Review of Atopic Dermatitis and Topical Therapies.

Atopic dermatitis is one of the most common skin disorders in the developed world, affecting up to 20% of children and 1% to 3% of adults. This review concisely explains the pathophysiology and epidemiology of atopic dermatitis, as well as potential challenges facing its successful treatment. Furthermore, mainstay topical treatment modalities are evaluated, such as emollients, topical corticosteroids, and topical calcineurin inhibitors.

Rapid improvements in health-related quality of life and itch with ixekizumab treatment in randomized phase 3 trials: results from UNCOVER-2 and UNCOVER-3.

Background: Patients with moderate-to-severe psoriasis report impaired health-related quality of life (HRQoL).

Objective: To assess speed of onset of ixekizumab-induced clinically relevant improvement in HRQoL.

Methods: This post hoc analysis used pooled data from patients randomized in UNCOVER-2 and UNCOVER-3, and treated with 80 mg ixekizumab every 2 weeks (IXEQ2W), 80 mg ixekizumab every 4 weeks (IXEQ4W), 50 mg etanercept (ETN) twice weekly or placebo (PBO) for 12 weeks.

Clinical similarity of biosimilar ABP 501 to adalimumab in the treatment of patients with moderate to severe plaque psoriasis: A randomized, double-blind, multicenter, phase III study.

Background: ABP 501 is a biosimilar of adalimumab.

Objective: We sought to compare the efficacy and safety of ABP 501 with adalimumab.

Methods: This 52-week, double-blind study randomized patients with moderate to severe psoriasis to ABP 501 or adalimumab.

Real-World Experience With Apremilast in Treating Psoriasis.

Background: Clinical trial data have shown apremilast, an oral phosphodiesterase-4 inhibitor, to be efficacious and safe for the treatment of psoriasis. However, little real-world experience using apremilast in the community setting has been documented.

Objectives: Many patients with psoriasis are often unresponsive to various treatment modalities, including topical, systemic, and biologic medications.

Topical tofacitinib for atopic dermatitis: a phase IIa randomized trial.

Background: Despite unmet need, 15 years have passed since a topical therapy with a new mechanism of action for atopic dermatitis (AD) has been approved. Janus kinase (JAK) inhibitor treatment effect via topical application in patients with AD is unknown.

Objectives: Tofacitinib, a small-molecule JAK inhibitor, was investigated for the topical treatment of AD.

The efficacy and safety of apremilast, etanercept and placebo in patients with moderate-to-severe plaque psoriasis: 52-week results from a phase IIIb, randomized, placebo-controlled trial (LIBERATE).

Background: Apremilast, an oral, small-molecule phosphodiesterase 4 inhibitor, has demonstrated efficacy in patients with moderate-to-severe psoriasis.

Objective: Evaluate efficacy and safety of apremilast vs. placebo in biologic-naive patients with moderate-to-severe plaque psoriasis and safety of switching from etanercept to apremilast in a phase IIIb, randomized, double-blind, placebo-controlled study (NCT01690299).

Treatment of plaque psoriasis with an ointment formulation of the Janus kinase inhibitor, tofacitinib: a Phase 2b randomized clinical trial.

Background: Most psoriasis patients have mild to moderate disease, commonly treated topically. Current topical agents have limited efficacy and undesirable side effects associated with long-term use. Tofacitinib is a small molecule Janus kinase inhibitor investigated for the topical treatment of psoriasis.

Tofacitinib improves pruritus and health-related quality of life up to 52 weeks: Results from 2 randomized phase III trials in patients with moderate to severe plaque psoriasis.

Background: Tofacitinib is an oral Janus kinase inhibitor that improves clinical measures of psoriasis.

Objective: We sought to assess patient-reported outcomes in tofacitinib-treated patients with moderate to severe plaque psoriasis over 52 weeks.

Methods: In 2 identical, phase III studies (Oral treatment for Psoriasis Trial Pivotal 1 [NCT01276639], n = 901, and Pivotal 2 [NCT01309737], n = 960), patients were randomized 2:2:1 to receive 5 or 10 mg of tofacitinib or placebo, twice daily.

Ixekizumab for treatment of adults with moderate-to-severe plaque psoriasis and psoriatic arthritis.

The interleukin (IL)-17 family of cytokines has emerged as an important pro-inflammatory mediator of psoriasis and psoriatic arthritis (PsA). Ixekizumab is an IL17A inhibitor that has been approved for the treatment of chronic plaque psoriasis. Phase III studies of ixekizumab in treating of PsA demonstrated promise by minimizing disease severity and progression.

Review of Systemic Treatment Options for Adult Atopic Dermatitis.

Background: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease.

EQ-5D health utilities: exploring ways to improve upon responsiveness in psoriasis.

Aims: To determine if EuroQoL 5-Dimension Health Questionnaire (EQ-5D) health utility scores were able to discriminate among different levels of improvement in psoriasis severity following therapy.

Materials And Methods: Data were from three placebo-controlled phase 3 ixekizumab studies (UNCOVER-1, UNCOVER-2, and UNCOVER-3) with patients who had baseline Dermatology Life Quality Index scores >10 (DLQI >10). Psoriasis severity (Psoriasis Area and Severity Index [PASI]), general health utility (EQ-5D), and psoriasis-specific utility (EQ-PSO, UNCOVER-3 only) were assessed.

