Publications by authors named "Shawn G Kwatra"
Patients with prurigo nodularis (PN) present with pruritus which may lead to sleep disturbances and systemic comorbidities. The objective of our study was to determine the risk of sleep disorders in PN and its association with systemic inflammation and adverse cardiovascular outcomes. We conducted a retrospective population-level cohort using a global health records database to analyze the development of sleep disorders, C-reactive protein (CRP) levels, and risk of cardiovascular disease and mortality in PN compared to controls.
View Article and Find Full Text PDFBackground: Risk factors and the temporal relationship between atopic dermatitis (AD) and atopic march remain understudied.
Objective: Determine risk factors for atopic march in early-onset AD patients and the temporality between AD and atopic march.
Methods: We used the MarketScan Research Database for our retrospective cohort analysis from 2010 to 2018, comparing infants diagnosed with AD before age 1 with controls without early-onset AD.
Article Synopsis
- Atopic dermatitis (AD) significantly affects patients' quality of life, causing itching, skin pain, and sleep disturbances; ruxolitinib cream has shown effectiveness in treating these symptoms in adults and adolescents through two phase III clinical trials.
- In the TRuE-AD studies, patients applied different strengths of ruxolitinib cream or a vehicle cream, with results indicating that those using ruxolitinib experienced quick relief from symptoms like skin pain and sleep issues within hours or weeks of application.
- Analysis of patient-reported outcomes revealed notable improvements in overall quality of life and symptom burden after two weeks of using ruxolitinib cream compared to the vehicle, with sustained benefits observed throughout the study periods.
Article Synopsis
- The study examines the effectiveness and safety of risankizumab for treating moderate-to-severe plaque psoriasis, focusing on racial and ethnic disparities in diagnosis and representation in clinical trials.
- A total of 897 patients participated, with significant reductions in psoriasis severity and improvements in quality of life reported, particularly among Black or African American and Hispanic or Latino patients.
- Results suggest that risankizumab shows similar efficacy across different racial and ethnic groups without any new safety concerns arising during the treatment.
Chronic spontaneous urticaria (CSU) should be on every dermatology practitioner's radar. CSU is a skin disorder marked by wheals, angioedema, or both for more than 6 weeks. Patients with CSU experience unexplained, itchy wheals that appear and disappear, traveling around the body and lasting less than 24 hours per area.
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- Prurigo nodularis (PN) is a chronic skin condition marked by extremely itchy nodules that can worsen due to scratching, creating a cycle of discomfort and skin damage.
- Recent research shows that PN involves an imbalance in the neuroimmune system, with factors like sensory neurons and inflammatory cells playing a key role in its development.
- The review suggests that understanding the dysregulated type 2 immune responses may lead to new treatments that can better manage the symptoms of PN.
Article Synopsis
- - The study focused on atopic dermatitis (AD) and evaluated how much time patients spent with clear skin and minimal itch while being treated with upadacitinib compared to a placebo and dupilumab.
- - Researchers analyzed data from three phase 3 studies involving nearly 2,400 patients, with treatments lasting from 16 to 24 weeks and assessed using established skin severity and itch scales.
- - Results showed that patients on upadacitinib experienced significantly more days with better skin conditions and reduced itching compared to those on placebo or dupilumab.
Chronic pruritus of unknown origin (CPUO) is characterized by chronic itch for 6 weeks or greater without an identifiable primary cause. Studies are needed to investigate circulating blood biomarkers to elucidate disease pathogenesis. The objective of this study was to investigate changes in circulating blood metabolites in CPUO patients and to identify potential therapeutic targets.
View Article and Find Full Text PDFBackground: Understanding co-occurrence patterns and prognostic implications of immune-related adverse events is crucial for immunotherapy management. However, previous studies have been limited by sample size and generalisability. In this study, we leveraged a multi-institutional cohort and a population-level database to investigate co-occurrence patterns of and survival outcomes after multi-organ immune-related adverse events among recipients of immune checkpoint inhibitors.
