1
|
Choon SE, van de Kerkhof P, Gudjonsson JE, de la Cruz C, Barker J, Morita A, Romiti R, Affandi AM, Asawanonda P, Burden AD, Gonzalez C, Marrakchi S, Mowla MR, Okubo Y, Oon HH, Terui T, Tsai TF, Callis-Duffin K, Fujita H, Jo SJ, Merola J, Mrowietz U, Puig L, Thaçi D, Velásquez M, Augustine M, El Sayed M, Navarini AA, Pink A, Prinz J, Turki H, Magalhães R, Capon F, Bachelez H. International Consensus Definition and Diagnostic Criteria for Generalized Pustular Psoriasis From the International Psoriasis Council. JAMA Dermatol 2024:2818462. [PMID: 38691347 DOI: 10.1001/jamadermatol.2024.0915] [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] [Indexed: 05/03/2024]
Abstract
Importance Generalized pustular psoriasis (GPP) lacks internationally accepted definitions and diagnostic criteria, impeding timely diagnosis and treatment and hindering cross-regional clinical and epidemiological study comparisons. Objective To develop an international consensus definition and diagnostic criteria for GPP using the modified Delphi method. Evidence Review The rarity of GPP presents a challenge in acquiring comprehensive published clinical data necessary for developing standardized definition and criteria. Instead of relying on a literature search, 43 statements that comprehensively addressed the fundamental aspects of the definitions and diagnostic criteria for GPP were formulated based on expert reviews of 64 challenging GPP cases. These statements were presented to a panel of 33 global GPP experts for voting, discussion, and refinements in 2 virtual consensus meetings. Consensus during voting was defined as at least 80% agreement; the definition and diagnostic criteria were accepted by all panelists after voting and in-depth discussion. Findings In the first and second modified Delphi round, 30 (91%) and 25 (76%) experts participated. In the initial Delphi round, consensus was achieved for 53% of the statements, leading to the approval of 23 statements that were utilized to develop the proposed definitions and diagnostic criteria for GPP. During the second Delphi round, the final definition established was, "Generalized Pustular Psoriasis is a systemic inflammatory disease characterized by cutaneous erythema and macroscopically visible sterile pustules." It can occur with or without systemic symptoms, other psoriasis types, and laboratory abnormalities. GPP may manifest as an acute form with widespread pustules or a subacute variant with an annular phenotype. The identified essential criterion was, "Macroscopically visible sterile pustules on erythematous base and not restricted to the acral region or within psoriatic plaques." Conclusions and Relevance The achievement of international consensus on the definition and diagnostic criteria for GPP underscores the importance of collaboration, innovative methodology, and expert engagement to address rare diseases. Although further validation is needed, these criteria can serve as a reference point for clinicians, researchers, and patients, which may contribute to more accurate diagnosis and improved management of GPP.
Collapse
Affiliation(s)
- Siew Eng Choon
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine & Health Sciences, Monash University, Johor Bahru, Malaysia
| | | | - Johann E Gudjonsson
- Department of Dermatology and Department of Internal Medicine, University of Michigan, Ann Arbor
| | | | - Jonathan Barker
- St John's Institute of Dermatology, King's College London and Guy's and St Thomas's Hospitals, London, United Kingdom
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | | | | | | | | | | | - Hazel H Oon
- National Skin Centre, Lee Kong Chian School of Medicine, Singapore, Singapore
| | | | | | | | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | | | - Ulrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Lluïs Puig
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Andrew Pink
- St John's Institute of Dermatology, King's College London and Guy's and St Thomas's Hospitals, London, United Kingdom
| | - Jörg Prinz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian-University of Munich, Munich, Germany
| | - Hamida Turki
- Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | | | - Francesca Capon
- Division of Genetics and Molecular Medicine, King's College, London, United Kingdom
| | - Hervé Bachelez
- Department of Dermatology, Hôpital Saint-Louis APHP, Laboratory of Genetic of Skin Diseases, INSERM U1163, Imagine Institute for Human Genetic Diseases, Paris Cité University, Paris, France
| |
Collapse
|
2
|
Ikumi N, Hayama K, Kitamura N, Terui T, Takei M, Nakamura H, Fujita H. Higher prevalence of nail psoriasis in patients with psoriatic arthritis receiving biologic therapy: A single center cross sectional study. J Dermatol 2024. [PMID: 38507363 DOI: 10.1111/1346-8138.17196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/30/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Natsumi Ikumi
- Division of Cutaneous Science, Dermatology of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Cutaneous Science, Dermatology of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Noboru Kitamura
- Division of Hematology and Rheumatology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Dermatology of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Masami Takei
- Division of Hematology and Rheumatology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Nakamura
- Division of Hematology and Rheumatology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Dermatology of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Terui T, Okubo Y, Kobayashi S, Sano S, Morita A, Imafuku S, Tada Y, Abe M, Yaguchi M, Uehara N, Handa T, Tanaka M, Zhang W, Paris M, Murakami M. Author Correction: Efficacy and Safety of Apremilast for the Treatment of Japanese Patients with Palmoplantar Pustulosis: Results from a Phase 2, Randomized, Placebo-Controlled Study. Am J Clin Dermatol 2024; 25:165-167. [PMID: 38060175 PMCID: PMC10796414 DOI: 10.1007/s40257-023-00825-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- Tadashi Terui
- Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi, Tokyo, 173-8610, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Burden AD, Bissonnette R, Navarini AA, Murakami M, Morita A, Haeufel T, Ye B, Baehner F, Terui T. Spesolimab Efficacy and Safety in Patients with Moderate-to-Severe Palmoplantar Pustulosis: A Multicentre, Double-Blind, Randomised, Placebo-Controlled, Phase IIb, Dose-Finding Study. Dermatol Ther (Heidelb) 2023; 13:2279-2297. [PMID: 37731086 PMCID: PMC10539230 DOI: 10.1007/s13555-023-01002-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/02/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION We evaluated the anti-interleukin-36 receptor antibody spesolimab in patients with moderate-to-severe palmoplantar pustulosis (PPP). METHODS This phase IIb trial comprised a loading dose period to week (W) 4, then maintenance dosing to W52. Patients were randomised 2:1:1:1:2 to subcutaneous spesolimab 3000 mg to W4 then 600 mg every 4 weeks (q4w), spesolimab 3000 mg to W4 then 300 mg q4w, spesolimab 1500 mg to W4 then 600 mg q4w, spesolimab 1500 mg to W4, 300 mg q4w to W16 then 300 mg every 8 weeks (q8w), or placebo switching to spesolimab 600 mg q4w at W16. The primary efficacy endpoint was percentage change from baseline in Palmoplantar Pustular Area and Severity Index (PPP ASI) at W16. Secondary endpoints included a Palmoplantar Pustular Physician's Global Assessment (PPP PGA) score of 0/1. Safety (including adverse events [AEs], local tolerability) was assessed. RESULTS 152 patients were treated. The primary endpoint was not met; mean differences for spesolimab versus placebo ranged from - 14.6% (95% confidence interval [CI]: - 31.5%, 2.2%) to - 5.3% (95% CI: - 19.1%, 8.6%); none reached significance. At W16, 23 (21.1%) and two (4.7%) patients in the combined spesolimab and placebo groups, respectively, achieved PPP PGA 0/1 (mean difference 16.4%; 95% CI: 3.8%, 25.7%), increasing to 59 (54.1%; combined spesolimab) and 12 (27.9%; placebo switch to spesolimab) patients at W52. Non-Asian patients had significant improvements in the primary endpoint (mean difference - 17.7%; nominal P = 0.0394) and PPP PGA 0/1 at W16 with spesolimab versus placebo. Rates of AEs and AE-related discontinuations were similar for spesolimab and placebo. Local tolerability events and injection-site reactions were more frequent with spesolimab than placebo. CONCLUSION The primary objective to demonstrate a non-flat dose-response relationship and proof-of-concept was not achieved; improvements with spesolimab occurred in secondary endpoints and in non-Asian patients, indicating potential modest benefits. Spesolimab was generally well tolerated (ClinicalTrials.gov NCT04015518).
