goldfarb N, Gonzalez Brant E, Grimstad Ø, Guilbault S, Hamzavi I, Hughes R, Ingram JR, Jemec GBE, Ju Q, Kappe N, Kirby B, Kirby JS, Lowes MA, Matusiak L, Micha S, Micheletti RG, Miller AP, Moseng D, Naik HB, Nassif A, Nikolakis G, Paek SY, Pascual JC, Prens E, Resnik B, Riad H, Sayed C, Smith SD, Soliman Y, Szepietowski JC, Tan J, Thorlacius L, Tzellos T, van der Zee HH, Villumsen B, Wang L, Zouboulis CC, Strunk A. Factors associated with disease-specific life impact in patients with hidradenitis suppurativa: results from the Global VOICE project. Br J Dermatol 2023; 188:808-810. [PMID: 36891871 DOI: 10.1093/bjd/ljad069] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/30/2023] [Accepted: 03/12/2023] [Indexed: 03/10/2023]
Abstract
Patients with hidradenitis suppurativa experience significant life impact related to their disease. Younger age, Black race, high BMI, active smoking, flares, depression, anxiety, high comorbidity burden, disability, and difficult access to a dermatologist adversely influence life impact related to having hidradenitis suppurativa. Attention to these factors, particularly modifiable ones, may reduce overall impact of disease.
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Affiliation(s)
- Amit Garg
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - Sahil Rawal
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - Oleg Akilov
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Christine Ardon
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Falk G Bechara
- Department of Dermatology, Venereology and Allergology, International Center for Hidradenitis suppurativa/Acne inversa (ICH), St. Josef Hospital, Ruhr-University, Bochum, Germany
| | - Arnon D Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Science, Ben-Gurion University, Israel
| | - Steven R Cohen
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Véronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Maïa Delage
- Centre Médical, Institut Pasteur, Paris, France
| | - Solveig Esmann
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Shani Fisher
- Dermatology Department, Emek Medical Center, Afula, Israel
| | | | - Amelia Glowaczewska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Noah Goldfarb
- Departments of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | | | - Øystein Grimstad
- Department of Dermatology, NLSH Bodø, Institute of Clinical Medicine, UiT- The Arctic University of Norway, Tromsø, Norway
| | | | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Rosalind Hughes
- Department of Dermatology, St Vincent's University Hospital, and Charles Institute, University College Dublin, Dublin, Ireland
| | - John R Ingram
- Division of Infection and Immunity, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Qiang Ju
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, China
| | - Naomi Kappe
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian Kirby
- Department of Dermatology, St Vincent's University Hospital, and Charles Institute, University College Dublin, Dublin, Ireland
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Milton S Hershey Medical Center, Hershey, PA, USA
| | | | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Stella Micha
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Robert G Micheletti
- Departments of Dermatology and Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela P Miller
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Dagfinn Moseng
- Department of Dermatology, NLSH Bodø, Institute of Clinical Medicine, UiT- The Arctic University of Norway, Tromsø, Norway
| | - Haley B Naik
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Aude Nassif
- Centre Médical, Institut Pasteur, Paris, France
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - So Yeon Paek
- Department of Dermatology, Baylor University Medical Center, Texas A&M College of Medicine, Dallas, TX, USA
| | - Jose Carlos Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Barry Resnik
- Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hassan Riad
- Dermatology Department, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Christopher Sayed
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Saxon D Smith
- ANU Medical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Yssra Soliman
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Poland
| | - Jerry Tan
- Department of Medicine, Western University, Windsor campus, Ontario, Canada
| | - Linnea Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Thrasyvoulos Tzellos
- Department of Dermatology, NLSH Bodø, Institute of Clinical Medicine, UiT- The Arctic University of Norway, Tromsø, Norway
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Lanqi Wang
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, China
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Andrew Strunk
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
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7
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Midgette B, Strunk A, Akilov O, Alavi A, Ardon C, Bechara FG, Cohen AD, Cohen S, Daveluy S, Del Marmol V, Delage M, Esmann S, Fisher S, Giamarellos-Bourboulis EJ, Glowaczewska A, Goldfarb N, Brant EG, Grimstad Ø, Guilbault S, Hamzavi I, Hughes R, Ingram JR, Jemec GBE, Ju Q, Kappe N, Kirby B, Kirby JS, Lowes MA, Matusiak L, Micha S, Micheletti R, Miller AP, Moseng D, Naik H, Nassif A, Nikolakis G, Paek SY, Pascual JC, Prens E, Resnik B, Riad H, Sayed C, Smith SD, Soliman Y, Szepietowski JC, Tan J, Thorlacius L, Tzellos T, van der Zee HH, Villumsen B, Wang L, Zouboulis C, Garg A. Factors associated with treatment satisfaction in patients with hidradenitis suppurativa: results from the Global VOICE project. Br J Dermatol 2022; 187:927-935. [PMID: 36056741 DOI: 10.1111/bjd.21798] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/13/2022] [Accepted: 07/28/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Nearly half of patients with hidradenitis suppurativa (HS) report dissatisfaction with their treatment. However, factors related to treatment satisfaction have not been explored. OBJECTIVES To measure associations between treatment satisfaction and clinical and treatment-related characteristics among patients with HS. METHODS Treatment satisfaction was evaluated utilizing data from a cross-sectional global survey of patients with HS recruited from 27 institutions, mainly HS referral centres, in 14 different countries from October 2017 to July 2018. The primary outcome was patients' self-reported overall satisfaction with their current treatments for HS, rated on a five-point scale from 'very dissatisfied' to 'very satisfied'. RESULTS The final analysis cohort comprised 1418 patients with HS, most of whom were European (55%, 780 of 1418) or North American (38%, 542 of 1418), and female (85%, 1210 of 1418). Overall, 45% (640 of 1418) of participants were either dissatisfied or very dissatisfied with their current medical treatment. In adjusted analysis, patients primarily treated by a dermatologist for HS had 1·99 [95% confidence interval (CI) 1·62-2·44, P < 0·001] times the odds of being satisfied with current treatment than participants not primarily treated by a dermatologist. Treatment with biologics was associated with higher satisfaction [odds ratio (OR) 2·36, 95% CI 1·74-3·19, P < 0·001] relative to treatment with nonbiologic systemic medications. Factors associated with lower treatment satisfaction included smoking (OR 0·78, 95% CI 0·62-0·99; active vs. never), depression (OR 0·69, 95% CI 0·54-0·87), increasing number of comorbidities (OR 0·88 per comorbidity, 95% CI 0·81-0·96) and increasing flare frequency. CONCLUSIONS There are several factors that appear to positively influence satisfaction with treatment among patients with HS, including treatment by a dermatologist and treatment with a biologic medication. Factors that appear to lower treatment satisfaction include active smoking, depression, accumulation of comorbid conditions and increasing flare frequency. Awareness of these factors may support partnered decision making with the goal of improving treatment outcomes. What is already known about this topic? Nearly half of patients with hidradenitis suppurativa report dissatisfaction with their treatments. What does this study add? Satisfaction with treatment is increased by receiving care from a dermatologist and treatment with biologics. Satisfaction with treatment is decreased by tobacco smoking, accumulation of comorbid conditions including depression, and higher flare frequency. What are the clinical implications of this work? Awareness of the identified factors associated with poor treatment satisfaction may support partnered decision making and improve treatment outcomes.
