Publications by authors named "Brett King"
Background: Celiac disease (CeD) has shown an association with autoimmune disorders including vitiligo and alopecia areata (AA). Ritlecitinib, a JAK3 and TEC kinase family inhibitor, has been approved for treatment of patients with AA and is in late-stage development for vitiligo. Ritlecitinib inhibits cytotoxic T cells, NK cells, and B cells which play a role in the pathogenesis of CeD.
View Article and Find Full Text PDFSarcoidosis is a multisystem inflammatory disorder that most commonly affects the lungs, lymphatic system, eyes, and skin. Cutaneous involvement is present in approximately 20% to 30% patients. Prednisone and corticotropin repository are the only Food and Drug Administration-approved therapies for sarcoidosis.
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- Small studies suggest that low-dose oral minoxidil (LDOM) might be effective and safe for hair loss, but more extensive research and guidelines are needed.* -
- An expert consensus statement was developed involving 43 dermatologists to standardize LDOM prescribing practices, covering various aspects like indications, dosing, and monitoring.* -
- The consensus reached includes 76 relevant points, but topics related to pediatric use and titration protocols need further investigation, highlighting gaps in research for younger patients.*
Advances in understanding of AA have led to the first approved therapies for this disease, and in the past two years, there have been three medicines approved for the treatment of severe alopecia areata. There are numerous clinical trials of novel therapeutics underway across the spectrum of AA.
View Article and Find Full Text PDFBackground: Baricitinib, an oral selective Janus kinase inhibitor, is approved to treat adults with severe alopecia areata (AA).
Objective: To report the week 152 efficacy results from the phase 3 trial BRAVE-AA2 down-titration substudy.
Methods: BRAVE-AA2 enrolled 546 adults with severe AA (Severity of Alopecia Tool [SALT] score ≥50).
Article Synopsis
- The ALLEGRO study assessed the effectiveness and safety of ritlecitinib, a treatment for alopecia areata (AA), focusing on patient-reported hair loss outcomes.
- Patients aged 12 and older with significant scalp hair loss participated in a 48-week trial comparing different dosages of ritlecitinib to a placebo.
- Results showed that 5-36% of ritlecitinib patients reported improved hair loss after 24 weeks, which correlated with positive changes in emotional symptoms and activity limitations, indicating the treatment's beneficial effects.
Article Synopsis
- The ALLEGRO studies show that ritlecitinib is effective and well-tolerated for treating alopecia areata in patients aged 12 and older for up to 24 months.
- Results indicate significant improvement in hair regrowth, with a marked increase in patients achieving favorable Severity of Alopecia Tool (SALT) scores at both 12 and 24 months.
- The safety profile of ritlecitinib remains consistent with previous studies, confirming its long-term tolerability for users.
Article Synopsis
- This study investigates the effectiveness and safety of ritlecitinib, a treatment for alopecia areata (AA), over 48 weeks in patients with varying responses by Week 24.
- Results showed that over 85% of patients who had good responses at Week 24 maintained their improvement, while some nonresponders also began to show better results by Week 48.
- The study had a small sample size, but it concludes that ritlecitinib can lead to sustained hair regrowth in many patients with AA.
Article Synopsis
- A post-hoc analysis of the ALLEGRO study assessed the effects of ritlecitinib, an oral JAK inhibitor, in treating patients aged 12 and older with alopecia totalis (AT) and alopecia universalis (AU) over 48 weeks.
- Out of 718 patients, those treated with ritlecitinib showed significantly higher hair regrowth response rates compared to the placebo group, improving from week 24 to week 48.
- Ritlecitinib was well tolerated, demonstrating clinical efficacy and an acceptable safety profile for patients with both AT and AU.
Article Synopsis
- A study assessed the efficacy and safety of ritlecitinib, a JAK3/TEC inhibitor, in treating nonsegmental vitiligo among patients with different skin types over 24 weeks, involving 247 patients with light skin and 117 with dark skin.
- Results showed significant improvement in facial vitiligo scores after 24 weeks for both skin types, with a 15.2% change for light skin and 37.4% for dark skin, alongside continuous repigmentation through week 48.