Collapse
Affiliation(s)
- A David Burden
- School of Infection and Immunity, University of Glasgow, Glasgow, UK.
| | | | | | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Thomas Haeufel
- Boehringer Ingelheim International GmbH, Ingelheim, Germany
| | - Binqi Ye
- Boehringer Ingelheim (China) Investment Corporation Limited, Shanghai, People's Republic of China
| | - Frank Baehner
- Boehringer Ingelheim International GmbH, Ingelheim, Germany
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Terui T, Okubo Y, Kobayashi S, Sano S, Morita A, Imafuku S, Tada Y, Abe M, Yaguchi M, Uehara N, Handa T, Tanaka M, Zhang W, Paris M, Murakami M. Efficacy and Safety of Apremilast for the Treatment of Japanese Patients with Palmoplantar Pustulosis: Results from a Phase 2, Randomized, Placebo-Controlled Study. Am J Clin Dermatol 2023; 24:837-847. [PMID: 37233897 PMCID: PMC10213585 DOI: 10.1007/s40257-023-00788-2] [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] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a pruritic, painful, recurrent, and chronic dermatitis with limited therapeutic options. OBJECTIVE To evaluate the efficacy and safety of apremilast for the treatment of Japanese patients with PPP and inadequate response to topical treatment. METHODS This phase 2, randomized, double-blind, placebo-controlled study enrolled patients with Palmoplantar Pustulosis Area and Severity Index (PPPASI) total score ≥ 12 and moderate or severe pustules/vesicles on the palm or sole (PPPASI pustule/vesicle severity score ≥ 2) at screening and baseline with an inadequate response to topical treatment. Patients were randomized (1:1) to apremilast 30 mg twice daily or placebo for 16 weeks, followed by a 16-week extension phase during which all patients received apremilast. The primary endpoint was achievement of PPPASI-50 response (≥ 50% improvement from baseline in PPPASI). Key secondary endpoints included change from baseline in PPPASI total score, Palmoplantar Pustulosis Severity Index (PPSI), and patient's visual analog scale (VAS) for PPP symptoms (pruritus and discomfort/pain). RESULTS A total of 90 patients were randomized (apremilast: 46; placebo: 44). A significantly greater proportion of patients achieved PPPASI-50 at week 16 with apremilast versus placebo (P = 0.0003). Patients receiving apremilast showed greater improvement in PPPASI at week 16 versus placebo (nominal P = 0.0013), as well as PPSI and patient-reported pruritus and discomfort/pain (nominal P ≤ 0.001 for all). Improvements were sustained through week 32 with apremilast treatment. The most common treatment-emergent adverse events included diarrhea, abdominal discomfort, headache, and nausea. CONCLUSIONS Apremilast treatment demonstrated greater improvements in disease severity and patient-reported symptoms versus placebo at week 16 in Japanese patients with PPP with sustained improvements through week 32. No new safety signals were observed. CLINICALTRIALS GOV: NCT04057937.
Collapse
Affiliation(s)
- Tadashi Terui
- Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi, Tokyo, 173-8610, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Hayashi N, Hayama K, Takahashi K, Kurokawa I, Okazaki M, Kashiwagi T, Iwashita E, Terui T. Real-world safety and effectiveness of adalimumab in patients with hidradenitis suppurativa: A 52-week analysis of a postmarketing surveillance study in Japan. J Dermatol 2023; 50:1034-1044. [PMID: 37264993 DOI: 10.1111/1346-8138.16835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/24/2022] [Revised: 04/16/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023]
Abstract
Adalimumab is a human monoclonal antibody against tumor necrosis factor-α that was approved in Japan for the treatment of hidradenitis suppurativa (HS), a chronic recurrent inflammatory skin disease. We report the results of the final analysis of the postmarketing surveillance (PMS) study (ClinicalTrials.gov: NCT03894956), which evaluated the 52-week safety and efficacy of adalimumab for HS treatment in real-world clinical practice in Japan. This multicenter, prospective, open-label, observational study (March 2019 to May 2021) included patients with HS treated with subcutaneous adalimumab at doses following the package insert. The primary endpoint was safety, and the secondary endpoints were effectiveness, including HS clinical response (HiSCR), C-reactive protein (CRP), skin pain, and Dermatology Life Quality Index (DLQI). Of the 84 patients registered at 65 sites, 83 patients were included in the analyses. Adverse drug reactions (ADRs) were reported by 10 (12.0%) patients; two patients reported a serious ADR, including one patient with serious infection. Other safety events of special interest reported were liver disorder and dermatitis psoriasiform (one patient each). Almost all patients with ADRs were recovering or had recovered, except for one patient who experienced a serious ADR of liver disorder and died. At 12 weeks, 55.4% of patients achieved HiSCR; this increased to 60.5% and 62.8% at 24 and 52 weeks of adalimumab treatment, respectively. Significant reductions from baseline in CRP (P < 0.05), skin pain (P < 0.0001), and DLQI (P < 0.0001) were observed at all time points. The results from this PMS study demonstrated that long-term adalimumab treatment is well tolerated and effective in patients with HS in real-world clinical practice in Japan.
Collapse
|
7
|
Shimizu K, Fujita H, Fujisawa D, Hayama K, Aoki S, Kubo A, Terui T. Case of type 1 segmental Darier's disease with a novel mosaic mutation in the ATP2A2 gene. J Dermatol 2023; 50:e240-e242. [PMID: 36890674 DOI: 10.1111/1346-8138.16770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Keisuke Shimizu
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Daisuke Fujisawa
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Satomi Aoki
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Akiharu Kubo
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
8
|
Akiyama M, Takeichi T, Ikeda S, Ishiko A, Kurosawa M, Murota H, Shimomura Y, Suzuki T, Tamai K, Tanaka A, Terui T, Amagai M. Recent Advances in Clinical Research on Rare Intractable Hereditary Skin Diseases in Japan. Keio J Med 2023:2023-0008-IR. [PMID: 37380461 DOI: 10.2302/kjm.2023-0008-ir] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Our Research Group for Rare and Intractable Skin Diseases operates within the Project for Research on Intractable Diseases of the Ministry of Health, Labour, and Welfare of Japan and is conducting research on eight rare intractable skin diseases. Five of these are monogenic disorders (epidermolysis bullosa, congenital ichthyoses, oculocutaneous albinism, pseudoxanthoma elasticum, and hereditary angioedema), and for a sixth [generalized pustular psoriasis (GPP)], genetic predisposing factors are important. This review introduces our activities for raising public awareness of these six intractable hereditary skin diseases and summarizes our recent achievements in clarifying the situation of medical treatments for these diseases in Japan. We note our current progress in elucidating the pathogeneses of these diseases and in developing new treatment methods, and we discuss our progress in establishing clinical practice guidelines. A nationwide survey on epidermolysis bullosa and a clinical survey on congenital ichthyoses are progressing. The Angioedema Activity Score and the Angioedema Quality-of-Life Questionnaire, the latter of which is a quality-of-life evaluation tool, have been established for hereditary angioedema. Registries of patients with oculocutaneous albinism and pseudoxanthoma elasticum have been created, and the registry for the latter has achieved its target of 170 cases. For GPP, the results of our survey on clinical practice were published in 2021. Information regarding all six of these hereditary skin diseases has been disseminated to academic societies, medical professionals, patients, and the general public.
Collapse
Affiliation(s)
- Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigaku Ikeda
- Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Ishiko
- Department of Dermatology, Toho University School of Medicine, Tokyo, Japan
| | - Michiko Kurosawa
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yutaka Shimomura
- Department of Dermatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tamio Suzuki
- Department of Dermatology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Katsuto Tamai
- Department of Stem Cell Therapy Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akio Tanaka
- Department of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
- Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| |
Collapse
|
9
|
Griffiths CE, Gooderham M, Colombel JF, Terui T, Accioly AP, Gallo G, Zhu D, Blauvelt A. 32236 Safety of ixekizumab in adult patients with moderate-to-severe psoriasis: Data from 15 clinical trials with over 18,000 patient-years of exposure. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.842] [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]
|
10
|
Terui T, Okubo Y, Kobayashi S. 33142 Efficacy and safety of apremilast for the treatment of Japanese patients with palmoplantar pustulosis: Results from a phase 2, randomized, placebo-controlled study. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.233] [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: 10/14/2022]
|
11
|
Burden AD, Bissonnette R, Navarini AA, Murakami M, Morita A, Mozzicato S, Ye B, Baehner F, Terui T. 32923 A multicenter, double-blind, randomized, placebo-controlled, phase IIb dose-finding study to evaluate efficacy and safety of spesolimab in patients with moderate-to-severe palmoplantar pustulosis. J Am Acad Dermatol 2022. [DOI: 10.1016/j.jaad.2022.06.558] [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: 11/25/2022]
|
12
|
Hayama K, Fujita H, Terui T. Current trend in the treatment of generalized pustular psoriasis in Japan: Results from a questionnaire‐based epidemiological study. J Dermatol 2022; 49:e439-e440. [DOI: 10.1111/1346-8138.16530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology Nihon University School of Medicine Tokyo Japan
| |
Collapse
|
13
|
Hayashi N, Hayama K, Takahashi K, Kurokawa I, Okazaki M, Kashiwagi T, Iwashita E, Terui T. Real-world safety and effectiveness of adalimumab in patients with hidradenitis suppurativa: 12-week interim analysis of post-marketing surveillance in Japan. J Dermatol 2022; 49:411-421. [PMID: 35040156 PMCID: PMC9305509 DOI: 10.1111/1346-8138.16297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022]
Abstract
Hidradenitis suppurativa (HS) is a painful chronic skin disease characterized by abscesses, nodules, and tunnels in the skin. Adalimumab, a monoclonal antibody against tumor necrosis factor‐α, is approved for the treatment of HS in Europe, the USA, and Japan. This multicenter, open‐label, post‐marketing, observational study (ClinicalTrials.gov: NCT03894956) evaluated the safety and effectiveness of adalimumab in routine clinical practice in Japan (March 2019–May 2021). Patients with HS were treated with s.c. doses of adalimumab according to the dosage described in the package insert. The primary end‐point was safety (data cut‐off, December 2020). Secondary end‐points assessed effectiveness, including HS Clinical Response (HiSCR), skin pain, Dermatology Life Quality Index (DLQI), and C‐reactive protein (CRP). Here, we report 12‐week interim effectiveness results. A total of 84 eligible patients from 65 sites were enrolled; 83 patients were included in this analysis. Mean age was 42.0 years, mean body mass index was 26.9 kg/m2, 78.3% of patients were male, 61.4% had Hurley stage III disease, 39.8% had a disease duration ≥10 years, and 7.2% had a family history of HS. The most common affected sites were the axilla (60.2%), buttocks (59.0%), and the inguinal and femoral regions (47.0%). Mean abscess and inflammatory nodule count was 13.0 (standard deviation, 12.0). Among patients with a comorbidity (57.8%), the most common were diabetes mellitus, hypertension, and chronic kidney disease. No patient reported a serious infection or any safety event of special interest. One patient died from a serious adverse event of cardiac failure unrelated to adalimumab. At week 12, 57.4% of patients achieved HiSCR, and significant reductions from baseline in skin pain, DLQI (both p < 0.0001), and CRP (p = 0.0029) were observed. These results support the administration of adalimumab as a well‐tolerated and effective treatment for Japanese patients with HS in real‐world clinical practice.