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- - The Phase 3 PRIME/PRIME2 trials showed that dupilumab is effective and safe for adults with moderate-to-severe prurigo nodularis, as confirmed by pooled data from both trials.
- - In a 24-week study, patients receiving dupilumab had significantly better improvements in itch and skin clarity compared to those on a placebo, with notable results seen as early as 12 weeks.
- - The analysis concluded that dupilumab's benefits were consistent across different demographic groups, though the data collection was limited to the 24-week treatment duration.
Article Synopsis
- Prurigo nodularis (PN) is a chronic skin condition marked by severe itching and skin nodules, and it may also involve systemic inflammation linked to other health issues.
- A study investigated the effects of dupilumab, a newly approved treatment for PN, on inflammatory proteins in blood samples from three patients after six months of therapy.
- Results showed significant clinical improvements and a reduction in various inflammatory proteins related to different immune pathways, suggesting dupilumab could help alleviate both skin symptoms and systemic inflammation risks.
Article Synopsis
- Prurigo nodularis (PN) is a skin condition marked by severe chronic itching, and its severity was measured using the Worst Itch Numeric Rating Scale (WI-NRS) in two phase 3 studies testing the drug dupilumab.
- The objective of these studies was to confirm the reliability and validity of the WI-NRS and to identify what constitutes a significant improvement in scores for patients suffering from moderate to severe PN.
- Results showed a successful assessment of WI-NRS, with high relevance and clarity for patients, and the study analyzed data from various trials conducted between December 2019 and August 2021, involving a total of 311 participants.
Importance: Prurigo nodularis (PN) and chronic pruritus of unknown origin (CPUO) are chronic pruritic diseases that dramatically impair quality of life, but therapeutic options are limited. Abrocitinib, a Janus kinase 1 inhibitor, represents a promising therapy for both conditions.
Objective: To assess the efficacy and safety of 200-mg oral abrocitinib administered once daily in adults with moderate to severe PN or CPUO.
Article Synopsis
- - Chronic pruritus, or long-term itch lasting 6 weeks or more, affects about 22% of people, leading to poor sleep and decreased quality of life, though it represents only 1% of doctor visits.
- - The condition can be classified into inflammatory (60% of cases), neuropathic (25%), or other causes (15%), with common inflammatory triggers being eczema and psoriasis, while neuropathic issues may arise from nerve dysfunction.
- - Diagnosis often involves thorough history-taking and lab tests, with initial treatments typically being topical anti-inflammatory medications; if these fail, referral to a specialist or systemic treatments may be necessary.
Background: Prurigo nodularis (PN) is an intensely pruritic disease characterized by itchy nodules on the trunk/extremities; it is often accompanied by skin pain and sleep disruption with negative impacts on the quality of life (QoL). The patient-reported outcome (PRO) instruments, Worst Itch-Numeric Rating Scale (WI-NRS), Skin Pain-NRS, Sleep-NRS and Dermatology Life Quality Index (DLQI) have been psychometrically validated and the clinically meaningful within-patient improvement thresholds (responder definition) have been established through data pooled from the two Phase-3 trials (PRIME, NCT04183335 and PRIME2, NCT04202679) of dupilumab in adults with PN uncontrolled on topical therapies.
Objectives: To estimate the proportion of dupilumab-treated patients (vs.
A Practical Approach to Diagnosing and Managing Chronic Spontaneous Urticaria.
Dermatol Ther (Heidelb)
June 2024
Chronic spontaneous urticaria (CSU) is an unpredictable inflammatory skin condition characterized by the spontaneous onset of itchy wheals, angioedema, or both, which occurs for longer than 6 weeks overall. Despite the relatively straightforward diagnostic algorithm for CSU, relying primarily on a detailed medical history and only limited laboratory tests, patients often wait years to be diagnosed, with many cycling through different healthcare practitioners before a diagnosis is made. Even then, current treatment options for CSU are limited, with approximately half of patients resistant to standard-of-care second-generation antihistamines at standard or higher doses.
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