- Additionally, the study noted variations in immune response markers related to skin type, suggesting that dark-skinned patients may respond to the treatment faster than those with light skin
Article Synopsis
- - This study aimed to explore large somas presumed to be displaced retinal ganglion cells (dRGCs) in the living human retina, focusing on their presence and characteristics in both healthy individuals and those with glaucoma.
- - Researchers used advanced imaging techniques on eight subjects to measure the density, size, and distribution of these somas across different retinal locations, noting significant differences between healthy individuals and glaucoma patients.
- - Findings indicated that these somas are likely dRGCs, showing a high susceptibility to glaucoma-related damage, particularly in areas affected by arcuate defects in glaucoma patients.
Importance: Baricitinib has demonstrated efficacy for treating severe alopecia areata in adults. There is currently limited information about the need for continuous therapy after achieving scalp hair regrowth.
Objective: To report results from the randomized withdrawal period of the BRAVE-AA1 trial.
Article Synopsis
- Alopecia areata (AA) is a hair loss disorder that significantly affects quality of life, and studies have shown that the JAK inhibitor deuruxolitinib can promote hair regrowth in affected individuals.
- A Phase 3 trial tested deuruxolitinib in adults aged 18-65 with severe hair loss, finding that a significant percentage of patients experienced notable improvements in hair regrowth compared to a placebo.
- Although the treatment was generally well-tolerated with mostly mild side effects, further research is needed to assess long-term safety and the effects of stopping the treatment.
Advancements in high-resolution imaging of the iridocorneal angle.
Front Ophthalmol (Lausanne)
August 2023
High-resolution imaging methods of the iridocorneal angle (ICA) will lead to enhanced understanding of aqueous humor outflow mechanisms and a characterization of the trabecular meshwork (TM) morphology at the cellular level will help to better understand glaucoma mechanics (e.g., cellular level biomechanics of the particulate glaucomas).
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- Ritlecitinib, a drug being tested for alopecia areata, caused reversible axonal swelling and auditory potential changes in dogs at doses higher than what's approved for humans.
- * A phase 2a study evaluated the effects of ritlecitinib on auditory and nerve fiber changes in 71 patients, comparing results with a placebo group over 9 months.
- * Findings showed no significant differences in auditory or nerve fiber measures between the treatment and placebo groups, suggesting that dog toxicity findings may not apply to human patients.
Article Synopsis
- - The study aimed to assess patient satisfaction with hair growth in people with alopecia areata (AA) receiving ritlecitinib or a placebo, focusing on how well patients felt their treatment was working compared to what clinicians observed.
- - In the ALLEGRO-2b/3 trial, 718 AA patients with significant scalp hair loss were given either ritlecitinib or a placebo for 24 weeks, after which some switched treatments; satisfaction was measured through a specific survey evaluating different aspects of hair growth.
- - Results showed that at week 24, satisfaction with hair growth was significantly higher in ritlecitinib groups (up to 67.5%) compared to placebo (22.6%),
Purpose: To develop criteria to predict visual hemifields with deep perimetric defects based on retinal nerve fibre layer (RNFL) reflectance, in a transparent process whose components can be assessed by independent laboratories analysing data from their own small groups.
Methods: The analysis was carried out in four stages, using three independent groups of patients-30, 33 and 62 participants-with glaucoma and age-similar controls. The first stage used Group 1 to develop a criterion for RNFL reflectance images at 24, 36 or 48 μm below the inner limiting membrane (ILM).
Importance: Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact.
Objective: To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI).
Evidence Review: A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds.
Article Synopsis
- * A safety analysis of four studies showed that adverse events (AEs) occurred in about 70-75% of patients on ritlecitinib compared to 69.5% in the placebo group, with some patients experiencing serious AEs.
- * Overall, ritlecitinib is deemed well tolerated and presents an acceptable safety profile over a 24-month period for adolescents and adults with AA.
Article Synopsis
- Alopecia areata (AA) is an autoimmune condition causing hair loss that can range from small patches to total loss of hair on the scalp and body, linked to immune responses targeting hair follicles.
- Current treatment options are limited, with only two FDA-approved systemic drugs, baricitinib and ritlecitinib, specifically for severe AA, while other off-label treatments exist but often lack effectiveness and safety.
- The review discusses the role of T cells in AA's development and explores new therapeutic approaches being researched that target various T-cell signaling pathways, aiming for more effective treatments beyond just JAK inhibitors.