Collapse
|
14
|
Saeki H, Tsunemi Y, Arai S, Ichiyama S, Katoh N, Kikuchi K, Kubo A, Terui T, Nakahara T, Futamura M, Murota H, Igarashi A. English version of guidelines for the management of asteatosis 2021 in Japan. J Dermatol 2021; 49:e77-e90. [PMID: 34970776 DOI: 10.1111/1346-8138.16293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 11/27/2022]
Abstract
This is the English version of guidelines for the management of asteatosis 2021 in Japan. Asteatosis is a synonym of xerosis found in a wide range of diseases that induce dry skin through impaired functions of either water retention of the stratum corneum or skin covering with acid mantle. Patients with asteatosis may be accompanied by pruritus. Moisturizers are the first-line treatment for asteatosis and their adequate use must be recommended. The main purpose of the present guidelines is to define skin symptoms requiring treatment with moisturizers for medical use in patients with asteatosis. If the deterioration of marked scaling or scratch marks is predicted, therapeutic intervention with moisturizers for medical use should be considered even in the absence of pruritus. Regarding six important points requiring decision-making in clinical practice (clinical questions), we evaluated the balance between the benefits and harm of medical interventions in reference to previous reports of clinical research, and presented the recommendation grades and evidence levels to optimize the patient outcome by medical interventions.
Collapse
Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Yuichiro Tsunemi
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - Satoru Arai
- Department of Dermatology, St. Luke's International Hospital, Tokyo, Japan
| | - Susumu Ichiyama
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Norito Katoh
- Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | | | - Akiharu Kubo
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Takeshi Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Futamura
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Department of Allergy, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | |
Collapse
|
15
|
Hayama K, Fujita H, Hashimoto T, Terui T. Overall Impairment of Quality of Life in Japanese Patients with Hidradenitis Suppurativa: Comparison with National Standard. Acta Derm Venereol 2021; 102:adv00632. [PMID: 34935991 PMCID: PMC9558336 DOI: 10.2340/actadv.v101.1013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communication)
Collapse
Affiliation(s)
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan.
| | | | | |
Collapse
|
16
|
Nishimori N, Toyoshima S, Sasaki-Sakamoto T, Hayama K, Terui T, Okayama Y. Serum level of hemokinin-1 is significantly lower in patients with chronic spontaneous urticaria than in healthy subjects. Allergol Int 2021; 70:480-488. [PMID: 34090787 DOI: 10.1016/j.alit.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 03/29/2021] [Accepted: 04/07/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND We previously reported upregulation of expression of Mas-related G protein-coupled receptor X2 (MRGPRX2) on mast cells (MCs) in the skin of patients with severe chronic spontaneous urticaria (CSU). Serum levels of substance P (SP) were reportedly significantly elevated, in correlation with the severity of CSU. Hemokinin-1 (HK-1) reportedly induced histamine release from LAD2 cells via MRGPRX2. We aimed to investigate HK-1's role in CSU. METHODS The concentrations of HK-1 and SP were measured using ELISAs. Skin- and synovium-derived cultured MCs were generated by culturing dispersed skin and synovial cells, respectively, with stem cell factor. MRGPRX2 expression in the MCs was reduced using a lentiviral shRNA silencing technique. RESULTS Anti-SP Ab used in the SP ELISA showed 100% cross-reactivity to HK-1, but anti-HK-1 Ab showed 0% cross-reactivity to SP. The serum level of HK-1 was significantly lower in patients with CSU (n = 151) than in non-atopic healthy control (NC) subjects (n = 114). The EC50 of histamine release from MCs induced by HK-1 (5056 nM) was 12-fold higher than by SP (426 nM). Brief pretreatment of MCs with HK-1 at concentrations of 3.0-10 μM significantly reduced histamine release by 0.1 μM SP. However, brief incubation of MCs with HK-1 did not elicit rapid MRGPRX2 internalization. CONCLUSIONS In NC subjects, high HK-1 concentrations may desensitize MGRPRX2-mediated MC activation, thereby preventing MC degranulation by SP.
Collapse
|
17
|
Ikumi N, Terui T, Fujita H. Peripheral arthritis presenting pencil-in-cup deformity in a patient with palmoplantar pustulosis. J Dermatol 2021; 48:e612-e613. [PMID: 34569649 DOI: 10.1111/1346-8138.16174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/09/2021] [Accepted: 09/12/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Natsumi Ikumi
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Kumagaya General Hospital, Saitama, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
18
|
Okubo Y, Morishima H, Zheng R, Terui T. Sustained efficacy and safety of guselkumab in patients with palmoplantar pustulosis through 1.5 years in a randomized phase 3 study. J Dermatol 2021; 48:1838-1853. [PMID: 34453358 PMCID: PMC9290648 DOI: 10.1111/1346-8138.16132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022]
Abstract
The safety and efficacy of guselkumab for palmoplantar pustulosis (PPP) have been established through week (W)52; however, no sufficient information is available beyond 1 year. This study was conducted to assess the efficacy and safety of guselkumab through W84, and to explore factors associated with the sustainability of its efficacy in Japanese PPP patients. Patients received guselkumab 100 or 200 mg at W0, W4, W12, and every 8 weeks (q8w) until W60, or placebo at W0, W4, and W12. At W16, patients receiving placebo were re‐randomized to receive guselkumab 100/200 mg at W16, W20, and q8w until W60. Efficacy end‐points included PPP Area and Severity Index (PPPASI), PPP Severity Index (PPSI), Physician’s Global Assessment scores, and patient reported outcomes (PRO) (Dermatology Life Quality Index, EuroQoL‐5 Dimensions, and 36‐item Short Form Health Survey). Post‐hoc comparison of patient characteristics was performed between PPPASI‐75/90 responders and non‐responders at W60, and sustained responders and non‐responders at W84. Safety was evaluated through W84. A total of 45, 43, 21, and 24 patients from the guselkumab 100 mg, guselkumab 200 mg, placebo→guselkumab 100 mg, and placebo→guselkumab 200 mg groups, respectively, completed the study through W84. Overall, the mean improvement in the guselkumab groups from baseline in the PPPASI and PPSI total scores at W84 was ~79% and ~66%, respectively. All PRO improved through W84. The proportion of responders through W60 was higher in patients who had not received prior phototherapy and non‐biologic systemic therapy for PPP. Non‐smokers and patients with no prior non‐biologic systemic treatment tended numerically towards sustained efficacy through W84. The majority of treatment‐emergent adverse events (TEAE) were mild to moderate (~88%) with low incidence of serious TEAE (7.6%). Overall, guselkumab showed sustained efficacy and safety with improvement in the health‐related quality of life through W84 in Japanese PPP patients.
Collapse
Affiliation(s)
- Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Tadashi Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
19
|
Ikumi N, Hayama K, Terui T, Kitamura N, Takei M, Fujita H. Retrospective study of the differences in the management for pustulotic arthro-osteitis in patients with palmoplantar pustulosis between dermatologists and rheumatologists. J Dermatol 2021; 48:e551-e553. [PMID: 34405436 DOI: 10.1111/1346-8138.16118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/28/2021] [Accepted: 08/04/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Natsumi Ikumi
- Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Tokyo, Japan.,Department of Internal Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Tokyo, Japan
| | - Noboru Kitamura
- Department of Internal Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Masami Takei
- Department of Internal Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
20
|
Niwa Y, Hayama K, Izaki S, Koga H, Ishii N, Terui T, Fujita H. Mucosa-predominant pemphigus vulgaris with anti-desmocollin 2 and 3 antibody positivity and ocular symptoms. Clin Exp Dermatol 2021; 46:1590-1592. [PMID: 34056753 DOI: 10.1111/ced.14771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Y Niwa
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - K Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - S Izaki
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - H Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - N Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - T Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - H Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
21
|
Nishimura-Tagui M, Hayama K, Fujita H, Miyamoto Y, Ishii N, Terui T. Disseminated Mycobacterium massiliense skin infection in an immunocompromised patient requiring long-term treatment. J Dermatol 2021; 48:e201-e202. [PMID: 33580889 DOI: 10.1111/1346-8138.15808] [Citation(s) in RCA: 2] [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] [Received: 06/26/2020] [Accepted: 01/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Maho Nishimura-Tagui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yuji Miyamoto
- Leprosy Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan
| | - Norihisa Ishii
- Leprosy Research Center, National Sanatorium Tamazenshoen, Higashimurayama, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
22
|
Toyoshima S, Sakamoto-Sasaki T, Kurosawa Y, Hayama K, Matsuda A, Watanabe Y, Terui T, Gon Y, Matsumoto K, Okayama Y. miR103a-3p in extracellular vesicles from FcεRI-aggregated human mast cells enhances IL-5 production by group 2 innate lymphoid cells. J Allergy Clin Immunol 2021; 147:1878-1891. [PMID: 33465368 DOI: 10.1016/j.jaci.2021.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 06/30/2020] [Revised: 12/27/2020] [Accepted: 01/05/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mast cells (MCs) are key regulators of IgE-mediated allergic inflammation. Cell-derived extracellular vesicles (EVs) contain bioactive compounds such as microRNAs. EVs can transfer signals to recipient cells, thus using a novel mechanism of cell-to-cell communication. However, whether MC-derived EVs are involved in FcεRI-mediated allergic inflammation is unclear. OBJECTIVE We sought to investigate the effect of EVs derived from FcεRI-aggregated human MCs on the function of human group 2 innate lymphoid cells (ILC2s). METHODS Human cultured MCs were sensitized with and without IgE for 1 hour and then incubated with anti-IgE antibody, IL-33, or medium alone for 24 hours. EVs in the MC supernatant were isolated by using ExoQuick-TC. RESULTS Coculture of ILC2s with EVs derived from the FcεRI-aggregated MCs significantly enhanced IL-5 production and sustained upregulation of IL-5 mRNA expression in IL-33-stimulated ILC2s, but IL-13 production and IL-13 mRNA expression were unchanged. miR103a-3p expression was upregulated in IL-33-stimulated ILC2s that had been cocultured with EVs derived from anti-IgE antibody-stimulated MCs. Transduction of an miR103a-3p mimic to ILC2s significantly enhanced IL-5 production by IL-33-stimulated ILC2s. miR103a-3p promoted demethylation of an arginine residue of GATA3 by downregulating protein arginine methyltransferase 5 (PRMT5) mRNA. Reduction of protein arginine methyltransferase 5 expression in ILC2s by using a small interfering RNA technique resulted in upregulation of IL-5 production by IL-33-stimulated ILC2s. Furthermore, the level of miR103a-3p expression was significantly higher in EVs from sera of patients with atopic dermatitis than in EVs from nonatopic healthy control subjects. CONCLUSION Eosinophilic allergic inflammation may be exacerbated owing to ILC2 activation by MC-derived miR103a-3p.
