Publications by authors named "Hijnen D"

Background: Janus kinase inhibitors (JAKi) have the potential to alter the landscape of atopic dermatitis (AD) management dramatically, owing to promising efficacy results from phase III trials and their rapid onset of action. However, JAKi are not without risk, and their use is not appropriate for all patients with AD, making this a medication class that dermatologists should understand and consider when treating patients with moderate-to-severe AD.

Objectives: To provide a consensus expert opinion statement from the International Eczema Council (IEC) that provides a pragmatic approach to prescribing JAKi, including choosing appropriate patients and dosing, clinical and laboratory monitoring and advice about long-term use.

View Article and Find Full Text PDF
Article Synopsis
  • Dupilumab is an effective treatment for moderate-to-severe atopic dermatitis (AD) and severe asthma (SA), but there hasn't been much real-world analysis on its adverse events, particularly those related to the eyes (DAOSD).
  • This study analyzed data from patients with AD and SA receiving dupilumab to compare the prevalence of adverse events, focusing on ocular problems and treatment discontinuation rates.
  • Results showed a higher prevalence of ocular adverse events in AD patients (62.1%), while SA patients experienced more headaches and injection site reactions, underlining the need for physician awareness when prescribing dupilumab to AD patients and emphasizing the effectiveness of ophthalmic treatments for managing eye-related issues.
View Article and Find Full Text PDF
Article Synopsis
  • * Key discussions included the prevalence of AD, advancements in treatment and management, and the importance of considering environmental and lifestyle factors affecting patients.
  • * The forum emphasizes the need for increased awareness and collaboration among stakeholders to close the gap between research advancements and practical applications in patient care.
View Article and Find Full Text PDF

Background: Narrowband ultraviolet B (NB-UVB) phototherapy is commonly prescribed for patients with moderate-to-severe atopic eczema (AE). The efficacy of NB-UVB, however, has not yet properly been established, as current evidence is of low certainty. Our aim is to assess the short-term and long-term (cost-)effectiveness and safety of NB-UVB in adult AE patients by performing a pragmatic, multicenter, prospective, randomized, open-label, blinded-endpoint (PROBE) trial.

View Article and Find Full Text PDF
Article Synopsis
  • The study explores how patients on immunosuppressants (ISPs) respond to SARS-CoV-2 infections compared to healthy controls, particularly looking at antibody levels post-infection.
  • Patients with immune-mediated inflammatory diseases (IMIDs) on different ISP therapies showed variable antibody responses, with those on anti-CD20 and sphingosine-1 phosphate therapies having lower antibody levels.
  • Despite lower antibody titers, the breakthrough infections in these patients were mostly mild, indicating that ISPs may not severely impede the overall immune response to SARS-CoV-2.
View Article and Find Full Text PDF
Article Synopsis
  • Atopic dermatitis is a long-lasting skin condition that causes significant itchiness, pain, and sleep issues, affecting patients' quality of life, and upadacitinib is an FDA-approved oral medication for its treatment.
  • This study evaluated the effectiveness of upadacitinib on various patient-reported outcomes over 52 weeks in adults and adolescents suffering from moderate-to-severe atopic dermatitis, using data from two phase III clinical trials.
  • Results showed that patients taking upadacitinib experienced significant and rapid improvements in itch and other related symptoms, with benefits lasting through the study duration, while the placebo group did not show the same level of improvement.
View Article and Find Full Text PDF

Background: The noninflammatory immunoglobulin G4 (IgG4) is linked to tolerance and is unique to humans. Although poorly understood, prolonged antigenic stimulation and IL-4-signaling along the T helper 2-axis may be instrumental in IgG4 class switching. Recently, repeated SARS-CoV-2 mRNA vaccination has been linked to IgG4 skewing.

View Article and Find Full Text PDF

Background: Upadacitinib was the first JAK-1 selective inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and safety have been shown in clinical trials, real-world data on the use of upadacitinib in patients that have been treated with other immunosuppressants and targeted therapies is limited.

Objectives: To provide real-world evidence on the use of upadacitinib treatment in moderate-to-severe atopic dermatitis.

View Article and Find Full Text PDF

Treat-to-target (T2T) is a pragmatic therapeutic strategy being gradually introduced into dermatology after adoption in several other clinical areas. Atopic dermatitis (AD), one of the most common inflammatory skin diseases, may also benefit from this structured and practical therapeutic approach. We aimed to evaluate existing data regarding the T2T approach in dermatology, with a specific focus on AD, as well as the views of International Eczema Council (IEC) members on the potential application of a T2T approach to AD management.

View Article and Find Full Text PDF

Background: Abrocitinib is a JAK-1 selective inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and safety have been shown in phase 3 clinical trials, data on real-world patients with a treatment history of advanced systemics are scarce.

Objectives: The objective of the study was to evaluate the effectiveness and safety of abrocitinib treatment in patients with difficult-to-treat AD in daily practice.

View Article and Find Full Text PDF

Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs.

