Publications by authors named "Siegfried E"

Background And Objectives: A wholesale recommendation against use of live virus vaccines in patients treated with any medication classified as an immunosuppressant has been based on global theoretical concerns rather than clinical outcomes for specific drugs.

Methods: A retrospective search of electronic medical records identified patients seen by the Allergy and/or Dermatology services between 2017 and 2023 at a pediatric tertiary center who received a live attenuated vaccine during the 6 week interval prior to the first prescription for methotrexate or dupilumab until 6 weeks after the last prescription for either medication. Individual charts of identified patients were manually reviewed for evidence of adverse events.

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  • The Measure Up 1, 2, and AD Up studies assessed the effectiveness and side effects of upadacitinib for treating atopic dermatitis in adolescents aged 12-17 over a period of 76 weeks, extending the research beyond the previously available 52-week data.
  • In a randomized clinical trial, participants received either upadacitinib (15 mg or 30 mg) or a placebo, with some receiving topical corticosteroids, allowing for varied analysis of its efficacy and safety.
  • Results showed that a significant percentage of adolescents achieved a major improvement in their condition, with 89.1%, 84.4%, and 87.8% meeting the criteria for reduction in severity, showcasing the medication
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  • * Mild-to-moderate AD is typically treated with topical anti-inflammatory medications and basic skin care, while moderate-to-severe cases often need systemic therapy, including off-label immunosuppressants, which carry safety concerns.
  • * New targeted biologics and small molecules are emerging as more effective and safer treatment options for AD, leading to the development of standardized recommendations for treating pediatric patients with moderate-to-severe cases.
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Janus kinase inhibitors (JAKi) are drugs that block tyrosine kinases responsible for transducing cytokine signals. The first JAKi was approved by the US Food and Drug Administration (FDA) in 2011 to treat rheumatoid arthritis in adults. A pediatric indication was not approved until 8 years later, for acute graft-versus-host disease.

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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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  • Lebrikizumab, an antibody targeting IL-13, showed effectiveness in treating moderate-to-severe atopic dermatitis (AD) in adolescents during three Phase 3 trials (ADvocate1, ADvocate2, ADhere).
  • The analysis focused on 16-week outcomes from these trials, evaluating both physician and patient-reported improvements in symptoms like itching and sleep loss.
  • Results indicated significant improvements in clinical measures for adolescents receiving lebrikizumab compared to placebo, reinforcing its potential as an effective treatment option for AD.
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  • Atopic dermatitis (AD) affects around 7% of adolescents worldwide, and a new topical cream containing ruxolitinib (a JAK 1/JAK2 inhibitor) showed promise in treating this condition in two phase 3 trials.
  • The study focused on patients aged 12-17 and assessed the safety and effectiveness of 1.5% ruxolitinib cream compared to a placebo, with evaluations at the 8-week mark and during a long-term safety period of up to 52 weeks.
  • Results indicated that a significant portion of participants using the 1.5% cream experienced substantial improvements in skin condition and itchiness, with 89% choosing to continue the treatment in the long-term
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The theory describing the evolution of offspring size often assumes that the production cost per unit volume is the same for small and large offspring. However, this may not be true if indirect costs of reproduction (e.g.

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Background And Objective: Current regulatory labeling recommends avoiding live vaccine use in dupilumab-treated patients. Clinical data are not available to support more specific guidance for live or live attenuated vaccines administration in dupilumab-treated patients.

Methods: Children (6 months-5 years old) with moderate-to-severe atopic dermatitis (AD) enrolled in a phase 2/3 clinical trial of dupilumab (LIBERTY AD PRESCHOOL Part A/B; NCT03346434) and subsequently participated in the LIBERTY AD PED-OLE (NCT02612454).

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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 investigates how well dupilumab controls atopic dermatitis (AD) in children, adolescents, and adults, focusing on the factors influencing patient responses to the treatment.
  • Data from multiple clinical trials involving over 2,000 participants were analyzed to determine how drug exposure affects treatment efficacy, measured by EASI and IGA scores.
  • Findings revealed that older age, higher body weight, lower baseline chemokine levels, and Asian race were linked to slightly lower responses, with children showing better drug effects compared to adults at similar drug concentrations.
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Pediatric psoriasis (PsO) and its associated comorbidities carry physical and psychosocial burdens in children and adolescents, which can negatively impact quality of life. However, features distinguishing pediatric PsO from eczema and other common inflammatory skin diseases may not be obvious to primary care providers, which may contribute to underrecognition and misdiagnosis. Accurate diagnosis of pediatric PsO is critical for managing the physical and psychological burdens associated with this disease.

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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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Methotrexate (MTX) is a readily accessible drug, first used in 1948 and employed for a wide variety of indications since then. However, despite widespread off-label use, FDA labeling does not include approved indications for the use of MTX for many inflammatory skin diseases in pediatric patients, including morphea, psoriasis, atopic dermatitis, and alopecia areata, among others. Without published treatment guidelines, some clinicians may be hesitant to use MTX off-label, or uncomfortable prescribing MTX in this population.

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Background: Children with severe atopic dermatitis (AD) have a multidimensional disease burden.

Objective: Here we assess the clinically meaningful improvements in AD signs, symptoms, and quality of life (QoL) in children aged 6-11 years with severe AD treated with dupilumab compared with placebo.

Methods: R668-AD-1652 LIBERTY AD PEDS was a randomized, double-blinded, placebo-controlled, parallel-group, phase III clinical trial of dupilumab with concomitant topical corticosteroids (TCS) in children aged 6-11 years with severe AD.

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  • Atopic dermatitis commonly starts in childhood and often continues into adolescence and adulthood, creating a significant need for effective treatments in teens.
  • The study evaluated the safety and effectiveness of upadacitinib, a medication for moderate-to-severe atopic dermatitis in adolescents aged 12 to 17, through three clinical trials conducted worldwide.
  • Results showed that a larger percentage of adolescents taking upadacitinib (both 15 mg and 30 mg doses) achieved significant improvements in their skin condition compared to those on a placebo after 16 weeks of treatment.
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  • The study reviews cases of psoriasiform eruptions in children caused by TNF inhibitors, which are commonly used to treat nondermatologic conditions like inflammatory bowel disease.
  • 103 pediatric patients, predominantly around the age of 13.8, developed skin eruptions months after starting treatment, often without prior personal or familial history of psoriasis.
  • Treatment involved topical medications for all patients, with some requiring additional systemic therapies like methotrexate or corticosteroids to manage the skin condition.
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Utilizing direct mechanocatalytical conditions, the Sonogashira coupling was successfully performed on the surface of milling tools by using pure Pd and Pd coated steel balls. The optimization of co-catalyst forming additives led to a protocol, which generates quantitative yields under aerobic conditions for various substrates within as little as 90 minutes. Using state-of-the-art spectroscopic, diffractive, as well as in situ methods lead to the identification of a previously unknown and highly reactive complex of the co-catalyst copper.

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Atopic dermatitis (AD) is a chronic inflammatory skin disease that can significantly decrease quality of life. AD is commonly associated with comorbidities including ocular surface disease (OSD). Conjunctivitis is the most common OSD associated with AD and can increase in incidence with use of monoclonal antibody biologics that target the type 2 inflammatory pathway.

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