Collapse
Affiliation(s)
- Shota Toyoshima
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan; Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Tomomi Sakamoto-Sasaki
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan; Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Yusuke Kurosawa
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan; Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Divison of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Akira Matsuda
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasuo Watanabe
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Divison of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuhiro Gon
- Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kenji Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yoshimichi Okayama
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan; Center for Allergy, Nihon University Itabashi Hospital, Tokyo, Japan; Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan.
| |
Collapse
|
23
|
Fujita H, Ohtsuki M, Morita A, Nagao R, Seko N, Matsumoto K, Tani Y, Terui T. Safety and effectiveness of secukinumab in psoriasis vulgaris and psoriatic arthritis: Real-world evidence in Japan. J Dermatol 2020; 48:175-183. [PMID: 33099791 PMCID: PMC7894540 DOI: 10.1111/1346-8138.15655] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022]
Abstract
Secukinumab, a fully human monoclonal antibody that selectively neutralizes interleukin‐17A, has been available for the treatment of moderate to severe psoriasis and psoriatic arthritis since February 2015 in Japan. Because there was a time gap after the previous approval of biologics for psoriatic disease indication, it was suggested that patients to be treated with secukinumab at its launch might have refractory disease symptoms. In order to assess the safety and effectiveness of secukinumab in those patients, a 52‐week, open‐label, multicenter, observational cohort study was conducted. In total, 306 and 250 patients were included in the safety and effectiveness analysis sets, respectively. Over half of patients had previously received biologics (56.9%). Adverse events, serious adverse events and adverse reactions were reported in 41.2%, 7.2% and 24.2% of patients, respectively. The most commonly reported adverse reactions were oral candidiasis (2.9%), consistent with those reported in clinical studies. In addition, none of the patient characteristics assessed for the effect on safety of secukinumab increased the occurrence of adverse reactions. Psoriasis Area and Severity Index score (mean ± standard deviation) improved from baseline (14.7 ± 12.3) to week 12 (1.78 ± 3.3), which was maintained up to week 24 (1.59 ± 3.0). The proportion of patients with a Dermatology Life Quality Index score of 0/1 improved from baseline (2.2%) to week 12 (64.7%) and sustained up to week 24 (71.4%). In addition to the skin symptoms, improvement was observed in all psoriatic arthritis disease‐related assessments. The current study reaffirmed the safety and effectiveness of secukinumab with broader patients than those in the clinical studies.
Collapse
Affiliation(s)
- Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | | | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | | | | | | | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
24
|
Hayama K, Fujita H, Iwatsuki K, Terui T. Improved quality of life of patients with generalized pustular psoriasis in Japan: A cross-sectional survey. J Dermatol 2020; 48:203-206. [PMID: 33099802 PMCID: PMC7894492 DOI: 10.1111/1346-8138.15657] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/23/2020] [Indexed: 12/30/2022]
Abstract
Generalized pustular psoriasis (GPP) is a rare variant of psoriasis with severe clinical symptoms. However, the quality of life (QoL) of the patients is largely unknown. We conducted a nationwide cross‐sectional survey of Japanese GPP patients using the 36‐Item Short‐Form Health Survey version 2 (SF‐36v2) to elucidate patients’ QoL and how their QoL had changed over the last decade. We analyzed QoL data of 83 patients obtained from 2016 to 2019 (present group) and compared it with that of 105 patients collected in a previous survey conducted between 2003 and 2007 (past group). Although the QoL of the present patients was still largely impaired in comparison with the standard Japanese population, substantial improvement was found in some SF‐36v2 subscales including “general health”, “vitality”, “social functioning” and “mental health” as compared with that of the past group. Advances in treatment may contribute to this QoL improvement.
Collapse
Affiliation(s)
- Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
25
|
Ikumi N, Fujita H, Terui T. Guselkumab improves joint pain in patients with pustulotic arthro-osteitis: A retrospective pilot study. J Dermatol 2020; 48:199-202. [PMID: 33051886 DOI: 10.1111/1346-8138.15632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/10/2020] [Accepted: 09/08/2020] [Indexed: 11/27/2022]
Abstract
Pustulotic arthro-osteitis (PAO) is an osteoarticular complication of palmoplantar pustulosis (PPP). Although guselkumab, an anti-interleukin-23p19 antibody, has been shown to be effective for PPP, its efficacy for PAO is still not well understood. We conducted a retrospective observational study to evaluate the effectiveness of 28-week guselkumab treatment for five PAO patients in daily clinical practice. Four patients had sternoclavicular arthritis, and one had only sacroiliitis. Guselkumab improved pain visual assessment scale scores in all five patients by 54.2% (11.1-87.5%) on average at week 28 compared with baseline, and discontinuation or dose reduction of analgesics was possible in four of them. Three patients showed clinically significant improvement in Bath Ankylosing Spondylitis Disease Activity Index of 2 or more. On the other hand, beneficial change in Ankylosing Spondylitis Disease Activity Score of 1.1 or more was observed in only one patient. Bone scintigraphy demonstrated decreased uptake in sternoclavicular joints after guselkumab treatment in all four patients with sternoclavicular arthritis. Improvement of Palmoplantar Pustulosis Area and Severity Index was also confirmed. Guselkumab can be a treatment option for intractable PAO.
Collapse
Affiliation(s)
- Natsumi Ikumi
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
26
|
Morita A, Takahashi H, Ozawa K, Imafuku S, Takekuni N, Takahashi K, Matsuyama T, Okubo Y, Zhao Y, Kitamura S, Takei K, Yokoyama M, Hayashi N, Terui T. Long-term analysis of adalimumab in Japanese patients with moderate to severe hidradenitis suppurativa: Open-label phase 3 results. J Dermatol 2020; 48:3-13. [PMID: 33029861 PMCID: PMC7821142 DOI: 10.1111/1346-8138.15605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/12/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
This phase 3, multicenter, open-label single-arm study evaluated adalimumab (ADA) in Japanese patients with moderate to severe hidradenitis suppurativa (HS). Fifteen patients received ADA 160 mg s.c. at week 0, 80 mg at week 2 and 40 mg at week 4 and every week thereafter. At any time after week 52, patients were given the option to receive 80 mg ADA every other week or remain on 40 mg every week. The primary end-point (achievement of HS Clinical Response [HiSCR] at week 24) and results up to week 24 were published previously. Secondary end-points included total abscess and inflammatory nodule (AN) count, 30% or more and 1 unit or more reduction in Patient's Global Assessment of Skin Pain Numeric Rating Scale (NRS30), modified Sartorius score and quality of life (QoL). After 12 weeks of ADA treatment, the achievement rate in HiSCR was 86.7%; HiSCR achievement rate was sustained through week 52 at 66.7%. Improvements at week 12 were also seen in the proportion of patients achieving an AN count of 0-2; NRS30 response rate among the nine patients with a baseline NRS of 3 or more; mean decrease in modified Sartorius score (61.4); and QoL as assessed by Dermatology Life Quality Index and Treatment Satisfaction Questionnaire; these improvements were maintained through 52 weeks. Similar efficacy was observed when patients switched dosing from ADA 40 mg every week to ADA 80 mg every other week. There were no new safety findings with ADA 40 mg weekly dosing during the study, and no differences in safety were found between patients who switched to 80 mg ADA every other week and patients who remained on 40 mg every week. The results of this study indicate that long-term ADA treatment is effective and well tolerated in Japanese patients with moderate to severe HS.
