Publications by authors named "Silverberg J"
In atopic dermatitis (AD), the real-world impact of achieving itch and skin lesion treatment targets compared to partial improvement remains unclear. We assessed the relationship between itch relief (reduction in Worst Itch Numeric Rating Scale [WI-NRS]) and skin clearance (Investigator Global Assessment [IGA] 0/1) with other patient-reported outcomes. Using TARGET-DERM AD registry data on adults receiving standard-of-care treatment, we described and modeled the relationship of itch severity (Worst Itch Numeric Rating Scale [WI-NRS]) and skin lesion severity (IGA) outcomes with patient-reported (quality of life ([DLQI)], AD severity [(POEM]), sleep ([Sleep-NRS]), and skin pain [(Pain-NRS]).
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- Moderate-to-severe atopic dermatitis (AD) significantly affects patients' quality of life, and advanced systemic therapeutics (AST) like dupilumab and upadacitinib are available but underutilized.
- A study of 3,076 patients in the U.S. found that 436 were eligible for AST treatment, and factors like private insurance and disease severity influenced their treatment initiation.
- Despite the availability of AST, many patients—47% of adolescents and 58% of adults—remain untreated, highlighting a need for greater advocacy and accessibility for those with severe AD.
Efficacy and safety of tozorakimab in moderate-to-severe atopic dermatitis: A Phase 2a randomized controlled trial (FRONTIER-2).
J Eur Acad Dermatol Venereol
November 2024
Background: Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by intense pruritus and eczematous lesions. Tozorakimab is a high-affinity human monoclonal antibody that neutralizes interleukin-33, a broad-acting alarmin cytokine that is over-expressed in keratinocytes of patients with AD.
Objectives: This Phase 2a study (FRONTIER-2; NCT04212169) evaluated the safety and efficacy of tozorakimab in adults with moderate-to-severe AD.
As the available treatments for moderate-to-severe atopic dermatitis (AD) expand, understanding patient and physician preferences becomes crucial for informed decision-making. To quantify patient and physician preferences for biologics and oral systemic AD treatment attributes. We conducted a cross-sectional, online discrete choice experiment (DCE) involving 306 AD patients and 206 physicians throughout the United Kingdom and Germany.
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- Treg impairment is linked to chronic inflammatory diseases, and the study explores the use of a new medication, rezpegaldesleukin (REZPEG), for restoring Tregs in patients with atopic dermatitis and psoriasis.
- Two trials showed that REZPEG is safe and well-tolerated, with effective dosing leading to significant improvements in disease severity scores after treatment.
- Patients who received the higher dose exhibited lasting benefits, such as significant EASI score improvements and sustained Treg increases, indicating the potential for long-term control of these skin conditions without ongoing treatment.
Article Synopsis
- * The study compared the effectiveness and safety of upadacitinib (UPA) and dupilumab (DUPI) in adolescents and adults with moderate-to-severe AD over 16 weeks, with UPA showing better results in reducing skin severity and itching.
- * UPA was found to be significantly more effective than DUPI in achieving the treatment goals, with no new safety concerns reported during the study.
The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic.
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- Dermatology residency education currently lacks sufficient training on diversity, equity, and inclusion (DEI), which may negatively impact care for diverse populations.
- A study aimed to identify key DEI topics to integrate into residency programs, gathering input from experts and participants through anonymous surveys.
- Sixty-one DEI topics were proposed by dermatology experts, and the study utilized a modified electronic Delphi method to reach a consensus on which topics should be prioritized in curricula.
Article Synopsis
- * Factors like healthcare access, environment, and socioeconomic status contribute to these disparities, with systemic racism exacerbating the issue for minority groups.
- * The text discusses the root causes of these racial/ethnic differences in AD and suggests strategies for better diagnosis and management of the condition.
Article Synopsis
- Scientists are researching new medicines to help people with atopic dermatitis (AD), which is a type of skin condition.
- They are checking how safe these new treatments are by looking at lots of patients and comparing different drugs.
- So far, early results show that some medicines might cause more infections or acne compared to others, but they will keep studying to learn more about safety over time.
Article Synopsis
- 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.
