Publications by authors named "Michael Cork"

Attenuated total reflection (ATR) Fourier transform infrared spectroscopy (FT-IR) is used to characterize a vast array of materials at the molecular level in various industry types. Here we compare the performance of a portable spectrometer with a novel three-bounce-two-pass (3B2P) ATR scanning interface to the same device with a standard one-bounce (1B) ATR, and to a benchtop spectrometer with a 10-bounce (10B) ATR, in ideal sample-interface conditions and an applied dermatological study setting. In both application settings, the benchtop 10B ATR interface showed the highest signal-to-noise ratio (SNR), however, the novel 3B2P produced a six-fold increase in the sensitivity of the portable spectrometer when analyzing isopropanol and showed the greatest consistency of SNR of all devices when analyzing isopropanol and in vivo skin samples.

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  • The study aimed to assess long-term infection rates in children aged 6 months to 5 years with moderate-to-severe atopic dermatitis (AD) treated with the medication dupilumab.
  • It analyzed data from an ongoing open-label extension (OLE) study, showing that long-term dupilumab treatment resulted in lower infection rates compared to previous shorter trials.
  • The findings indicate that dupilumab treatment is associated with a reduced frequency of infections and is considered safe for young children with AD.
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In a randomized phase 2b trial (NCT03703102) for adult patients with moderate-to-severe atopic dermatitis (AD), treatment with the T cell rebalancing anti-OX40 receptor antibody rocatinlimab (AMG 451/KHK4083) led to significant improvements in clinical measurements versus placebo including whole-body Eczema Area and Severity Index (EASI) score. AD manifestations can impact variable anatomic regions, and involvement of the head and neck, a sensitive, hard-to-treat area, can negatively impact quality of life. In this post hoc analysis, we investigated response to rocatinlimab treatment across anatomic regions, including the head and neck.

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  • Moderate-to-severe atopic dermatitis (AD) significantly affects both children and their caregivers, prompting the study of dupilumab's impacts on symptoms and quality of life (QoL).
  • In a study involving children aged 6 months to 5 years, dupilumab was compared to a placebo over 16 weeks, showing notable improvements in caregiver-reported AD symptoms and QoL as early as week 4.
  • The results indicated that dupilumab not only helped alleviate AD symptoms in young patients but also enhanced the overall well-being of their caregivers and families.
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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.

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Introduction: Increased skin pH values in patients with atopic dermatitis (AD) contribute to poor antimicrobial and permeability barrier functions of the skin. In practice, the majority of topical preparations available for dry skin conditions do not provide sufficient pH and buffering capacity for maintaining optimum skin surface conditions. To address this issue, we tested a novel zinc lactobionate preparation to determine whether the regular application would lower skin surface pH, and in doing so improve the condition of lesional skin.

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Interleukin-33 (IL-33) is a proinflammatory alarmin cytokine released by damaged epithelial tissue cells that initiates and amplifies both type 1 and type 2 inflammatory cascades. A role for IL-33 in atopic dermatitis (AD; a chronic, relapsing type 2 inflammatory disease of the skin) has been proposed. Itepekimab is a novel human IgG4P monoclonal antibody against IL-33, currently in clinical development for chronic obstructive pulmonary disease (COPD).