Collapse
Affiliation(s)
- Akimichi Morita
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Kentaro Ozawa
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Affiliation(s)
- Nobuyuki Nishimori
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, 1738610 Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
28
|
Kawana H, Fujita H, Fujisawa D, Ishii M, Murata M, Kurumatani A, Hayama K, Tanaka M, Terui T. Spitz nevus with unusual dermoscopic figures in an adult female. Clin Case Rep 2020; 8:1007-1009. [PMID: 32577253 PMCID: PMC7303874 DOI: 10.1002/ccr3.2801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/25/2019] [Revised: 01/18/2020] [Accepted: 02/11/2020] [Indexed: 11/12/2022] Open
Abstract
Spitz nevus is an important differential diagnosis of malignant melanoma, especially in young adults. This case provides a significant information about unusual dermoscopic features of adult Spitz nevus, which may reflect changes over the years.
Collapse
Affiliation(s)
- Hironori Kawana
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Hideki Fujita
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Daisuke Fujisawa
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Madoka Ishii
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Miwa Murata
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Ayano Kurumatani
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Koremasa Hayama
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Masaru Tanaka
- Department of DermatologyTokyo Women’s Medical University Medical Center EastTokyoJapan
| | - Tadashi Terui
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| |
Collapse
|
29
|
Hayama K, Fujita H, Hashimoto T, Terui T. Questionnaire-based epidemiological study of hidradenitis suppurativa in Japan revealing characteristics different from those in Western countries. J Dermatol 2020; 47:743-748. [PMID: 32441411 PMCID: PMC7818453 DOI: 10.1111/1346-8138.15378] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/07/2020] [Indexed: 01/14/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic relapsing skin disease localized mainly on the apocrine gland‐bearing areas. In Japan, HS is yet to be fully understood, and no criteria have been established for its diagnosis or severity assessment. The purpose of this study was to investigate and characterize HS in Japan. We conducted a nationwide questionnaire‐based study, in which Japanese diagnostic criteria were proposed. Question items included age, sex, disease duration, past history, family history, smoking status, disease severity scores (Hurley stage, modified Sartorius score and Physician Global Assessment [PGA] score), treatments, comorbidities and prognosis. We analyzed 300 patients (219 males and 81 females) diagnosed with HS based on our criteria. Average disease duration was 92.3 ± 6.82 months. Only 12 (4%) patients had a family history of HS. Disease severity was classified by PGA score (mild, 100 [33.3%]; moderate, 133 [44.3%]; severe, 34 [11.3%]; most severe, 29 [9.7%]) and Hurley stage (I, 69 [23%]; II, 109 [36.3%]; III, 121 [40.3%]). Disease severities based on PGA score and Hurley stage were positively correlated to modified Sartorius score using the Kruskal–Wallis test (P < 0.001, respectively). Patients with diabetes mellitus showed higher PGA scores (χ2 = 10.977, P = 0.01185). Presence of axillary lesions related to higher PGA scores (χ2 = 8.6378, P = 0.03452). The results in this study and previous studies indicate that Japanese HS patients have different backgrounds from those in Western countries, and are characterized by male predominance, higher incidence of Hurley stages II and III, higher PGA scores in patients with axillary lesions and much fewer familial cases.
Collapse
Affiliation(s)
- Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | | |
Collapse
|
30
|
Yamamoto T, Fukuda K, Morita A, Kimura T, Morishima H, Goto R, Zheng R, Terui T. Efficacy of guselkumab in a subpopulation with pustulotic arthro-osteitis through week 52: an exploratory analysis of a phase 3, randomized, double-blind, placebo-controlled study in Japanese patients with palmoplantar pustulosis. J Eur Acad Dermatol Venereol 2020; 34:2318-2329. [PMID: 32173916 PMCID: PMC7586986 DOI: 10.1111/jdv.16355] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/18/2020] [Indexed: 12/11/2022]
Abstract
Background Previous studies of guselkumab have demonstrated clinical benefits in patients with plaque‐type psoriasis, generalized pustular psoriasis, erythrodermic psoriasis and palmoplantar pustulosis (PPP). Objective The aim of this exploratory analysis of a double‐blind, multicenter, placebo‐controlled, phase 3 study in Japanese patients with PPP was to evaluate the efficacy of guselkumab in the subset of patients with pustulotic arthro‐osteitis (PAO). Methods Patients were randomized to receive guselkumab 100 or 200 mg at weeks 0, 4, 12 and every 8 weeks, or placebo with cross‐over to guselkumab 100 or 200 mg at week 16 (placebo group). Efficacy endpoints were changes from baseline in magnetic resonance imaging (MRI) score, EuroQOL‐5 dimensions (EQ‐5D) index score, EQ‐5D pain/discomfort dimension score and C‐reactive protein (CRP, mg/L) level in all PAO patients through week 52. Data from both guselkumab groups were combined and presented as results for a single overall guselkumab group. Results Among 159 patients with PPP, 66 with PAO were randomized across treatment groups. For patients with MRI data for all regions assessed, the proportion of patients in the guselkumab group with PAO characterized as severe decreased from 23.8% (10/42) at baseline to 5.4% (2/42) at week 52. The mean (SD) change from baseline at week 52 in EQ‐5D index score was 0.20 (0.17) among PPP patients with PAO and 0.15 (0.17) among those without PAO in the guselkumab group. Among all PAO patients, the proportions with an EQ‐5D pain/discomfort dimension score of no or slight pain/discomfort in the guselkumab group increased from baseline to week 52 [33.3% (7/21) vs. 87.5% (35/40)]. The mean (SD) CRP levels decreased in all PAO patients in the guselkumab group at week 52 compared to baseline [−1.71 (8.16) mg/L]. Conclusion Guselkumab treatment showed beneficial outcomes for PAO signs and symptoms in Japanese patients with PPP.
Collapse
Affiliation(s)
- T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - K Fukuda
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - A Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - T Kimura
- Janssen Pharmaceutical K.K, Tokyo, Japan
| | | | - R Goto
- Janssen Pharmaceutical K.K, Tokyo, Japan
| | - R Zheng
- Janssen Pharmaceutical K.K, Tokyo, Japan
| | - T Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
31
|
Endo T, Toyoshima S, Hayama K, Tagui M, Niwa Y, Ito M, Terui T, Okayama Y. Relationship between changes in the 7-day urticaria activity score after treatment with omalizumab and the responsiveness of basophils to FcεRI stimulation in patients with chronic spontaneous urticaria. Asia Pac Allergy 2020; 10:e12. [PMID: 32411577 PMCID: PMC7203440 DOI: 10.5415/apallergy.2020.10.e12] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/02/2020] [Indexed: 12/04/2022] Open
Abstract
Background About one-half of all patients with chronic spontaneous urticaria have low or less reactivity of the basophils to FcεRI stimulation. However, the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FcεRI stimulation are still unclear. Furthermore, it also remains unknown as to what factors induce the poor reactivity of basophils to FcεRI stimulation. Objective The aim of the study is to investigate the differences in the clinical characteristics between patients who show normal and attenuated basophil reactivities to FcεRI stimulation. Methods We compared the clinical characteristics, including the autologous serum skin test-positive rates, serum concentrations of anti-IgE and anti-FcεRIα autoantibodies, and the FcεRI-crosslinking ability of these autoantibodies between patients with a negative basophil activation test (BAT) (≤10% CD203chigh basophils, n = 9) and positive BAT (>10% CD203chigh basophils, n = 13). We also monitored the changes in the 7-day urticaria activity scores after treatment with omalizumab, as compared to the score at the baseline, between the BAT-positive and BAT-negative patients. Results The BAT-negative patients showed a significantly higher urticaria control test score than the BAT-positive patients (p = 0.01). There were no significant differences in the autologous serum skin test-positive rates, concentrations of anti-IgE and anti-FcεRIα autoantibodies, and the FcεRI-crosslinking ability of these autoantibodies between the 2 groups. After treatment with omalizumab for 35 days, the score decreased to under 15 (corresponding to controlled or mild chronic spontaneous urticaria) in all of the BAT-negative patients, whereas in 6 out of the 13 BAT-positive patients, the scores remained over 16 (corresponding to moderate or severe chronic spontaneous urticaria). Conclusions The weak reactivity of basophils to FcεRI stimulation may not be due to the desensitization of basophils by anti-IgE or anti-FcεRIα autoantibodies. The time to response to omalizumab might differ between BAT-negative and BAT-positive patients with chronic spontaneous urticaria.