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Affiliation(s)
- Bria Midgette
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - Andrew Strunk
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - Oleg Akilov
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Christine Ardon
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Falk G Bechara
- Department of Dermatology, Venereology and Allergology, St Josef Hospital, Ruhr-University, Bochum, Germany
| | - Arnon D Cohen
- Department of Quality Measures and Research, Clalit Health Services, Tel Aviv, Israel
| | - Steven Cohen
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Véronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Maïa Delage
- Centre Médical, Institut Pasteur, Université de Paris, Paris, France
| | - Solveig Esmann
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Shani Fisher
- Dermatology Department, Emek Medical Center, Afula, Israel
| | | | - Amelia Glowaczewska
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Noah Goldfarb
- Departments of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | | | - Øystein Grimstad
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | | | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Rosalind Hughes
- Department of Dermatology, St Vincent's University Hospital, and Charles Institute, University College Dublin, Dublin, Ireland
| | - John R Ingram
- Division of Infection and Immunity, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Qiang Ju
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Naomi Kappe
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian Kirby
- Department of Dermatology, St Vincent's University Hospital, and Charles Institute, University College Dublin, Dublin, Ireland
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Milton S Hershey Medical Center, Hershey, PA, USA
| | | | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Stella Micha
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Robert Micheletti
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Angela P Miller
- Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA
| | - Dagfinn Moseng
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Haley Naik
- Department of Dermatology, University of California, San Francisco, CA, USA
| | - Aude Nassif
- Centre Médical, Institut Pasteur, Université de Paris, Paris, France
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - So Yeon Paek
- Department of Dermatology, Baylor University Medical Center, Texas A&M College of Medicine, Dallas, TX, USA
| | - Jose Carlos Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Barry Resnik
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, Miami, FL, USA
| | - Hassan Riad
- Dermatology Department, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Christopher Sayed
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Saxon D Smith
- Department of Dermatology, Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yssra Soliman
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jerry Tan
- Department of Medicine, Western University, Windsor campus, Windsor, ON, Canada
| | - Linnea Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Thrasyvoulos Tzellos
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Lanqi Wang
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Christos Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Amit Garg
- Department of Dermatology, Donald & Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
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8
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Xu X, Prens E, Florencia E, Leenen P, Boon L, Asmawidjaja P, Mus AM, Lubberts E. Interleukin-17A Drives IL-19 and IL-24 Expression in Skin Stromal Cells Regulating Keratinocyte Proliferation. Front Immunol 2021; 12:719562. [PMID: 34616394 PMCID: PMC8488340 DOI: 10.3389/fimmu.2021.719562] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Received: 06/03/2021] [Accepted: 08/25/2021] [Indexed: 01/05/2023] Open
Abstract
IL-17A has been shown to be up-regulated in psoriasis lesions and is central to psoriasis pathogenesis. IL-19, along with other IL-20 subfamily cytokines such as IL-20 and IL-24, is induced by IL-17A and contributes especially to epidermal hyperplasia in psoriasis. However, the regulation, cellular sources of IL-19 and whether targeting of IL-17A by biologics influence IL-19 expression is not completely understood. To investigate the regulation of IL-19 by IL-17A in psoriasis, the imiquimod-induced psoriasis mouse (IMQ) model was used. Enhanced expression of IL-17A in the IMQ model was achieved by anti-IL-10 antibody treatment. Assessments of skin inflammation macroscopically, by histology and flow cytometry, all confirmed increased psoriatic symptoms. Interestingly, depletion of IL-10 markedly upregulated IL-23/IL-17 pathway related cytokines followed by a significant increase in IL-19 and IL-24. The up-regulation of IL-19 and IL-24, but not IL-17A, coincided with increased keratinocyte proliferation. To investigate the cellular source and effects of biologics on IL-19, human skin fibroblasts from healthy controls and psoriasis patients were cultured alone or co-cultured with activated memory CD4+ T cells. Besides IL-1β, IL-17A induced direct expression of IL-19 and IL-24 in skin fibroblasts and keratinocytes. Importantly, intrinsic higher expression of IL-19 in psoriatic skin fibroblasts was observed in comparison to healthy skin fibroblasts. Neutralization of IL-17A in the human skin fibroblast-T cell co-culture system significantly suppressed IL-19 and IL-24 expression. Together, our data show that IL-17A-induced IL-19 and IL-24 expression in skin stromal cells contribute to keratinocyte proliferation.
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Affiliation(s)
- Xiaofei Xu
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Dermatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Errol Prens
- Department of Dermatology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Edwin Florencia
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Dermatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Pieter Leenen
- Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Luis Boon
- Polypharma Biologics, Utrecht, Netherlands
| | - Patrick Asmawidjaja
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Anne-Marie Mus
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Erik Lubberts
- Department of Rheumatology, Erasmus Medical Center, Rotterdam, Netherlands.,Department of Immunology, Erasmus Medical Center, Rotterdam, Netherlands
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9
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Kirby JS, Prens E, Jemec G, v. Malathong, Prasad S, Schall T, Staehr P, f. Investigators. LB791 Avacopan, a highly selective small molecule inhibitor of c5a receptor, in patients with Hidradenitis Suppurativa: Initial results from a randomized, double-blind, placebo-controlled, phase 2 study (aurora). J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Zouboulis C, Marmol V, Jemec G, Katoulis A, Prens E, Giamarellos‐Bourboulis E. Further evidence for the immediate knowledge improvement through EADV Schools on hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol 2020; 34:e852-e853. [DOI: 10.1111/jdv.16744] [Citation(s) in RCA: 1] [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] [Received: 05/24/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Affiliation(s)
- C.C. Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology Dessau Medical Center Brandenburg Medical School Theodor Fontane Dessau Germany
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
| | - V. Marmol
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Dermatology Department Erasme Hospital Université Libre de Bruxelles Brussels Belgium
| | - G.B.E. Jemec
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Roskilde and Health Sciences Faculty University of Copenhagen Copenhagen Denmark