Methods: IMID patients on active treatment with ISPs and controls (i.

View Article and Find Full Text PDF

Background: Itch, and thereby the scratching behavior, is a common complaint in atopic dermatitis. Scratching damages the skin, which in turn worsens the itch. This itch-scratch cycle perpetuates the skin condition and has a major impact on the patient's quality of life.

View Article and Find Full Text PDF

Background: Despite enormous clinical improvements, due to better management strategies and the availability of biologicals, immune-mediated inflammatory diseases (IMIDs) still have a significant impact on patients' lives. To further reduce disease burden, provider- as well as patient-reported outcomes (PROs) should be taken into account during treatment and follow-up. Web-based collection of these outcomes generates valuable repeated measurements, which could be used (1) in daily clinical practice for patient-centered care, including shared decision-making; (2) for research purposes; and (3) as an essential step toward the implementation of value-based health care (VBHC).

View Article and Find Full Text PDF

Background: Evidence about tralokinumab treatment for moderate-to-severe atopic dermatitis (AD) in daily practice is limited.

Aim: To report the first evidence, to our knowledge, from daily practice of treatment with tralokinumab in patients with AD.

Methods: In this observational prospective study, patients with AD who received tralokinumab treatment in the context of routine care at the Erasmus Medical Centre were included between November 2021 and February 2022.

View Article and Find Full Text PDF

Purpose: During the SARS-CoV-2 pandemic, national and international societies have recommended continuing biological agents in patients with immune-mediated inflammatory diseases (IMID) in the absence of SARS-CoV-2 symptoms. However, adherence to biological treatment might decrease, because these recommendations contradict patients' beliefs. Especially an increased concern about side effects could have influenced the adherence to biological treatment during the first lockdown.

View Article and Find Full Text PDF

For patients with immune-mediated inflammatory diseases (IMIDs), concerns exist about increased disease activity after vaccination. We aimed to assess changes in disease activity after SARS-CoV-2 vaccination in patients with IMIDs, and determine risk factors for increased disease activity. In this substudy of a prospective observational cohort study (Target-to-B!), we included patients with IMIDs who received a SARS-CoV-2 vaccine.

View Article and Find Full Text PDF

Objectives: To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections.

Methods: Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included.

View Article and Find Full Text PDF

Background: Concerns have been raised regarding the risks of SARS-CoV-2 breakthrough infections in vaccinated patients with immune-mediated inflammatory diseases treated with immunosuppressants, but clinical data on breakthrough infections are still scarce. The primary objective of this study was to compare the incidence and severity of SARS-CoV-2 breakthrough infections between patients with immune-mediated inflammatory diseases using immunosuppressants, and controls (patients with immune-mediated inflammatory diseases not taking immunosuppressants and healthy controls) who had received full COVID-19 vaccinations. The secondary objective was to explore determinants of breakthrough infections of the delta (B.

View Article and Find Full Text PDF
Article Synopsis
  • - The study investigates how specific immunosuppressive therapies affect the immune response to SARS-CoV-2 vaccination in patients with immune-mediated inflammatory disorders, focusing on the humoral immune response.
  • - Conducted in the Netherlands with over 3,200 participants, the research compares the immune responses of patients on immunosuppressants to controls, including healthy individuals and those without systemic immunosuppressants.
  • - Findings indicate that certain immunosuppressive treatments, like anti-CD20 therapy and S1P modulators, result in lower chances of achieving adequate immunity post-vaccination, regardless of the type of immune disorder present.
View Article and Find Full Text PDF

Background: Studies have suggested incremental short-term adverse events (AE) after repeated vaccination. In this report, we assessed occurrence and risk factors for short-term AEs following repeated SARS-CoV-2 vaccination in patients with various immune-mediated inflammatory diseases (IMIDs).

Methods: Self-reported daily questionnaires on AEs during the first 7 days after vaccination were obtained of 2259 individuals (2081 patients and 178 controls) participating in an ongoing prospective multicenter cohort study on SARS-CoV-2 vaccination in patients with various IMIDs in the Netherlands (T2B-COVID).

View Article and Find Full Text PDF

To optimally tailor atopic dermatitis (AD) care to patients' needs, especially considering the many emerging therapeutic options, insight into patients' needs and preferences regarding AD care is needed. To explore patients' needs and preferences regarding AD care, a qualitative study consisting of three focus groups with a total of 20 adult AD patients was conducted. All sessions were transcribed verbatim and inductively analyzed using several phases of coding to create an overview of patients' needs and preferences.

View Article and Find Full Text PDF

The first wave of the coronavirus disease 2019 (COVID-19) pandemic had an enormous impact on health-care services, including on care provision for children with atopic dermatitis (AD). We investigated the impact of COVID-19 on the care for children with moderate to severe AD at our tertiary outpatient clinic and examined satisfaction with care. We reviewed outpatient records, comparing total number and types of consultations during the first COVID-19 wave (March until July 2020) with the corresponding months of 2019 and 2018.

View Article and Find Full Text PDF