Collapse
Affiliation(s)
- Takahiro Endo
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Shota Toyoshima
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Maho Tagui
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yusuke Niwa
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Mana Ito
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshimichi Okayama
- Allergy and Immunology Research Project Team, Research Institute of Medical Science, Nihon University School of Medicine, Tokyo, Japan.,Center for Allergy, Nihon University School of Medicine, Tokyo, Japan.,Center for Medical Education, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
32
|
Nishimura-Tagui M, Hayama K, Fujita H, Sato N, Nakamura M, Yagami A, Matsunaga K, Terui T. Case of anaphylaxis due to lotus root. J Dermatol 2020; 47:e227-e228. [PMID: 32232879 DOI: 10.1111/1346-8138.15329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Maho Nishimura-Tagui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Nayu Sato
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Aichi, Japan.,General Research and Development Institute, Hoyu Co., Ltd., Aichi, Japan
| | - Masashi Nakamura
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Aichi, Japan.,General Research and Development Institute, Hoyu Co., Ltd., Aichi, Japan
| | - Akiko Yagami
- Deparatment of Allergology, Fujita Health University School of Medicine, Aichi, Japan
| | - Kayoko Matsunaga
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Aichi, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
33
|
Hayama K, Fujita H, Fujimaki M, Takahashi S, Yoshida Y, Nozaki T, Terui T. Rapid recurrence of dermatofibrosarcoma protuberans after initiation of adalimumab therapy in a patient with ankylosing spondylitis. J Dermatol 2020; 47:e244-e246. [PMID: 32207546 DOI: 10.1111/1346-8138.15328] [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] [Indexed: 11/29/2022]
Affiliation(s)
- Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Mitsue Fujimaki
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Shogo Takahashi
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Orthopedic Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Takamasa Nozaki
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
34
|
Murakami M, Terui T. Palmoplantar pustulosis: Current understanding of disease definition and pathomechanism. J Dermatol Sci 2020; 98:13-19. [PMID: 32201085 DOI: 10.1016/j.jdermsci.2020.03.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/08/2020] [Indexed: 12/24/2022]
Abstract
Pustulosis palmaris et plantaris, or palmoplantar pustulosis (PPP), is a chronic pustular dermatitis involving the palms and soles and is characterized by vesicles, pustules, erythema, lichenification, and abnormal desquamation. It is one of the most common skin diseases in Japan but its pathomechanism is unclear and the disease remains poorly defined. Consequently, adequate treatment for PPP is lacking. As a localized type of pustular psoriasis, PPP has long been treated with the conventional therapies used for plaque-type psoriasis, especially in Western countries. However, PPP may be a distinct entity, with a much lower prevalence in Western countries than in Japan. Furthermore, while treatment has yielded insights into the underlying pathology in plaque-type psoriasis, the pathogenesis of PPP has yet to be elucidated. In 2018, Gulselkumab, a monoclonal antibody against interleukin (IL)-23, was certified for use in Japan and is the first biologic effective in PPP both in Japanese and other patients. In this review, we summarize the current understanding of PPP, including the revised definition and possible pathomechanism. The information presented herein provides a more complete picture of PPP and may facilitate the development of improved treatment options.
Collapse
Affiliation(s)
- Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan.
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan.
| |
Collapse
|
35
|
Armstrong A, Paul C, Puig L, Boehncke WH, Freeman M, Torii H, Papp K, Griffiths CEM, Blauvelt A, Reich K, Gooderham M, Terui T, Renda L, Agada N, Xu W, Gallo G, Lebwohl MG. Safety of Ixekizumab Treatment for up to 5 Years in Adult Patients with Moderate-to-Severe Psoriasis: Results from Greater Than 17,000 Patient-Years of Exposure. Dermatol Ther (Heidelb) 2020; 10:133-150. [PMID: 31749092 PMCID: PMC6994584 DOI: 10.1007/s13555-019-00340-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Long-term safety data are critical for evaluating therapies for psoriasis. Ixekizumab has demonstrated efficacy and is well tolerated for the treatment of moderate-to-severe plaque psoriasis. We examined the safety and tolerability of up to 5 years of ixekizumab therapy in patients with psoriasis. METHODS Integrated safety data were analyzed from 13 ixekizumab clinical studies. Rates of treatment-emergent adverse events (TEAEs), serious AEs (SAEs) and AEs of special interest were analyzed for the 12-week induction period in the combined pivotal studies, and for all pooled studies by year(s) of therapy and overall, reported as exposure-adjusted incidence rates (IRs) per 100 patient-years (p-y) and/or frequencies. RESULTS Total ixekizumab exposure was 17,003.4 p-y (N = 5898); 2749 patients had ≥ 4 years of exposure. When compared across years of exposure, rates for AEs remained largely stable or declined, including TEAEs leading to discontinuation (3.8/100 p-y in year 1, declining to 2.0/100 p-y in year 5); SAEs (range 6.2-7.0/100 p-y); serious infections (range 1.3-1.7/100 p-y); nonmelanoma skin cancer (ranging from 0.5/100 p-y in year 1 to 0.2/100 p-y in years 4-5); other malignancies (range 0.4-0.6/100 p-y); inflammatory bowel disease including ulcerative colitis and Crohn's disease (IR 0.2/100 p-y); and major adverse cardiovascular events (MACE) (range 0.3-0.7/100 p-y). Candidiasis was reported in 327 patients (IR 1.9/100 p-y), with the majority identified as mucocutaneous. The rate of injection site reactions was 15.5/100 p-y during year 1 and 2.0-2.3/100 p-y by years 3-5. CONCLUSIONS The decrease in rates of TEAEs and the stable rates of SAEs, other malignancies and MACE during up to 5 years of ixekizumab dosing are consistent with previous reports describing a favorable safety profile of ixekizumab following shorter durations of exposure. FUNDING Eli Lilly and Company.
Collapse
Affiliation(s)
- April Armstrong
- Department of Clinical Research, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Carle Paul
- Dermatology Department, Toulouse University Hospital (CHU), Paul Sabatier University, Toulouse, France
| | - Luis Puig
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wolf Henning Boehncke
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
- Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | | | - Hideshi Torii
- Division of Dermatology, Tokyo Yamate Medical Center, Tokyo, Japan
| | - Kim Papp
- K Papp Clinical Research and Probity Medical Research, Waterloo, ON, Canada
| | - Christopher E M Griffiths
- Dermatology Centre, Salford Royal Hospital, University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | | | - Kristian Reich
- Center for Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Skinflammation® Center, Hamburg, Germany
| | - Melinda Gooderham
- Centre for Dermatology and Probity Medical Research, Peterborough, ON, Canada
| | - Tadashi Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Lisa Renda
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Noah Agada
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Wen Xu
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Gaia Gallo
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
36
|
Yamamoto T, Hiraiwa T, Tobita R, Hirano H, Masuda-Kuroki K, Ishii M, Murakami M, Terui T, Okubo Y. Characteristics of Japanese patients with pustulotic arthro-osteitis associated with palmoplantar pustulosis: a multicenter study. Int J Dermatol 2020; 59:441-444. [PMID: 31985054 DOI: 10.1111/ijd.14788] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/03/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Pustulotic arthro-osteitis (PAO) is a major comorbidity of palmoplantar pustulosis (PPP), which is frequently seen in Japanese patients. To determine the characteristics of Japanese patients with PAO, we conducted a multicenter, retrospective epidemiologic survey at four university hospitals. METHODS Clinical features including age, gender, duration of disease, extrapalmoplantar lesion, smoking habit, focal infection, site of joint pain, bone scintigraphy with Technetium99 , and therapies were retrospectively evaluated. RESULTS In total, 165 patients with PAO were identified among 576 patients with PPP (28.6%). The male to female ratio was 1 : 3.7, and the mean age was 50.2 years. The mean disease duration of PAO was 6.0 years. Smoking habit was observed in 104 patients. Focal infection was detected in 74 patients, who developed tonsillar infection (n = 41), sinusitis (8), odontogenic infection (40), and others (2). Fifteen patients had multifocal infection. Technetium bone scintigraphy was performed in 97 cases. Increased uptake was most frequently observed in the sternocostoclavicular regions, followed by wrist and ankle, sacroiliac joint, knee and elbow, finger and toe, lumbar spine, thoracic spine, scapula, and thigh. Patients were mainly treated with nonsteroidal anti-inflammatory drugs, methotrexate, cyclosporine, antibiotics, and biologics, as well as tonsillectomy and dental treatment. CONCLUSION PAO frequently involves the anterior chest wall of middle-aged women with smoking habit and is closely associated with focal infection.
Collapse
Affiliation(s)
- Toshiyuki Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Tomoko Hiraiwa
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Rie Tobita
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Hirofumi Hirano
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | | | - Madoka Ishii
- Department of Dermatology, Nihon University, Tokyo, Japan
| | | | - Tadashi Terui
- Department of Dermatology, Nihon University, Tokyo, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
37
|
Saeki H, Terui T, Morita A, Sano S, Imafuku S, Asahina A, Komine M, Etoh T, Igarashi A, Torii H, Abe M, Nakagawa H, Watanabe A, Yotsuyanagi H, Ohtsuki M. Japanese guidance for use of biologics for psoriasis (the 2019 version). J Dermatol 2020; 47:201-222. [PMID: 31916326 DOI: 10.1111/1346-8138.15196] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 12/11/2022]
Abstract
As the first biologics for psoriasis in Japan, infliximab and adalimumab, anti-tumor necrosis factor-α antibodies, became available in the field of dermatology in 2010, followed by ustekinumab, an anti-interleukin (IL)-12/IL-23p40 antibody, which was launched in Japan in 2011. Since 2015, three IL-17 inhibitors of secukinumab and ixekizumab, anti-IL-17A antibodies, and brodalumab, an anti-IL-17 receptor antibody, and two anti-IL-23p19 antibodies of guselkumab and risankizumab, have also been launched. It is important for physicians to select appropriate biologic therapy for each psoriatic patient after due consideration of disease factors, treatment factors and patient background factors, sharing such information with patients. The following can be listed as points to be considered for the selection of biologics: drug effects (e.g. strength of effectiveness, time to onset of effectiveness, effectiveness against arthritis, primary failure, secondary failure), safety (e.g. infections, administration-related reactions and relationships with other comorbidities), convenience for patients (e.g. hospital visit intervals, self-injection, maintenance therapy at clinics, feasibility of drug discontinuation/re-administration) and payment (medical costs) borne by patients. This guidance has been prepared with the aim of allowing dermatologists experienced in the treatment of psoriasis to use biologics appropriately according to the circumstances of individual patients after consideration of the above-mentioned factors.