| | - A.C. Katoulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- 2nd Department of Dermatology and Venereology “Attikon” General University Hospital Medical School National and Kapodistrian University of Athens Athens Greece
| | - E. Prens
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- Department of Dermatology Erasmus University Medical Center Rotterdam Netherlands
| | - E.J. Giamarellos‐Bourboulis
- European Hidradenitis Suppurativa Foundation e.V. Dessau Germany
- 4th Department of Internal Medicine Medical School National and Kapodistrian University of Athens Athens Greece
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11
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Patrick M, Sreeskandarajan S, Shefler A, Wasikowski R, Sarkar M, Chen J, Prens E, Hovnanian A, Weidinger S, Elder J, Kuo C, Gudjonsson J, Tsoi L. 273 Large scale functional inference for skin-expressing lncRNAs using expression and sequence information. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Weyne J, Blauvelt A, de Bruin-Weller M, Prens E, Asbell P, Sierka D, Chen Z, Shumel B. 407 High burden of patient-reported ocular disorders and symptoms in adults with moderate-to-severe atopic dermatitis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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de Bruin-Weller M, Griffiths C, Prens E, Szepietowski J, Etoh T, Rossi A, Gadkari A, Chen Z, Eckert L. Le dupilumab améliore les signes, les symptômes et la qualité de vie chez des patients adultes atteints de dermatite atopique non parvenus à un score IGA de 0/1. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Akinlade B, Guttman‐Yassky E, Bruin‐Weller M, Simpson E, Blauvelt A, Cork M, Prens E, Asbell P, Akpek E, Corren J, Bachert C, Hirano I, Weyne J, Korotzer A, Chen Z, Hultsch T, Zhu X, Davis J, Mannent L, Hamilton J, Teper A, Staudinger H, Rizova E, Pirozzi G, Graham N, Shumel B, Ardeleanu M, Wollenberg A. Conjunctivitis in dupilumab clinical trials. Br J Dermatol 2019. [DOI: 10.1111/bjd.18276] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Akinlade B, Guttman‐Yassky E, Bruin‐Weller M, Simpson E, Blauvelt A, Cork M, Prens E, Asbell P, Akpek E, Corren J, Bachert C, Hirano I, Weyne J, Korotzer A, Chen Z, Hultsch T, Zhu X, Davis J, Mannent L, Hamilton J, Teper A, Staudinger H, Rizova E, Pirozzi G, Graham N, Shumel B, Ardeleanu M, Wollenberg A. Dupilumab 临床试验中的结膜炎. Br J Dermatol 2019. [DOI: 10.1111/bjd.18288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Akinlade B, Guttman‐Yassky E, de Bruin‐Weller M, Simpson E, Blauvelt A, Cork M, Prens E, Asbell P, Akpek E, Corren J, Bachert C, Hirano I, Weyne J, Korotzer A, Chen Z, Hultsch T, Zhu X, Davis J, Mannent L, Hamilton J, Teper A, Staudinger H, Rizova E, Pirozzi G, Graham N, Shumel B, Ardeleanu M, Wollenberg A. Conjunctivitis in dupilumab clinical trials. Br J Dermatol 2019; 181:459-473. [PMID: 30851191 PMCID: PMC6850316 DOI: 10.1111/bjd.17869] [Citation(s) in RCA: 241] [Impact Index Per Article: 48.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dupilumab blocks the shared receptor component for interleukin (IL)-4 and IL-13. It is approved in the U.S.A. for patients aged ≥ 12 years with moderate-to-severe atopic dermatitis (AD) uncontrolled by topical prescription medicines or who cannot use topical medicines, for patients in Japan whose AD is uncontrolled with existing therapies, for patients with moderate-to-severe AD in Europe who are candidates for systemic therapy and for patients aged ≥ 12 years for maintenance treatment of moderate-to-severe asthma uncontrolled with their current medicines. AD trials have reported increased incidence of conjunctivitis for dupilumab vs. placebo. OBJECTIVES To characterize further the occurrence and risk factors of conjunctivitis in dupilumab clinical trials. METHODS We evaluated randomized placebo-controlled trials of dupilumab in AD (n = 2629), asthma (n = 2876), chronic rhinosinusitis with nasal polyps (CRSwNP) (n = 60) and eosinophilic oesophagitis (EoE) (n = 47). RESULTS In most AD trials, dupilumab-treated patients had higher conjunctivitis incidence than placebo controls. Higher baseline AD severity and previous history of conjunctivitis were associated with increased conjunctivitis incidence. Conjunctivitis was mostly mild to moderate. Most cases recovered or resolved during the treatment period; two patients permanently discontinued dupilumab due to conjunctivitis or keratitis. Common treatments included ophthalmic corticosteroids, antibiotics, and antihistamines or mast cell stabilizers. Most cases were diagnosed by the investigators. In asthma and CRSwNP trials, the incidence of conjunctivitis was lower for both dupilumab and placebo than in AD trials; dupilumab did not increase the incidence compared with placebo. In the EoE trial, no patients had conjunctivitis. CONCLUSIONS Conjunctivitis was more frequent with dupilumab treatment in most AD trials. In dupilumab trials in other type 2 diseases, incidence of conjunctivitis was overall very low, and was similar for dupilumab and placebo. In AD, the incidence of conjunctivitis was associated with AD severity and prior history of conjunctivitis. The aetiology and treatment of conjunctivitis in dupilumab-treated patients require further study. What's already known about this topic? Ocular disorders, including allergic conjunctivitis, are common in patients with atopic dermatitis (AD). In most dupilumab AD trials, dupilumab-treated patients had higher conjunctivitis incidence than those receiving placebo. Most cases were mild to moderate and recovered or were recovering during study treatment; study treatment discontinuation due to conjunctivitis was rare. Conjunctivitis incidence was very low and similar for dupilumab and placebo in clinical trials in asthma, chronic rhinosinusitis with nasal polyps and eosinophilic oesophagitis. What does this study add? This analysis confirms and extends the results of the individual clinical trials. Baseline disease-related factors, including AD severity, prior conjunctivitis history and certain biomarkers (thymus and activation-regulated chemokine, IgE, eosinophils), were associated with increased incidence of conjunctivitis. Patients who responded well to dupilumab had reduced incidence of conjunctivitis. Further study is needed to elucidate the aetiology and treatment of conjunctivitis in dupilumab-treated patients with AD.
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Affiliation(s)
- B. Akinlade
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | - E. Guttman‐Yassky
- Department of DermatologyIcahn School of Medicine at Mount Sinai Medical CenterNew YorkNYU.S.A.
| | - M. de Bruin‐Weller
- Department of Dermatology & Allergology, University Medical Center UtrechtUtrechtthe Netherlands
| | - E.L. Simpson
- Department of DermatologyOregon Health & Science UniversityPortlandORU.S.A.
| | - A. Blauvelt
- Oregon Medical Research CenterPortlandORU.S.A.
| | - M.J. Cork
- Sheffield Dermatology ResearchDepartment of Infection, Immunity and Cardiovascular DiseaseThe University of Sheffield Medical SchoolSheffieldU.K.
| | - E. Prens
- Department of DermatologyErasmus MCRotterdamthe Netherlands
| | - P. Asbell
- Hamilton Eye InstituteUniversity of Tennessee Health Science CenterMemphisTNU.S.A.
| | - E. Akpek
- Wilmer Eye Institute at Johns Hopkins University School of MedicineBaltimoreMDU.S.A.
| | - J. Corren
- David Geffen School of Medicine at UCLALos AngelesCAU.S.A.
| | - C. Bachert
- ENT DepartmentGhent University HospitalGhentBelgium
- Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - I. Hirano
- Northwestern University Feinberg School of MedicineChicagoILU.S.A.
| | - J. Weyne
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | - A. Korotzer
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | - Z. Chen
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | | | - X. Zhu
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | - J.D. Davis
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | | | | | | | | | | | | | | | - B. Shumel
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
| | - M. Ardeleanu
- Regeneron Pharmaceuticals, Inc.TarrytownNYU.S.A.