Article Synopsis
- A 59-year-old man suffered from Western Gaboon viper (Bitis rhinoceros) envenomation, initially treated with North American crotalid antivenom, which proved ineffective.
- He experienced worsening symptoms, including swelling and low platelet counts, prompting a transfer to a facility that provided South African Institute for Medical Research (SAIMR) polyvalent antivenom.
- After receiving the appropriate antivenom, the patient's condition rapidly improved, demonstrating the importance of using species-specific antivenom for viper bites and consulting poison centers for proper treatment guidance.*
Article Synopsis
- The study aimed to understand the complexities behind starting systemic treatments in patients with moderate-to-severe atopic dermatitis (AD).
- It analyzed data from the CorEvitas AD Registry, revealing that many patients who seemed to have severe AD were not prescribed systemic therapies despite high disease burden and poor quality of life.
- Significant factors linked to the initiation of systemic treatments included disease severity, previous biologic use, and patient-reported symptoms, suggesting more research is needed to uncover why some severely affected patients remain untreated.
Article Synopsis
- Moderate-to-severe atopic dermatitis (AD) significantly affects the quality of life for young children and their caregivers, with skin pain being a major symptom.
- In a study involving 162 children aged 6 months to 5 years, those treated with dupilumab showed a greater reduction in skin pain compared to the placebo group after 16 weeks.
- The results indicate that dupilumab treatment leads to rapid and significant improvements in skin pain, benefiting both the overall patient population and specific subgroups struggling with more severe symptoms.
Article Synopsis
- * The review introduces a mnemonic, VINDICATE-P, to categorize the various comorbidities linked with AD, including cardiovascular, infectious, and neurological conditions, among others.
- * Understanding these comorbidities can differ based on the patient's age, and further research is necessary to explore how they develop and how best to screen for them in AD patients.
Article Synopsis
- - Atopic dermatitis (AD) has a complex and varied progression, not just limited to childhood but also affecting adults, with some individuals experiencing symptoms from childhood into adulthood.
- - Recent studies show different patterns of AD onset, including cases that start in childhood and others that begin in adulthood, indicating various triggers or factors involved.
- - Evaluating how AD develops over time is crucial for creating personalized treatment plans, highlighting the need for a nuanced understanding of the condition's changes over a person's life.
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.
Article Synopsis
- - The study analyzed contact allergies to peppermint (MP) oil using data from the North American Contact Dermatitis Group, finding that out of 28,128 patients tested, only 161 (0.6%) exhibited an allergic reaction.
- - The majority of allergic patients were female (77%) and over 40 years old (71.4%), with common dermatitis locations being the face (31.7%), hands (17.4%), and generalized areas (18.6%).
- - A significant number (30.4%) experienced strong to extreme reactions, primarily linked to products like oral hygiene items, foods, and lip products; many also had co-reactions with other fragrance allergens, indicating that around 40% of cases
Article Synopsis
- Photoallergic contact dermatitis (PACD) is a hypersensitivity reaction triggered by allergens only when exposed to UV light, requiring photopatch testing (PhotoPT) for diagnosis.* -
- A study from 2009-2020 involving 454 patients revealed that most were women, aged 21-60, and the majority were White; results showed 119 positive tests, predominantly related to sunscreen agents like benzophenones.* -
- Among the diagnosed conditions, approximately 17.2% of patients had PACD, while other diagnoses included allergic contact dermatitis, polymorphous light eruption, and chronic actinic dermatitis, highlighting the need for photopatch testing in these cases.*
Article Synopsis
- - Lebrikizumab is a new monoclonal antibody that has shown effectiveness in treating moderate-to-severe atopic dermatitis (AD) in Phase 3 clinical trials, with a goal of providing stable disease control for patients.
- - In the studies (ADvocate1 and ADvocate2), patients who responded to lebrikizumab after 16 weeks were re-randomized to receive different treatment frequencies (every 2 weeks, every 4 weeks, or placebo) for an additional 36 weeks, assessing the maintenance of treatment effects.
- - Results showed that a significant percentage of patients maintained improvement in their skin condition and itching, with 70.8% and 71.2% of those
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.