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  • The study compares the real-world effectiveness and safety of three treatments for atopic dermatitis: dupilumab, ciclosporin (CyA), and methotrexate (MTX), using data from the A-STAR register in the UK and Ireland.
  • It involved 488 patients (adults and children) and measured treatment outcomes like the Eczema Area and Severity Index (EASI) and quality of life scales over 12 months.
  • Results showed that dupilumab and CyA led to faster improvements in skin severity scores and overall patient outcomes compared to MTX, indicating dupilumab is an effective option in managing atopic dermatitis.
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  • Atopic eczema is a frequent skin condition in children that can decrease their quality of life and is associated with other allergic conditions like asthma and food allergies.
  • The study aimed to see if applying daily emollients in the first year of life could prevent eczema and other related atopic diseases in infants at high risk.
  • The trial involved over 1,300 newborns, with results showing a slight difference in eczema rates at age 2, suggesting emollient use may have a modest protective effect.
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  • - Abrocitinib is an FDA-approved oral medication for treating moderate-to-severe atopic dermatitis (AD) in both adults and adolescents, and it has proven to be effective in clinical trials with a good safety profile over time.
  • - A 200-mg daily dose of abrocitinib offers quicker relief from itching and better skin improvement compared to dupilumab, but monitoring for potential side effects is crucial due to risks associated with all oral JAK inhibitors.
  • - The use of abrocitinib is appropriate for qualified patients needing systemic AD therapy, though caution is advised for specific populations such as older adults and those with certain health risks, with a recommendation to start with a lower 100-mg dose in
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Background: Pediatric patients with moderate-to-severe atopic dermatitis (AD) often experience a high disease burden and have a high risk of persistent disease. Standard-of-care immunosuppressive systemic treatments have been used off-label for AD in pediatric patients despite concerns for suboptimal safety with continuous use and risk of relapse upon discontinuation. The biologic agent dupilumab is the first systemic treatment approved for moderate-to-severe AD in children as young as 6 months.

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  • Atopic dermatitis (AD) significantly affects the quality of life for young children and their families, prompting the need for effective treatments.
  • The LIBERTY AD PRESCHOOL part B trial tested the efficacy of dupilumab in 162 children aged 6 months to 5 years with moderate-to-severe AD, comparing it to a placebo alongside topical corticosteroids.
  • Results showed that a higher percentage of children treated with dupilumab experienced meaningful improvements in AD signs and symptoms compared to those on placebo, with notable effects on itching and overall quality of life within just 16 weeks.*
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Atopic dermatitis (AD) is the most common inflammatory skin disease in children. Children with severe AD have a multidimensional disease burden characterized by skin lesions, itching, frequent infections, sleep deprivation, and a high rate of comorbidities. These impact the mental health and overall quality of life of not only the children but also of their parents and caregivers.

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  • Patients with atopic dermatitis (AD), especially young children, are more prone to skin infections, prompting research into the effects of dupilumab treatment in this demographic.
  • In a clinical trial involving 162 children aged 6 months to 5 years, those treated with dupilumab showed no significant difference in total infection rates compared to the placebo group but had fewer non-herpetic and bacterial infections.
  • The findings indicate that dupilumab does not increase the overall risk of infections and may lower the frequency of certain skin infections in infants and young children with moderate-to-severe AD.
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  • - The study investigated the effects of a new zinc lactobionate emollient cream on the skin barrier of patients with atopic dermatitis (AD), aiming to lower elevated skin surface pH which can harm skin function.
  • - In a controlled trial with 23 adult participants, the cream significantly decreased skin surface pH and transepidermal water loss (TEWL) over 56 days, indicating improved skin barrier integrity compared to a control cream.
  • - Results suggest that maintaining an acidic skin pH and providing necessary lipids can enhance skin health and alleviate symptoms of AD by reducing sensitivity to irritants and allergens.
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Objective: This study aims to assess the efficacy and safety of combining the 308-nm Excimer lamp with Tacrolimus 0.1% ointment, compared to Tacrolimus 0.1% ointment monotherapy, for treating pediatric vitiligo involving less than 10% of the body surface area.

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Background: Studies across the globe generally reported increased mortality risks associated with particulate matter with aerodynamic diameter () exposure with large heterogeneity in the magnitude of reported associations and the shape of concentration-response functions (CRFs). We aimed to evaluate the impact of key study design factors (including confounders, applied exposure model, population age, and outcome definition) on effect estimates by harmonizing analyses on three previously published large studies in Canada [Mortality-Air Pollution Associations in Low Exposure Environments (MAPLE), 1991-2016], the United States (Medicare, 2000-2016), and Europe [Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), 2000-2016] as much as possible.

Methods: We harmonized the study populations to individuals years of age, applied the same satellite-derived exposure estimates, and selected the same sets of potential confounders and the same outcome.

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Background: Atopic dermatitis (AD) is characterized by skin barrier defects that are often measured by biophysical tools that observe the functional properties of the stratum corneum (SC).

Objectives: To employ in vivo infrared spectroscopy alongside biophysical measurements to analyse changes in the chemical composition of the SC in relation to AD severity.