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17
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Garg A, Neuren E, Cha D, Kirby JS, Ingram JR, Jemec GBE, Esmann S, Thorlacius L, Villumsen B, Marmol VD, Nassif A, Delage M, Tzellos T, Moseng D, Grimstad Ø, Naik H, Micheletti R, Guilbault S, Miller AP, Hamzavi I, van der Zee H, Prens E, Kappe N, Ardon C, Kirby B, Hughes R, Zouboulis CC, Nikolakis G, Bechara FG, Matusiak L, Szepietowski J, Glowaczewska A, Smith SD, Goldfarb N, Daveluy S, Avgoustou C, Giamarellos-Bourboulis E, Cohen S, Soliman Y, Brant EG, Akilov O, Sayed C, Tan J, Alavi A, Lowes MA, Pascual JC, Riad H, Fisher S, Cohen A, Paek SY, Resnik B, Ju Q, Wang L, Strunk A. Evaluating patients' unmet needs in hidradenitis suppurativa: Results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project. J Am Acad Dermatol 2019; 82:366-376. [PMID: 31279015 DOI: 10.1016/j.jaad.2019.06.1301] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [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: 02/13/2019] [Revised: 06/12/2019] [Accepted: 06/25/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND A needs assessment for patients with hidradenitis suppurativa (HS) will support advancements in multidisciplinary care, treatment, research, advocacy, and philanthropy. OBJECTIVE To evaluate unmet needs from the perspective of HS patients. METHODS Prospective multinational survey of patients between October 2017 and July 2018. RESULTS Before receiving a formal HS diagnosis, 63.7% (n = 827) of patients visited a physician ≥5 times. Mean delay in diagnosis was 10.2 ± 8.9 years. Patients experienced flare daily, weekly, or monthly in 23.0%, 29.8%, and 31.1%, respectively. Most (61.4% [n = 798]) rated recent HS-related pain as moderate or higher, and 4.5% described recent pain to be the worst possible. Access to dermatology was rated as difficult by 37.0% (n = 481). Patients reported visiting the emergency department and hospital ≥5 times for symptoms in 18.3% and 12.5%, respectively. An extreme impact on life was reported by 43.3% (n = 563), and 14.5% were disabled due to disease. Patients reported a high frequency of comorbidities, most commonly mood disorders. Patients were dissatisfied with medical or procedural treatments in 45.9% and 34.6%, respectively. LIMITATIONS Data were self-reported. Patients with more severe disease may have been selected. CONCLUSION HS patients have identified several critical unmet needs that will require stakeholder collaboration to meaningfully address.
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Affiliation(s)
- Amit Garg
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York.
| | - Erica Neuren
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Denny Cha
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - John R Ingram
- Institute of Infection and Immunity, University Hospital of Wales, Heath Park, Cardiff, United Kingdom
| | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Solveig Esmann
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Linnea Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | | | - Véronique Del Marmol
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Aude Nassif
- Department of Dermatology, Institut Pasteur, Centre Medical, Paris, France
| | - Maia Delage
- Department of Dermatology, Institut Pasteur, Centre Medical, Paris, France
| | - Thrasyvoulos Tzellos
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, Arctic University, Tromsø, Norway
| | - Dagfinn Moseng
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, Arctic University, Tromsø, Norway
| | - Øystein Grimstad
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Institute of Clinical Medicine, Arctic University, Tromsø, Norway
| | - Haley Naik
- Department of Dermatology, University of California, San Francisco, California
| | - Robert Micheletti
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Angie Parks Miller
- Hope For HS, Detroit, Michigan; Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Iltefat Hamzavi
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | - Hessel van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Naomi Kappe
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Christine Ardon
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Brian Kirby
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
| | - Rosalind Hughes
- Department of Dermatology, St. Vincent's University Hospital, Dublin, Ireland
| | - Christos C Zouboulis
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Centre, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Centre, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Falk G Bechara
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr-University, Bochum, Germany
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Amelia Glowaczewska
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Saxon D Smith
- Department of Dermatology, Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Noah Goldfarb
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Steven Daveluy
- Department of Dermatology, Wayne State University School of Medicine, Detroit, Michigan
| | - Christina Avgoustou
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Steven Cohen
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, New York
| | - Yssra Soliman
- Division of Dermatology, Albert Einstein College of Medicine, Bronx, New York
| | | | - Oleg Akilov
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Christopher Sayed
- Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jerry Tan
- Department of Medicine, Western University, Windsor Campus, Windsor, Ontario, Canada
| | - Afsaneh Alavi
- Division of Dermatology, Women College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Michelle A Lowes
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, New York
| | - José Carlos Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
| | - Hassan Riad
- Dermatology Department, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Shani Fisher
- Dermatology Department, Emek Medical Center, Afula, Israel
| | - Arnon Cohen
- Department of Quality Measures and Research Chief Physician Office, General Management Clalit Health Services, Tel Aviv, Israel
| | - So Yeon Paek
- Department of Dermatology, Baylor Scott & White Health, Dallas, Texas
| | - Barry Resnik
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, Miami, Florida
| | - Qiang Ju
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Lanqi Wang
- Department of Dermatology, Renji Hospital School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Andrew Strunk
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
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Rondags A, van Straalen K, Arends S, van der Zee H, Prens E, Spoorenberg A, Horváth B. 318 High prevalence of axial and peripheral spondyloarthritis features in patients with hidradenitis suppurativa. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Mehdizadeh A, Alavi A, Alhusayen R, Bauer B, Bechara FG, Bourcier M, Brassard A, Djamei V, Dutz J, George R, Ghias M, Gooderham M, Hamzavi I, Hoffman LK, Hou A, Hu H, Kimball AB, Kirchhof M, Kryzskaya D, Liy Wong MDC, Lowes MA, Lynde CW, McLellen C, Prens E, Prens L, Rogalska T, Sibbald RG, Sisic M, Tan MG, Wong DD. Proceeding report of the Symposium on Hidradenitis Suppurativa Advances (SHSA). Exp Dermatol 2017; 27:104-112. [DOI: 10.1111/exd.13445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Ali Mehdizadeh
- University of Toronto Dalla Lana School of Public Health; Toronto ON Canada
| | | | | | - Boris Bauer
- Universitatsklinikum Wurzburg; Wurzburg Germany
| | | | | | - Alain Brassard
- Department of Dermatology; University of Alberta; Edmonton AB Canada
| | - Vahid Djamei
- Dermatology, Information Systems (Business Informatics); Information Science University of Zürich; Zürich Switzerland
| | - Jan Dutz
- Department of Dermatology & Skin Science; University of British Columbia; Vancouver BC Canada