Collapse
Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Tadashi Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigetoshi Sano
- Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shinichi Imafuku
- Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Akihiko Asahina
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Takafumi Etoh
- Division of Dermatology, Tokyo Postal Services Agency Hospital, Tokyo, Japan
| | | | - Hideshi Torii
- Division of Dermatology, Tokyo Yamate Medical Center, Tokyo, Japan
| | | | - Hidemi Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Akira Watanabe
- Research Division for Development of Anti-Infective Agents, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | | |
Collapse
|
38
|
Griffiths C, Blauvelt A, Reich K, Gooderham M, Terui T, Agada N, Xu W, Gallo G, Lebwohl M, Seban E. Tolérance à long terme de l’ixékizumab chez des patients atteints de psoriasis modéré à sévère : résultats de plus de 17 000 patients-années d’exposition. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.588] [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]
|
39
|
Otake E, Hayama K, Fujita H, Shinkuma S, Shimizu H, Terui T. Leiomyomatosis developed in a patient of neurofibromatosis type 1 with fumarate hydratase gene mutation. J Dermatol 2019; 46:e456-e457. [DOI: 10.1111/1346-8138.15053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eika Otake
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Koremasa Hayama
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Hideki Fujita
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Satoru Shinkuma
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
- Division of Dermatology Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Hiroshi Shimizu
- Department of Dermatology Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Tadashi Terui
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| |
Collapse
|
40
|
Ikumi N, Fujita H, Terui T, Takahashi H, Miura K, Hatta Y, Takei M. Aggressive CD4-CD8-CD45RA+CCR10- Primary Cutaneous Peripheral T-cell Lymphoma, Not Otherwise Specified: A Case Report. Acta Derm Venereol 2019; 99:1176-1177. [PMID: 31502655 DOI: 10.2340/00015555-3310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
MESH Headings
- Aged
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- CD4 Antigens/analysis
- CD8 Antigens/analysis
- Disease Progression
- Fatal Outcome
- Humans
- Leukocyte Common Antigens/analysis
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/immunology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/immunology
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Receptors, CCR10/analysis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/genetics
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- Treatment Outcome
- Vorinostat/therapeutic use
Collapse
Affiliation(s)
- Natsumi Ikumi
- Department of Dermatology, Ninon University School of Medicine, 173-8610 Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
41
|
Affiliation(s)
- Yusuke Niwa
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Koremasa Hayama
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Tomomi Tagui
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Mana Ito‐Watanabe
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Takahiro Endo
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Hideki Fujita
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | - Tadashi Terui
- Division of Cutaneous Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| |
Collapse
|
42
|
Terui T, Kobayashi S, Okubo Y, Murakami M, Zheng R, Morishima H, Goto R, Kimura T. Efficacy and Safety of Guselkumab in Japanese Patients With Palmoplantar Pustulosis: A Phase 3 Randomized Clinical Trial. JAMA Dermatol 2019; 155:1153-1161. [PMID: 31268476 PMCID: PMC6613288 DOI: 10.1001/jamadermatol.2019.1394] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Question Is guselkumab, an anti–interleukin 23 monoclonal antibody, efficacious and safe in Japanese patients with palmoplantar pustulosis? Findings In this 60-week, randomized clinical trial of 159 patients with palmoplantar pustulosis, palmoplantar pustulosis area and severity index score was overall improved after subcutaneous injection of guselkumab, 100 mg and 200 mg or placebo; however, in the 200-mg group, the proportion of patients who achieved 50% or more reduction in palmoplantar pustulosis area and severity index score at week 16 was not significantly greater compared with placebo. Efficacy end points improved consistently through week 52, and health-related quality of life also improved significantly. Meaning Guselkumab may be an effective and safe treatment option for management of palmoplantar pustulosis. Importance Palmoplantar pustulosis (PPP) causes erythematous, scaly plaques with recurrent sterile pustules refractory to treatment and with few randomized clinical trials conducted. Evidence points to involvement of interleukin 23 in the pathogenesis of PPP. Objective To determine the efficacy and safety of guselkumab, an anti–IL-23 monoclonal antibody, in Japanese patients with PPP. Design, Setting, and Participants A phase 3 randomized clinical trial was conducted from December 15, 2015, to December 12, 2017. A total of 159 enrolled patients (aged ≥20 years) had an inadequate response to conventional therapies, with a diagnosis of PPP for 24 or more weeks before screening. Intention-to-treat analysis was performed. Interventions Subcutaneous injections of guselkumab, 100 or 200 mg, at weeks 0, 4, and 12, and every 8 weeks thereafter were administered; placebo was given at weeks 0, 4, and 12. Main Outcomes and Measures Changes from baseline in PPP Area and Severity Index (PPPASI) score (possible score range, 0-72, with higher scores indicating greater area and severity), PPP severity index (PPSI) score (possible score range, 0-12, with higher scores indicating greater severity), and proportion of PPPASI-50 (≥50% reduction) responders at weeks 16 and 52 were assessed. Safety was monitored through week 52. Results A total of 159 patients (mean [SD] age at diagnosis, 46.8 [11.9] years; 126 women [79.2%]) were enrolled. Treatment groups comprised guselkumab, 100 mg (n = 54), guselkumab, 200 mg (n = 52), or placebo (n = 53). Both guselkumab groups demonstrated significant improvement in least-squares mean changes in PPPASI score compared with placebo: −15.3 and −11.7 in the guselkumab 100-mg and 200-mg groups, respectively, and −7.6 in the placebo group (difference [SE] vs placebo: −7.7 [1.7] in the 100-mg group, P < .001; 95% CI, −11.00 to −4.38; and −4.1 [1.7] in the 200-mg group, P < .017; 95% CI, −7.47 to −0.75]). Least-squares mean changes in PPSI score showed significant improvement in both guselkumab groups (100 mg: −2.0 [0.5]; P < .001; 95% CI, −2.96 to −0.95; 200 mg: −1.0 [0.5; P = .04; 95% CI, −2.06 to −0.03). A significantly higher proportion of patients in the guselkumab 100-mg group (31 [57.4%]) achieved a PPPASI-50 response at week 16 vs placebo (18 [34.0%]; P = .02); however, the result was not significant for the guselkumab 200-mg group (19 [36.5%]) vs placebo; P = .78). Each efficacy end point improved consistently through week 52. Health-related quality of life improved significantly as indicated by a reduction in the Dermatology Life Quality Index score (100 mg: −2.6; 95% CI, −4.0 to −1.2; P < .001; 200 mg: −1.6; 95% CI, −3.1 to −0.2; P = .03). Serious treatment-emergent adverse events were observed in 8 patients (placebo group, 2 of 53 [3.8%]; combined guselkumab group, 6/157≠10.5%). No serious infections were reported. Conclusions and Relevance Targeting interleukin 23 with guselkumab may be an effective and safe treatment option for a recalcitrant disease such as PPP. Trial Registration ClinicalTrials.gov identifier: NCT02641730
Collapse
Affiliation(s)
- Tadashi Terui
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Satomi Kobayashi
- Department of Dermatology, Seibo International Catholic Hospital, Tokyo, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University School of Medicine, Ehime, Japan
| | | | | | | | | |
Collapse
|
43
|
Affiliation(s)
- Miwa Murata
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tohru Gonoi
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Tadashi Terui
- Division of Dermatological Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
44
|
Izaki S, Toyoshima S, Endo T, Hayama K, Okayama Y, Terui T. 014 Differentiation between control subjects and patients with chronic spontaneous urticaria based on the ability of anti-IgE autoantibodies to induce FcεRI crosslinking, as compared to anti-FcεRIα autoantibodies. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.017] [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: 10/26/2022]
|
45
|
Morita A, Takahashi H, Ozawa K, Imafuku S, Nakama T, Takahashi K, Matsuyama T, Okubo Y, Kitamura S, Matsuda N, Zhao Y, Yokoyama M, Hayashi N, Terui T. Twenty-four-week interim analysis from a phase 3 open-label trial of adalimumab in Japanese patients with moderate to severe hidradenitis suppurativa. J Dermatol 2019; 46:745-751. [PMID: 31282051 PMCID: PMC6771639 DOI: 10.1111/1346-8138.14997] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 11/05/2018] [Accepted: 05/23/2019] [Indexed: 12/30/2022]
Abstract
Hidradenitis suppurativa (HS) is a chronic skin disease characterized by recurrent painful inflamed nodules/abscesses and draining fistulas that negatively impact quality of life. Adalimumab, a monoclonal antibody against tumor necrosis factor‐α, has been approved in the EU, USA and Japan for the treatment of moderate to severe HS. This is an interim analysis of an ongoing phase 3, multicenter, open‐label, single‐arm study of the safety and efficacy of adalimumab weekly dosing in Japanese patients with moderate to severe HS. Fifteen patients received adalimumab 160 mg at week 0, 80 mg at week 2 and 40 mg every week thereafter starting at week 4. The fulfillment of Hidradenitis Suppurativa Clinical Response was assessed under adalimumab treatment; clinical response was assessed by skin pain, total abscess and inflammatory nodule count and modified Sartorius score; and quality of life and safety were assessed. At week 12, 86.7% of patients achieved clinical response, with improvements at week 12 across the primary and secondary end points generally sustained through week 24. Adalimumab weekly dosing was generally safe and well tolerated with no new safety findings through week 24. These results suggest that adalimumab is effective and well tolerated in Japanese patients with moderate to severe HS.