Dupilumab, A Monoclonal Antibody for Atopic Dermatitis: A Review of Current Literature.

Atopic dermatitis results when aberrant barrier function and immune activation occur within the skin. Standard therapies for atopic dermatitis have fallen short, prompting efforts to discover novel therapeutics for this disease. Of these, dupilumab, a fully human monoclonal antibody that inhibits the actions of both IL-4 and IL-13, has shown the greatest promise.

Drug survival of biologic therapy in a large, disease-based registry of patients with psoriasis: results from the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

Background: Drug survival is a marker for treatment sustainability in chronic diseases such as psoriasis.

Objective: The aim of these analyses was to assess survival of biologic treatments in the PSOriasis Longitudinal Assessment and Registry (PSOLAR).

Methods: PSOLAR is a large, prospective, international, disease-based registry of patients with psoriasis receiving (or eligible for) systemic therapy in a real-world setting.

Management of scalp psoriasis: current perspectives.

Psoriasis is a chronic inflammatory condition. The age of onset, chronicity, physical, and psychosocial consequences of the disease cause psoriasis to have a significant impact on patient quality of life. Scalp psoriasis is no different, and effective treatment results in an improvement in quality of life.

Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with difficult-to-treat nail and scalp psoriasis: Results of 2 phase III randomized, controlled trials (ESTEEM 1 and ESTEEM 2).

Background: In the phase III double-blind Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) 1 and 2, apremilast, an oral phosphodiesterase 4 inhibitor, demonstrated efficacy in moderate to severe psoriasis.

Objective: We sought to evaluate efficacy of apremilast in nail/scalp psoriasis in ESTEEM 1 and 2.

Methods: A total of 1255 patients were randomized (2:1) to apremilast 30 mg twice daily or placebo.

Selective Phosphodiesterase Inhibitors for Psoriasis: Focus on Apremilast.

Phosphodiesterase (PDE) 4 participates in regulating the inflammatory response by degrading cyclic adenosine 3'5'-monophosphate (cAMP), a key second messenger. Inhibition of PDE4 increases the intracellular cAMP level, which in turn results in a reduction in inflammatory mediators and an increase in anti-inflammatory mediators. Immune-modulating effects of PDE4 inhibitors have been investigated in a number of inflammatory conditions, such as asthma, atopic dermatitis, chronic obstructive pulmonary disease, Behçet’s disease, psoriasis, and psoriatic arthritis.

The psychosocial impact of hidradenitis suppurativa.

Increasingly, quality of life data are being captured along with other measures to evaluate success in the treatment of numerous disease states. This is no less true in hidradenitis suppurativa (HS), an inflammatory condition that features multiple symptoms, including abscesses that can develop in multiple sites on the body, often in sensitive areas, that can be painful, can rupture, and can produce malodorous pus. The collection of baseline data with respect to the personal impact of HS is a necessary first step to determine if various interventions enhance the quality of life for patients with HS.

Apremilast in the treatment of psoriasis and psoriatic arthritis.

Phosphodiesterase 4 (PDE4) is a key enzyme in the regulation of immune responses of inflammatory diseases through degradation of the second messenger, cyclic adenosine 3',5'-monophosphate (cAMP). Apremilast, a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines by increasing intracellular levels of cAMP and promoting the production of anti-inflammatory cytokines. The efficacy and safety of apremilast in the treatment of psoriasis and psoriatic arthritis has been demonstrated in phase 2 and 3 studies and will be reviewed here.

Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: a phase III, randomized controlled trial (ESTEEM 2).

Background: Apremilast, an oral phosphodiesterase 4 inhibitor, regulates immune responses associated with psoriasis.

Objectives: ESTEEM 2 evaluated the efficacy and safety of apremilast 30 mg twice daily for moderate-to-severe plaque psoriasis.

Methods: This phase III, double-blind, placebo-controlled trial randomized adults to apremilast or placebo (2 : 1).

Predictors of Topical Use in Psoriasis Patients in the REFINE Study.

Background: The factors influencing the use of topical agents in combination with biologic therapies for the treatment of plaque psoriasis (PsO) are not well understood.

Objective: To examine potential predictors of topical use in patients with moderate to severe plaque PsO receiving etanercept (ETN).

Methods: Post hoc descriptive analyses and a multinomial regression of the REFINE study data were used to examine associations between topical agent potency and covariates, including Psoriasis Area and Severity Index (PASI) score, study site, and province.

Methylisothiazolinone testing at 2000 ppm: a prevalent sensitizer for allergic contact dermatitis.

Background: Methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) have been identified as potent allergens. The optimal MI concentration for patch testing for reaction to these agents has not yet been identified, but it has been suggested that testing MI at 2000 ppm may reduce false-negative reactions.

Objective: The aim of this study was to report allergic reactions to MI and MCI/MI detected in a community dermatology practice setting in Ontario, Canada.

Interleukin-17 (IL-17) inhibitors in the treatment of plaque psoriasis: a review.

Acting on keratinocytes to produce antimicrobial peptides and chemokines, which in turn attract neutrophils and other inflammatory cells, interleukin-17 (IL-17) is believed to be a potent driver of plaque psoriasis. Its proinflammatory characteristics make IL-17 an attractive therapeutic target for addressing immune dysregulation. This review examines the role of IL-17 in the pathogenesis of plaque psoriasis and the potential implications of its inhibition.