| | - Ralph George
- Division of General Surgery; University of Toronto; Toronto ON Canada
| | - Mondana Ghias
- Montefiore Hospital and Medical Center; Bronx NY USA
| | | | | | | | - Angela Hou
- New York University Langone Medical Center; NewYork; NY USA
| | - Howard Hu
- University of Toronto Dalla Lana School of Public Health; Toronto ON Canada
| | | | - Mark Kirchhof
- Division of Dermatology; Department of Medicine; University of Ottawa; Ottawa ON Canada
| | - Darya Kryzskaya
- Division of Pediatric Dermatology; Montreal Children's Hospital; McGill University Health Center; Montreal QC Canada
| | | | | | - Charles W. Lynde
- Department of Medicine; University of Toronto; Toronto ON Canada
| | | | - Errol Prens
- Dermatology; Erasmus MC; Rotterdam The Netherlands
| | | | - Tetyana Rogalska
- Department of Family Medicine; University of Ottawa; Ottawa ON Canada
| | | | - Mia Sisic
- University of Windsor; Windsor ON Canada
| | - Marcus G. Tan
- Department of Medicine; University of Toronto; Toronto ON Canada
| | - Dennis D. Wong
- Department of Medicine; University of Toronto; Toronto ON Canada
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Blauvelt A, de Bruin-Weller M, Gooderham M, Cather JC, Weisman J, Pariser D, Simpson EL, Papp KA, Hong HCH, Rubel D, Foley P, Prens E, Griffiths CEM, Etoh T, Pinto PH, Pujol RM, Szepietowski JC, Ettler K, Kemény L, Zhu X, Akinlade B, Hultsch T, Mastey V, Gadkari A, Eckert L, Amin N, Graham NMH, Pirozzi G, Stahl N, Yancopoulos GD, Shumel B. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet 2017; 389:2287-2303. [PMID: 28478972 DOI: 10.1016/s0140-6736(17)31191-1] [Citation(s) in RCA: 734] [Impact Index Per Article: 104.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Dupilumab (an anti-interleukin-4-receptor-α monoclonal antibody) blocks signalling of interleukin 4 and interleukin 13, type 2/Th2 cytokines implicated in numerous allergic diseases ranging from asthma to atopic dermatitis. Previous 16-week monotherapy studies showed that dupilumab substantially improved signs and symptoms of moderate-to-severe atopic dermatitis with acceptable safety, validating the crucial role of interleukin 4 and interleukin 13 in atopic dermatitis pathogenesis. We aimed to evaluate the long-term efficacy and safety of dupilumab with medium-potency topical corticosteroids versus placebo with topical corticosteroids in adults with moderate-to-severe atopic dermatitis. METHODS In this 1-year, randomised, double-blinded, placebo-controlled, phase 3 study (LIBERTY AD CHRONOS), adults with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids were enrolled at 161 hospitals, clinics, and academic institutions in 14 countries in Europe, Asia-Pacific, and North America. Patients were randomly assigned (3:1:3) to subcutaneous dupilumab 300 mg once weekly (qw), dupilumab 300 mg every 2 weeks (q2w), or placebo via a central interactive voice/web response system, stratified by severity and global region. All three groups were given concomitant topical corticosteroids with or without topical calcineurin inhibitors where inadvisable for topical corticosteroids. Topical corticosteroids could be tapered, stopped, or restarted on the basis of disease activity. Coprimary endpoints were patients (%) achieving Investigator's Global Assessment (IGA) 0/1 and 2-point or higher improvement from baseline, and Eczema Area and Severity Index 75% improvement from baseline (EASI-75) at week 16. Week 16 efficacy and week 52 safety analyses included all randomised patients; week 52 efficacy included patients who completed treatment by US regulatory submission cutoff. This study is registered with ClinicalTrials.gov, NCT02260986. FINDINGS Between Oct 3, 2014, and July 31, 2015, 740 patients were enrolled: 319 were randomly assigned to dupilumab qw plus topical corticosteroids, 106 to dupilumab q2w plus topical corticosteroids, and 315 to placebo plus topical corticosteroids. 623 (270, 89, and 264, respectively) were evaluable for week 52 efficacy. At week 16, more patients who received dupilumab plus topical corticosteroids achieved the coprimary endpoints of IGA 0/1 (39% [125 patients] who received dupilumab plus topical corticosteroids qw and 39% [41 patients] who received dupilumab q2w plus topical corticosteroids vs 12% [39 patients] who received placebo plus topical corticosteroids; p<0·0001) and EASI-75 (64% [204] and 69% [73] vs 23% [73]; p<0·0001). Week 52 results were similar. Adverse events were reported in 261 (83%) patients who received dupilumab qw plus topical corticosteroids, 97 (88%) patients who received dupilumab q2w, and 266 (84%) patients who received placebo, and serious adverse events in nine (3%), four (4%), and 16 (5%) patients, respectively. No significant dupilumab-induced laboratory abnormalities were noted. Injection-site reactions and conjunctivitis were more common in patients treated with dupilumab plus topical corticosteroids-treated patients than in patients treated with placebo plus topical corticosteroids. INTERPRETATION Dupilumab added to standard topical corticosteroid treatment for 1 year improved atopic dermatitis signs and symptoms, with acceptable safety. FUNDING Sanofi and Regeneron Pharmaceuticals Inc.
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Affiliation(s)
| | | | - Melinda Gooderham
- SKiN Centre for Dermatology, Queen's University, and Probity Medical Research, Peterborough, ON, Canada
| | - Jennifer C Cather
- Modern Dermatology and Modern Research Associates, and Probity Medical Research, Dallas, TX, USA
| | | | - David Pariser
- Eastern Virginia Medical School and Virginia Clinical Research Inc, Norfolk, VA, USA
| | | | - Kim A Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | - H Chih-Ho Hong
- Department of Dermatology and Skin Science, University of British Columbia, and Probity Medical Research, Surrey, BC, Canada
| | - Diana Rubel
- Australian National University, Canberra, and Probity Medical Research, Phillip, ACT, Australia
| | - Peter Foley
- The University of Melbourne, Parkville, Skin & Cancer Foundation Inc, Carlton, and Probity Medical Research, Carlton, VIC, Australia
| | - Errol Prens
- Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Christopher E M Griffiths
- The Dermatology Centre, Salford Royal Hospital, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Takafumi Etoh
- Tokyo Teishin Postal Services Agency Hospital, Tokyo, Japan
| | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | | | - Karel Ettler
- Dermatology and Venereology, Hradec Kralove, Czech Republic
| | - Lajos Kemény
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Xiaoping Zhu
- Regeneron Pharmaceuticals Inc, Basking Ridge, NJ, USA
| | | | | | - Vera Mastey
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
| | | | | | - Nikhil Amin
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
| | | | | | - Neil Stahl
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
| | | | - Brad Shumel
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
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Blauvelt A, Puig L, Chimenti S, Vender R, Rajagopalan M, Romiti R, Skov L, Zachariae C, Young H, Prens E, Cohen A, van der Walt J, Wu JJ. Biosimilars for psoriasis: clinical studies to determine similarity. Br J Dermatol 2017; 177:23-33. [PMID: 27639072 DOI: 10.1111/bjd.15067] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Abstract
Biosimilars are drugs that are similar, but not identical, to originator biologics. Preclinical analytical studies are required to show similarity on a molecular and structural level, but efficacy and safety studies in humans are essential to determining biosimilarity. In this review, written by members of the International Psoriasis Council, we discuss how biosimilars are evaluated in a clinical setting, with emphasis on extrapolation of indication, interchangeability and optimal clinical trial design.
