IntroductionInterleukin (IL)-17 inhibitors are the most recent class of monoclonal antibodies approved by the FDA for psoriasis treatment. Preclinical and phase II studies of brodalumab, a high-affinity IL-17 receptor monoclonal antibody, have been encouraging.MethodsWe conducted a literature search using the PubMed database in order to assess the efficacy and safety profile of brodalumab. The search included the following key words: “psoriasis” and “IL-17” or “brodalumab.” We also reviewed citations within articles to identify relevant sources.ResultsAt week 12, the proportion of patients attaining a 75% improvement from the baseline Psoriasis Area and Severity Index (PASI 75) was similar among the three phase III trials (AMAGINE-1, 83%; AMAGINE-2, 86%; AMAGINE-3, 85%). Brodalumab remained efficacious through 52 weeks of treatment. It maintained a satisfactory safety profile; the most frequently reported adverse events consisted of nasopharyngitis, headache, upper respiratory tract infection, and arthralgia.ConclusionUse of brodalumab revealed prompt clinical improvement and a favorable short-term safety profile in phase III trials, although further extension studies are needed to assess long-term safety. Based on the results, brodalumab appears to be a potent therapeutic option for patients with moderate-to-severe plaque-type psoriasis.
IntroductionChronic skin conditions have been well reported to affect a patient’s quality of life on multiple dimensions, including the psychosocial domain. Psychosocial is defined as the interrelation of social factors with an individual’s thoughts and behavior. The assessment of the psychosocial impact of skin disease on a patient can help direct the dermatologists’ treatment goals. To evaluate the psychosocial impact of skin disease, we conducted a review of the literature on three skin conditions with onsets at various stages of life: acne, vitiligo, and psoriasis.MethodsA PubMed search was conducted in March 2015 using the terms “psychosocial” AND “acne”, “psychosocial” AND “vitiligo”, and “psychosocial” AND “psoriasis”. The results were limited to articles published in English in the past 5 years studying patients of all ages. Results and their references were evaluated for relevance according to their discussion of psychosocial qualities in their patients and the validity of psychosocial assessments. The search for acne yielded 51 results, and eleven were found to be relevant; vitiligo yielded 30 results with ten found to be relevant; and psoriasis yielded 70 results with seven found to be relevant.ResultsAccording to the articles evaluated, 19.2% of adolescent patients with acne were affected in their personal and social lives. Social phobia was present in 45% of patients with acne compared to 18% of control subjects. Race and sex played a role in self-consciousness and social perceptions of the disease. Vitiligo negatively affected marriage potential and caused relationship problems in >50% of patients. Psoriasis negatively affected multiple domains of life, including work, relationships, and social activities. Anxiety and depression affected not only psoriasis patients but also their cohabitants; up to 88% of cohabitants had an impaired quality of life.ConclusionThough all three skin conditions resulted in an increase in anxiety and depression among their patient populations, the psychosocial focus varied slightly for each disease. Overall, acne, vitiligo, and psoriasis can have negative psychosocial impact in different stages of life development.
IntroductionInterleukin-17 inhibitors are the newest class of monoclonal antibodies approved by the US Food and Drug Administration for the treatment of psoriasis. Preclinical and Phase II studies of ixekizumab, a high-affinity anti-IL-17A monoclonal antibody, have proved promising.MethodsWe conducted an extensive literature search using the PubMed database to assess the efficacy and safety profile of ixekizumab. The search included the following key words: “psoriasis” and “IL-17” or “ixekizumab.” We also reviewed citations within articles to identify relevant sources.ResultsBy week 12, the percentage of patients achieving a 75% improvement from baseline Psoriasis Area and Severity Index (PASI 75) was comparable among the three Phase III trials (UNCOVER-1, 89%; UNCOVER-2, 90%; UNCOVER-3, 87%). Ixekizumab continued to be efficacious through 60 weeks of treatment. The safety profile of ixekizumab was favorable; the most frequently reported adverse events consisted of nasopharyngitis, upper respiratory tract infection, injection-site reaction, and headache.ConclusionOverall, ixekizumab demonstrated rapid clinical improvement and favorable short-term safety profile in Phase III trials. The results support ixekizumab as an effective therapeutic option for patients with moderate-to-severe plaque-type psoriasis.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-016-0102-0) contains supplementary material, which is available to authorized users.
Background Patients with atopic dermatitis (AD) commonly turn to dietary modifications to manage their skin condition. Objectives To investigate patient-reported outcomes and perceptions regarding the role of diet in AD. Methods One hundred and sixty nine AD patients were surveyed in this cross-sectional study. The 61-question survey asked about dietary modifications, perceptions and outcomes. Results Eighty seven percent of participants reported a trial of dietary exclusion. The most common were junk foods (68%), dairy (49.7%) and gluten (49%). The best improvement in skin was reported when removing white flour products (37 of 69, 53.6%), gluten (37 of 72, 51.4%) and nightshades (18 of 35, 51.4%). 79.9% of participants reported adding items to their diet. The most common were vegetables (62.2%), fish oil (59.3%) and fruits (57.8%). The best improvement in skin was noted when adding vegetables (40 of 84, 47.6%), organic foods (17 of 43, 39.5%) and fish oil (28 of 80, 35%). Although 93.5% of patients believed it was important that physicians discuss with them the role of diet in managing skin disease, only 32.5% had consulted their dermatologist. Conclusions Since dietary modifications are extremely common, the role of diet in AD and potential nutritional benefits and risks need to be properly discussed with patients.
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