Methods: We conducted an observational cross-sectional cohort study where attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy measurements were collected on the forearm alongside surface pH, capacitance, erythema and transepidermal water loss (TEWL), combined with tape stripping, in a cohort of 75 participants (55 patients with AD stratified by phenotypic severity and 20 healthy controls).

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Background: A diagnosis of atopic dermatitis (AD) is common during infancy; however, it is unclear whether differential skin barrier development defines this period and signals disease onset in predisposed individuals.

Objective: We sought to study (NCT03143504) and assess the feasibility of remote skin testing from birth to monitor skin barrier maturation and model association with an AD diagnosis by age 12 months.

Methods: Biophysical testing and infrared spectroscopy were conducted at the maternity ward and family home.

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  • The study aimed to evaluate the effects of tralokinumab, a treatment for chronic moderate-to-severe atopic dermatitis, compared to a placebo on various clinically important outcomes in patients not reaching the main goal of clear skin at week 16.
  • A total of 1328 patients from two phase III trials, ECZTRA 1 and 2, were analyzed, focusing on improvements in eczema severity and patient-reported symptoms like itch and quality of life.
  • Results showed that significantly more patients using tralokinumab attained meaningful improvements in eczema severity (EASI-50), itch ratings, and quality of life compared to those on placebo, indicating tralokinumab's potential benefits beyond just achieving clear skin.
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Crisaborole 2% ointment is a non-steroidal treatment for mild-moderate atopic dermatitis (AD) and may produce fewer adverse effects than topical corticosteroids (TCS). We used PS-OCT to quantify dermal collagen at baseline and after 29 days of treatment with crisaborole and betamethasone valerate (BMV), in 32 subjects. PS-OCT detected a mean increase 1 × 10-6, 95% CI (6.

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Background: For children aged 6-11 years with uncontrolled severe atopic dermatitis (AD), 16 weeks of treatment with dupilumab resulted in substantial clinical benefit compared with placebo with an acceptable safety profile. However, longer-term safety and efficacy data are important to inform longitudinal AD management.

Objectives: This analysis of data from an open-label extension study (LIBERTY AD PED-OLE, NCT02612454) reports the long-term safety, efficacy, and pharmacokinetics of dupilumab in children with severe AD who had participated in the pivotal dupilumab LIBERTY AD PEDS study (NCT03345914).

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  • - The integrated care pathways for atopic dermatitis (AD-ICPs) serve to connect existing treatment guidelines and expert insights into a structured plan that caters to different levels of AD severity and healthcare resources across various countries.
  • - Developed by the GA LEN ADCARE network and other stakeholders in 2020-2021, the AD-ICPs detail diagnostics, treatment options, and emphasize the roles of pharmacologists and other contributors in managing AD, particularly in pediatric cases.
  • - The initiative aims to enhance AD management through a multidisciplinary approach that addresses urgent needs like better access to care, specialist training, educational programs, and personalized treatments, ultimately leading to improved patient outcomes.
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  • A study compared the safety and effectiveness of ciclosporin (CyA) and methotrexate (MTX) in treating severe atopic dermatitis (AD) in children and young people aged 2-16 who didn't respond to topical treatments.
  • Cyclists showed more significant improvement at the 12-week mark, with more patients achieving at least a 50% improvement in their AD scores compared to those on MTX.
  • However, by the 60-week follow-up, MTX demonstrated better long-term outcomes, indicating its potential superiority beyond the initial treatment period.
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Introduction: Atopic dermatitis (AD) is heterogeneous in distribution pattern and clinical features. This analysis assessed the effect of dupilumab on the extent and severity of AD across various signs (erythema, edema/papulation, excoriation, lichenification) in different anatomical regions (head and neck, trunk, upper extremities, lower extremities) in patients aged 6 months to 5 years.

Methods: In LIBERTY AD PRESCHOOL, a double-blind, placebo-controlled, phase III clinical trial, children aged 6 months to 5 years with moderate-to-severe AD were randomized 1:1 to subcutaneous dupilumab or placebo with concomitant low-potency topical corticosteroids (TCS) every 4 weeks for 16 weeks.

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