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Affiliation(s)
- A Blauvelt
- Oregon Medical Research Center, Portland, OR, U.S.A
| | - L Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Chimenti
- University of Rome Tor Vergate, Rome, Italy
| | - R Vender
- Dermatrials Research Inc., Hamilton, ON, Canada.,Venderm Innovations in Psoriasis, Hamilton, ON, Canada
| | | | - R Romiti
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | - L Skov
- Herllev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - C Zachariae
- Herllev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H Young
- Manchester Academic Health Science Centre, Department of Dermatology, University of Manchester, Salford Royal Hospital, Manchester, U.K
| | - E Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Quality Measurements and Research, Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel
| | | | - J J Wu
- Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, U.S.A
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Busard C, Menting S, van Bezooijen SJ, van den Reek J, Hutten B, Prens E, de Jong E, van Doorn M, Spuls P. Erratum to: Optimizing adalimumab treatment in psoriasis with concomitant methotrexate (OPTIMAP): study protocol for a pragmatic, single-blinded, investigator-initiated randomized controlled trial. Trials 2017; 18:113. [PMID: 28270175 PMCID: PMC5341450 DOI: 10.1186/s13063-017-1848-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/17/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- Celine Busard
- Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands.
| | - Stef Menting
- Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands
| | - Sun-Jine van Bezooijen
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Juul van den Reek
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elke de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martijn van Doorn
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Phyllis Spuls
- Department of Dermatology, Academic Medical Center, Amsterdam, The Netherlands
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Ring HC, Bay L, Kallenbach K, Miller IM, Prens E, Saunte DM, Bjarnsholt T, Jemec GBE. Normal Skin Microbiota is Altered in Pre-clinical Hidradenitis Suppurativa. Acta Derm Venereol 2017; 97:208-213. [PMID: 27377144 DOI: 10.2340/00015555-2503] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [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
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease defined by recurrent nodules, tunnels (sinus tracts) and scarring involving the intertriginous regions. The clinical course of HS is compatible with a biofilm-driven disease, and biofilm has been described in lesional HS skin. We therefore hypothesized that clinically unaffected HS skin would also have an increased presence of biofilm compared with that of healthy controls. We conducted a case-control study, investigating the morphology of the axillary skin microbiota. Peptide nucleic acid - fluorescence in situ hybridization probes were used in combination with confocal laser scanning microscopy. Significant differences were found in both distribution and quantity of the cutaneous microbiota in clinically non-affected axillary skin of patients with HS compared with healthy controls. Surprisingly, we detected fewer bacteria and less biofilm in patients with HS. The reduced microbiota in patients with HS may play an important role in the early course of the disease.
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Affiliation(s)
- Hans Christian Ring
- Department of Dermatology, University Hospital Zealand, Faculty of Health and Medical Sciences, University of Copenhagen, DK-4000 Roskilde, Denmark.
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Vossen A, Stubbs A, van Doorn M, van Straalen K, van der Zee H, Prens E. 188 Profiling of the transcriptome in hidradenitis suppurativa: A case-control sample. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gulliver W, Zouboulis CC, Prens E, Jemec GBE, Tzellos T. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa. Rev Endocr Metab Disord 2016; 17:343-351. [PMID: 26831295 PMCID: PMC5156664 DOI: 10.1007/s11154-016-9328-5] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hidradenitis suppurativa/acne inversa (HS) is a chronic inflammatory skin disease characterized by painful, recurrent nodules and abscesses that rupture and lead to sinus tracts and scarring. To date, an evidence-based therapeutic approach has not been the standard of care and this is likely due to the lack of evidence based treatment guidelines. The purpose of this study was to promote a holistic evidence-based approach which implemented Level of Evidence and Strength of Recommendation for the treatment of HS. Based upon the European Dermatology Forumguidelines for the management of HS, evidence-based approach was explored for the treatment of HS. The diagnosis of HS should be made by a dermatologist or other healthcare professional with expert knowledge in HS. All patients should be offered adjuvant therapy as needed (pain management, weight loss, tobacco cessation, treatment of super infections, and application of appropriate dressings). The treating physician should be familiar with disease severity scores, especially Hurley staging, physician global assessment and others. The routine use of patient'reported outcomesincluding DLQI, itch and pain assessment (Visual Analogue Scale) is strongly recommended. The need for surgical intervention should be assessed in all patients depending upon type and extent of scarring, and an evidence-based surgical approach should be implemented. Evidence-based medical treatment of mild disease consists of topical Clindamycin 1 % solution/gel b.i.d. for 12 weeks or Tetracycline 500 p.o. b.i.d. for 4 months (LOE IIb, SOR B), for more widespread disease. If patient fails to exhibit response to treatment or for a PGA of moderate-to-severe disease, Clindamycin 300 p.o. b.i.d. with Rifampicin 600 p.o. o.d. for 10 weeks (LOE III, SOR C) should be considered. If patient is not improved, then Adalimumab 160 mg at week 0, 80 mg at week 2; then 40 mg subcutaneously weekly should be administered (LOE Ib, SOR A). If improvement occurs then therapy should be maintained as long as HS lesions are present. If the patient fails to exhibit response, then consideration of second or third line therapy is required. A growing body of evidence is being published to guide the treatment of HS. HS therapy should be based upon the evaluation of the inflammatory components as well as the scarring and should be directed by evidence-based guidelines. Treatment should include surgery as well as medical treatment. Future studies should include benefit risk ratio analysis and long term assessment of efficacy and safety, in order to facilitate long term evidence based treatment and rational pharmacotherapy.
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Affiliation(s)
- Wayne Gulliver
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany
- Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfound land & Labrador Canada
| | - Christos C. Zouboulis
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Dessau, Germany
| | - Errol Prens
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - Gregor B. E. Jemec
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany
- Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Thrasivoulos Tzellos
- European Hidradenitis Suppurativa Foundation e.V, Dessau, Germany
- Department of Dermatology, Faculty of Health Sciences, University Hospital of North Norway, Harstad, Troms Norway
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Lipsker D, Severac F, Freysz M, Sauleau E, Boer J, Emtestam L, Matusiak Ł, Prens E, Velter C, Lenormand C, Meyer N, Jemec GB. The ABC of Hidradenitis Suppurativa: A Validated Glossary on how to Name Lesions. Dermatology 2016; 232:137-42. [DOI: 10.1159/000443878] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/06/2016] [Indexed: 11/19/2022] Open
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Abstract
The pathogenesis of hidradenitis suppurativa (HS) or acne inversa is not completely understood. Recent research has led to greater insight into the mechanisms involved in the disease. The primary defect in HS pathophysiology rests with the hair follicle. Follicular occlusion, followed by follicular rupture, and a foreign body-type immune response are necessary conditions for the development of clinical HS. A specific genetic signature and environmental factors, such as cigarette smoking, microbial colonization, and adiposity, all contribute to the HS phenotype. Translational research focused on the inflammatory mechanisms involved in HS is needed to develop novel therapeutic options for this debilitating disease.