Collapse
Affiliation(s)
- Akimichi Morita
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Kentaro Ozawa
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Ito-Watanabe M, Hayama K, Fujita H, Sasaki K, Numata M, Terui T. A case of contact dermatitis caused by a polyurethane hot melt adhesive. Contact Dermatitis 2019; 81:389-391. [PMID: 31215657 DOI: 10.1111/cod.13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Mana Ito-Watanabe
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Koremasa Hayama
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Hideki Fujita
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Kazumi Sasaki
- Biological Resource Center, National Institute of Technology and Evaluation, Tokyo, Japan
| | - Mitsuru Numata
- Biological Resource Center, National Institute of Technology and Evaluation, Tokyo, Japan
| | - Tadashi Terui
- Division of Cutaneous Science, Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
47
|
Izaki S, Toyoshima S, Endo T, Kanegae K, Nunomura S, Kashiwakura JI, Sasaki-Sakamoto T, Nakamura R, Akiyama H, Ra C, Hayama K, Terui T, Okayama Y. Differentiation between control subjects and patients with chronic spontaneous urticaria based on the ability of anti-IgE autoantibodies (AAbs) to induce FcεRI crosslinking, as compared to anti-FcεRIα AAbs. Allergol Int 2019; 68:342-351. [PMID: 30803853 DOI: 10.1016/j.alit.2019.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/21/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The reported prevalences of IgG autoantibodies (AAbs) to FcεRIα and IgE in sera from patients with chronic spontaneous urticaria (CSU) have varied, and these AAbs are also often observed in healthy control subjects. Regarding the histamine release activity of purified IgG from patients with CSU, the number of examined patients has been small. Thus, we sought to determine the prevalence and FcεRI crosslinking ability of these AAbs in a large number of patients with CSU and non-atopic control (NC) subjects. METHODS We compared the concentrations of anti-IgE and anti-FcεRIα AAbs and the abilities of these AAbs to cause FcεRI aggregation in patients with CSU (n = 134) and NC subjects (n = 55) using ELISA and an in vitro elicitation test, respectively. RESULTS The concentration of anti-IgE AAbs was significantly different between the NC subjects and the CSU patients (P < 0.0001, cutoff value: 0.558 μg/mL), whereas the concentration of anti-FcεRIα AAbs was not. A significant difference in the duration of illness was noted between patients with lower and those with higher concentrations of anti-IgE AAbs relative to the cutoff value. The abilities of anti-IgE AAbs, but not anti-FcεRIα AAbs, to induce FcεRI crosslinking were significantly higher in CSU patients than in NC subjects (P = 0.0106). CONCLUSIONS In the Japanese population of CSU patients studied, the ability of the anti-IgE AAbs to induce FcεRI crosslinking differed significantly between NC subjects and CSU patients, suggesting the involvement of anti-IgE AAbs in the pathogenesis of CSU in the Japanese population.
Collapse
Affiliation(s)
- Satoshi Izaki
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Shota Toyoshima
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Center for Institutional Research and Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Takahiro Endo
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuko Kanegae
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Center for Institutional Research and Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Satoshi Nunomura
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
| | - Jun-Ichi Kashiwakura
- Department of Immunology, Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Tomomi Sasaki-Sakamoto
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Center for Institutional Research and Medical Education, Nihon University School of Medicine, Tokyo, Japan
| | - Ryosuke Nakamura
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Haruyo Akiyama
- Division of Pharmacotherapeutics, Faculty of Pharmaceutical Sciences, Teikyo Heisei University, Tokyo, Japan
| | - Chisei Ra
- Department of Microbiology, Nihon University School of Medicine, Tokyo, Japan; Department of Clinical Laboratory, Asahi General Hospital, Chiba, Japan
| | - Koremasa Hayama
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tadashi Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshimichi Okayama
- Allergy and Immunology Research Project Team, Nihon University School of Medicine, Tokyo, Japan; Center for Institutional Research and Medical Education, Nihon University School of Medicine, Tokyo, Japan.
| |
Collapse
|
48
|
Stiefel F, Stiefel F, Terui T, Machino T, Ishitani K, Bourquin C. Spotlight on Japanese physicians: An exploration of their professional experiences elicited by means of narrative facilitators. Work 2019; 63:269-282. [PMID: 31156208 DOI: 10.3233/wor-192928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While investigation of physicians' work experience is often limited to issues of satisfaction or burnout, a broader view of their experiences is lacking. OBJECTIVE To explore professional experiences, we asked Japanese physicians (N = 18, 12 men and 6 women) of a general hospital to react to so-called "narrative facilitators". METHODS The narrative facilitators - inspired by clinical psychology, visual sociology and purpose-designed techniques - oriented physicians' narratives towards clinical practise, relationship with peers and context. Transcribed interviews were subject to thematic analysis. RESULTS The thematic analysis of participants' narratives revealed a lonely physician with a tough job, torn between the ideal of patient-centred care and a clinical reality, which limits these aspirations. Patients emerged as anxious and burdensome consumers of medicine. Feeling neither supported by peers nor the institution, physicians also perceived the society as somewhat negligent, delegating its problem to medicine. Communication difficulties, with patients and peers, and the absence of joyful aspects of the profession constituted fundamental elements of their narratives. CONCLUSIONS Comprehensive investigation of physicians' lived professional experience could become a key to conceive ways to support them.
Collapse
Affiliation(s)
- F Stiefel
- Psychiatric Liaison Service, University Hospital Lausanne, Switzerland.,Higashi Sapporo Hospital, Sapporo, Japan
| | - Fa Stiefel
- Higashi Sapporo Hospital, Sapporo, Japan
| | - T Terui
- Higashi Sapporo Hospital, Sapporo, Japan
| | - T Machino
- Higashi Sapporo Hospital, Sapporo, Japan
| | - K Ishitani
- Higashi Sapporo Hospital, Sapporo, Japan
| | - C Bourquin
- Psychiatric Liaison Service, University Hospital Lausanne, Switzerland
| |
Collapse
|
49
|
Terui T, Kobayashi S, Okubo Y, Murakami M, Hirose K, Kubo H. Efficacy and Safety of Guselkumab, an Anti-interleukin 23 Monoclonal Antibody, for Palmoplantar Pustulosis: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:309-316. [PMID: 29417135 DOI: 10.1001/jamadermatol.2017.5937] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Importance Palmoplantar pustulosis (PPP) is a recalcitrant skin disease with no biologics currently approved for treatment. The involvement of interleukin 23 (IL-23) and cytokines of the type 17 helper T cell lineage in the pathogenesis of PPP has been recently postulated. Objective To evaluate the efficacy and safety of guselkumab, an anti-IL-23 monoclonal antibody, in Japanese patients with PPP. Design, Setting, and Participants This double-blind, randomized, placebo-controlled, parallel-group, 24-week trial was conducted between May 14, 2013, and September 27, 2014, at 11 centers in Japan. Participants were patients with moderate to severe PPP that did not respond adequately to conventional treatments. Interventions Patients were randomized 1:1 to receive guselkumab, 200 mg, by subcutaneous injection or matching placebo at weeks 0 and 4. Main Outcomes and Measures Changes in total scores of skin-related outcomes from baseline at the end of week 16 (primary clinical cutoff) and through week 24 were measured. Serum biomarker analyses were performed at baseline, week 4, and week 16, and safety was monitored through week 24. Results Of 49 randomized patients (35 [71%] women; median [range] age, 52 [28-77] years), 41 completed the study at week 24. Mean (SD) PPP severity index total scores (primary end point) improved significantly from baseline in guselkumab-treated patients (-3.3 [2.43]) vs placebo (-1.8 [2.09]) (least squares mean difference, -1.5; 95% CI, -2.9 to -0.2; P = .03). At week 16, PPP area and severity index scores (least squares mean difference, -5.65; 95% CI, -9.80 to -1.50; P = .009) and proportion of patients achieving 50% reduction in these scores (difference in proportion, 39.2; 95% CI, 14.0-64.3; P = .009) improved significantly. A numerically higher proportion of patients had a physician's global assessment score of 1 or less in the guselkumab group vs placebo. Improvement in efficacy scores was maintained through week 24 in the guselkumab group. Significant reductions from baseline in serum IL-17A and IL-17F cytokine levels were observed at weeks 4 and 16. Frequency of treatment-emergent adverse events was comparable between the guselkumab group (19 of 25 patients [76%]) and the placebo group (18 of 24 patients [75%]). Frequent adverse effects included nasopharyngitis (14 patients [29%]), headache (3 patients [6%]), contact dermatitis (3 patients [6%]), and injection site erythema (3 patients [6%]). No major safety concerns emerged during the study. Conclusions and Relevance Targeting IL-23 and its associated immune cascade with guselkumab may be a safe and useful therapeutic option for treatment of PPP. Trial Registration clinicaltrials.gov Identifier: NCT01845987.
Collapse
Affiliation(s)
- Tadashi Terui
- Department of Dermatology, Nihon University School of Medicine, Tokyo, Japan
| | - Satomi Kobayashi
- Department of Dermatology, Seibo International Catholic Hospital, Tokyo, Japan
| | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University School of Medicine, Ehime, Japan
| | | | | |
Collapse
|
50
|
Endo T, Toyoshima S, Kanegae K, Izaki S, Nishimori N, Ito M, Sugai K, Hayama K, Terui T, Okayama Y. Identification of biomarkers for predicting the response to cyclosporine A therapy in patients with chronic spontaneous urticaria. Allergol Int 2019; 68:270-273. [PMID: 30355455 DOI: 10.1016/j.alit.2018.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/06/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022] Open
|