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Affiliation(s)
- Errol Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Inge Deckers
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Saunte D, Boer J, Stratigos A, Szepietowski J, Hamzavi I, Kim K, Zarchi K, Antoniou C, Matusiak L, Lim H, Williams M, Kwon H, Gürer M, Mammadova F, Kaminsky A, Prens E, van der Zee H, Bettoli V, Zauli S, Hafner J, Lauchli S, French L, Riad H, El-Domyati M, Abdel-Wahab H, Kirby B, Kelly G, Calderon P, del Marmol V, Benhadou F, Revuz J, Zouboulis C, Karagiannidis I, Sartorius K, Hagströmer L, McMeniman E, Ong N, Dolenc-Voljc M, Mokos Z, Borradori L, Hunger R, Sladden C, Scheinfeld N, Moftah N, Emtestam L, Lapins J, Doss N, Kurokawa I, Jemec G. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015. [DOI: 10.1111/bjd.14038] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [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]
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Daxhelet M, Suppa M, Benhadou F, Djamei V, Tzellos T, Ingvarsson G, Boer J, Martorell A, Ingram J, Desai N, Nassif A, Revuz J, Hotz C, Bettoli V, Deckers I, Jemec G, Prens E, Zouboulis C, del Marmol V. Establishment of a European Registry for hidradenitis suppurativa/acne inversa by using an open source software. J Eur Acad Dermatol Venereol 2015; 30:1424-6. [DOI: 10.1111/jdv.13267] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M. Daxhelet
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - M. Suppa
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - F. Benhadou
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - V. Djamei
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; University Hospital of Zurich; Zurich Switzerland
| | - T. Tzellos
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; University Hospital of North Norway; Troms Norway
| | - G. Ingvarsson
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; University Hospital of North Norway; Troms Norway
| | - J. Boer
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Deventer Hospital; Deventer The Netherlands
| | - A. Martorell
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hospital of Manises; Valencia Spain
| | - J.R. Ingram
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology & Wound Healing; Cardiff University; Cardiff UK
| | - N. Desai
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- St John's Institute of Dermatology; London UK
| | - A. Nassif
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Pasteur Institute; Paris France
| | - J. Revuz
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Private practice; Paris France
| | - C. Hotz
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hospital Henri-Mondor; Créteil France
| | - V. Bettoli
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Azienda Ospedaliero-Universitaria di Ferrara; Ferrara Italy
| | - I.E. Deckers
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - G.B. Jemec
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Health Sciences Faculty; Roskilde Hospital; University of Copenhagen; Copenhagen Denmark
| | - E. Prens
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Erasmus University Medical Center; Rotterdam The Netherlands
| | - C.C. Zouboulis
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Departments of Dermatology, Venereology, Allergology and Immunology; Dessau Medical Center; Dessau Germany
| | - V. del Marmol
- European Hidradenitis Suppurativa Foundation e.V.; Dessau Germany
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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Oranje AP, Verbeek R, Verzaal P, Haspels I, Prens E, Nagelkerken L. Wet-wrap treatment using dilutions of tacrolimus ointment and fluticasone propionate cream in human APOC1 (+/+) mice with atopic dermatitis. Br J Dermatol 2008; 160:54-61. [PMID: 18795918 DOI: 10.1111/j.1365-2133.2008.08834.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Wet-wrap treatment (WWT) with diluted topical steroids is widely used in atopic dermatitis (AD). Mice with transgenic overexpression of human apolipoprotein C1 (APOC1) in the liver and the skin are not only characterized by hyperlipidaemia and raised IgE levels, but also by pruritic dermatitis and a disturbed skin barrier function, providing a novel in vivo mouse model for AD. OBJECTIVES We investigated an adapted WWT method in the AD model in APOC1 mice in order to establish its efficacy. METHODS The effect of topical 0.1% and 0.03% tacrolimus ointment, tacrolimus base ointment, different dilutions of 0.05% fluticasone propionate (FP) cream and emollient on the development of dermatitis in APOC1 mice was investigated. WWT was performed with 0.03% tacrolimus ointment or 0.017% FP cream. RESULTS AD in APOC1 mice responded to topical treatment with tacrolimus or FP. In contrast to tacrolimus treatment, FP treatment was associated with loss of body weight. WWT reinforced several therapeutic aspects, notably improvements in transepidermal water loss and in epidermal thickness. WWT using tacrolimus 0.03% ointment was more effective than WWT using FP 0.017% cream. CONCLUSIONS AD in APOC1 mice responds to treatment with (diluted) tacrolimus or FP; treatment with FP cream, but not tacrolimus ointment, was associated with weight loss. In this study, the adapted WWT using tacrolimus or FP in mice had a limited improving effect as compared with open application of tacrolimus or FP.
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Affiliation(s)
- A P Oranje
- Department of Dermatology and Venereology (Paediatric Dermatology), Erasmus MC, 3015 CE Rotterdam, The Netherlands.
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Companjen A, van der Wel L, van der Fits L, Laman J, Prens E. Elevated interleukin-18 protein expression in early active and progressive plaque-type psoriatic lesions. Eur Cytokine Netw 2004; 15:210-6. [PMID: 15542445] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Psoriasis is a T cell-mediated inflammatory skin disease characterized by an elevated IFN-gamma and IL-12p70 expression in skin lesions. Interleukin-18 (IL-18) synergizes with IL-12 to induce IFN-gamma production and a strong T-helper-1-mediated immune response, or to induce Th2 polarization depending on the immunological context. We have previously shown that keratinocytes in normal skin produce and store large amounts of pro-IL-18. In this study, we hypothesized that the expression of IL-18 in psoriatic lesional skin might be altered compared to normal skin. Therefore, IL-18 expression was assessed in psoriatic, stable, plaque-type lesions and early active and progressive lesions. IL-18 mRNA and protein concentrations were constitutively high, and did not differ between normal and stable, plaque-type epidermis. In active and progressive lesions an elevated expression of total IL-18 protein relative to normal and stable, plaque-type epidermis was detected using ELISA, while on Western blot, the differences in pro- or mature IL-18 were less clear. Our results indicate that the role of IL-18 in the pathogenesis of early phases of psoriasis may be more prominent than in established psoriatic lesions.
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Affiliation(s)
- Arjen Companjen
- Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
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Van Neste D, Fuh V, Sanchez-Pedreno P, Lopez-Bran E, Wolff H, Whiting D, Roberts J, Kopera D, Stene JJ, Calvieri S, Tosti A, Prens E, Guarrera M, Kanojia P, He W, Kaufman KD. Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol 2000; 143:804-10. [PMID: 11069460 DOI: 10.1046/j.1365-2133.2000.03780.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.6] [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: 11/20/2022]
Abstract
BACKGROUND The growth of scalp hair is a cyclical process of successive phases of growth (anagen) and rest (telogen). In previous clinical trials in men with androgenetic alopecia, treatment with finasteride increased scalp hair counts in a defined area (i.e. increased hair density). OBJECTIVES The current study used a phototrichogram methodology to assess the effect of finasteride on the phases of the hair growth cycle. PATIENTS/METHODS Two hundred and twelve men, age 18-40 years, with androgenetic alopecia were randomized to receive finasteride 1 mg daily or placebo for 48 weeks. At baseline and at 24 and 48 weeks, macrophotographs were taken to measure total and anagen hair count in a 1-cm(2) target area of the scalp. RESULTS At baseline, mean total and anagen hair counts in the finasteride group were 200 and 124 hairs, respectively (% anagen = 62%) and the anagen to telogen ratio was 1.74 (geometric mean). In the placebo group, the respective values were 196 and 119 hairs (% anagen = 60%) and 1.57. At week 48, the finasteride group had a net improvement (mean +/- SE) compared with placebo in total and anagen hair counts of 17.3 +/- 2.5 hairs (8.3% +/- 1.4%) and 27.0 +/- 2.9 hairs (26% +/- 3.1%), respectively (P < 0.001). Furthermore, treatment with finasteride resulted in a net improvement in the anagen to telogen ratio of 47% (P < 0.001). In this study, treatment with finasteride 1 mg day(-1) for 48 weeks increased both total and anagen hair counts, and improved the anagen to telogen ratio. CONCLUSIONS These data provide direct evidence that finasteride 1 mg daily promotes the conversion of hairs into the anagen phase. These data support that finasteride treatment results in favourable effects on hair quality that contribute to the visible improvements in hair growth observed in treated patients.
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Affiliation(s)
- D Van Neste
- Skin Study Center-Skinterface, Tournai, Belgium
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Wei L, Vooys A, Debets R, Hegmans J, Benner R, Prens E. Differential regulation of IL-1α, IL-1ra, and IL-1R2 by IL-1β stimulation in a skin organ culture model. J Dermatol Sci 1998. [DOI: 10.1016/s0923-1811(98)83456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Prens E, Hegmans J, Lien RC, Debets R, Troost R, van Joost T, Benner R. Increased expression of interleukin-4 receptors on psoriatic epidermal cells. Am J Pathol 1996; 148:1493-502. [PMID: 8623919 PMCID: PMC1861571] [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: 01/31/2023]
Abstract
Abnormal keratinocyte proliferation and differentiation, the main characteristics of psoriasis, may be induced and maintained by cytokines produced by activated resident and recruited inflammatory cells in lesional skin. As the epidermal cytokine profile is clearly altered in psoriasis and because increased expression of interleukin-4 receptor (IL-4R) has been reported in some epithelial proliferative diseases, we investigated the expression of IL-4R on psoriatic epidermal cells (ECs). The expression of IL-4R on freshly isolated ECs from healthy skin and untreated psoriatic lesions was studied by immunostaining using an IL-4R-specific antibody and by examining their capacity to bind biotinylated recombinant human IL-4 using flow cytometry. The number of IL-4R+ ECs and the number of binding sites per cell were significantly increased on psoriatic ECs as compared with healthy control ECs. Immunostaining confirmed these results, whereby staining was mainly observed in the lower epidermal layers. In addition, an increased IL-4R mRNA expression was also observed in psoriatic epidermis using a digoxigenin-labeled IL-4R RNA probe. In short-term in vitro cultures, lipopolysaccharide/phorbol-myristate-acetate-stimulated and unstimulated psoriatic ECs did not produce any immunoreactive IL-4. The results of this study together with the reported increased expression of IL-4R in epithelial neoplasias suggest an association between overexpression of IL-4R and abnormal keratinocyte activation and proliferation.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Antigens, CD/genetics
- Antigens, CD/metabolism
- Biopsy
- Cell Division
- Cells, Cultured
- Epidermis/chemistry
- Epidermis/metabolism
- Epidermis/pathology
- Female
- Flow Cytometry
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Male
- Psoriasis/metabolism
- Psoriasis/pathology
- RNA, Messenger/analysis
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptors, Interleukin/analysis
- Receptors, Interleukin/genetics
- Receptors, Interleukin/metabolism
- Receptors, Interleukin-4
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Affiliation(s)
- E Prens
- Department of Immunology, University Hospital Rotterdam-Dijkzigt, The Netherlands
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Prens E, t Hooft-Benne K, Tank B, Van Damme J, van Joost T, Benner R. Adhesion molecules and IL-1 costimulate T lymphocytes in the autologous MECLR in psoriasis. Arch Dermatol Res 1996; 288:68-73. [PMID: 8932583 DOI: 10.1007/bf02505046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 02/03/2023]
Abstract
Membrane molecules such as CD36 (OKM5), intercellular adhesion molecule-1 (ICAM-1, CD54), gamma interferon-induced protein 10 (gamma-IP10) and IL-1 are induced and/or upregulated in psoriatic epidermis. These molecules have important accessory, trafficking or signalling functions in the immune system and also play a role in the pathophysiology of psoriasis. The relevance of adhesion molecules, CD36 and epidermal IL-1 in psoriasis was studied in vitro in the autologous mixed epidermal cell - T lymphocyte reaction (MECLR). Their level of expression was quantitated in epidermal cell suspensions (ECS) from patients with psoriasis and their function was assessed by blocking with specific mAbs and antisera or by depleting CD36+ cells from the ECS prior to the MECLR. ECS from psoriatic lesions contained increased numbers of CD36+ (23 +/- 12%), ICAM-1(+) (31 +/- 14%) and IL-1(+) (57 +/- 21%) cells. The autologous MECLR was inhibited in samples from all patients by mAb to CD2 (LFA-2), CD11a (LFA-1alpha), CD18 (LFA-1beta), ICAM-1, CD58 (LFA-3) and an antiserum to IL-1beta. Thus, adhesion molecules facilitate inflammation in psoriasis not only via adhesion and recruitment of T lymphocyte in psoriatic lesions, but also via activation of T cells. Furthermore CD36 molecules on psoriatic epidermal cells do not costimulate autologous T lymphocytes in psoriasis. The observed costimulatory function of IL-1beta in the MECLR emphasizes its relevance in psoriasis.
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Affiliation(s)
- E Prens
- Department of Immunology, Erasmus University Rotterdam, The Netherlands
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Affiliation(s)
- E Prens
- Department of Immunology, Erasmus University, and University Hospital Rotterdam-Dijkzigt, The Netherlands
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Abstract
A surprisingly high incidence of chloramphenicol sensitization is reported in 8 patients with periocular or periauricular dermatitis. In 6 of them, relevance was established to the use of topical chloramphenicol. Concurrent sensitization to polymyxin B sulphate was found in 2. The findings stress the fact that chloramphenicol allergy remains a persistent problem.
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