The British journal of dermatology
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Dupilumab [a monoclonal antibody blocking the shared receptor subunit for interleukin (IL)-4 and IL-13] is approved for patients aged ≥ 12 years with inadequately controlled, moderate-to-severe atopic dermatitis (AD). Dupilumab trials of up to 52 weeks demonstrated efficacy and a favourable safety profile in patients with moderate-to-severe AD inadequately controlled with topical medications. ⋯ There were no clinically important changes in routine laboratory parameters that could be attributed to dupilumab. This study supports the use of dupilumab as a systemic treatment for moderate-to-severe AD that does not require laboratory monitoring. What's already known about this topic? Long-term treatment of atopic dermatitis (AD) with conventional immunosuppressive agents is limited by the risk of significant side-effects and a need for repeated tests to monitor haematological and/or organ (e.g. liver, kidney) toxicities. Dupilumab [a monoclonal antibody blocking the shared receptor subunit for interleukin (IL)-4 and IL-13] is approved for the treatment of patients with inadequately controlled, moderate-to-severe AD. In 16-week and 52-week studies, dupilumab demonstrated a positive risk/benefit profile in moderate-to-severe AD. What does this study add? This study is the first comprehensive analysis of dupilumab laboratory safety data of the 16-week SOLO 1 & 2 (pooled N = 1376) and 52-week CHRONOS (N = 740) trials, demonstrating an absence of clinically important changes in haematology, serum chemistry and urinalysis parameters in patients with moderate-to-severe AD treated with dupilumab. Our data support the use of dupilumab as a systemic treatment for the long-term management of moderate-to-severe AD without routine laboratory monitoring in clinical practice.
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Meta Analysis Comparative Study
Conventional and combination topical photodynamic therapy for basal cell carcinoma: systematic review and meta-analysis.
Topical photodynamic therapy (PDT) is an established treatment option for low-risk basal cell carcinoma (BCC). ⋯ PDT is an effective treatment for low-risk BCC, with excellent cosmesis and safety. Imiquimod has higher efficacy than single-cycle PDT but more adverse effects. Highest efficacy is with excisional surgery. Fractionated and combination PDT options warrant further study.
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Review Meta Analysis Comparative Study
Comparative efficacy of biological treatments for moderate-to-severe psoriasis: a network meta-analysis adjusting for cross-trial differences in reference arm response.
Multiple biological therapies are approved for the treatment of moderate-to-severe psoriasis. ⋯ A model adjusted for reference arm response rates was found to fit clinical trial data significantly better than unadjusted models.
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Review Meta Analysis
The surface area of the hand and the palm for estimating percentage of total body surface area: results of a meta-analysis.
The estimation of body surface area involvement is an important tool. Hand surface area (HSA) or palm surface area (PSA) is commonly used for the estimate, with an assumption that HSA represents 1% of the total body surface area (TBSA). ⋯ The use of HSA equating to 1% TBSA results in an overestimate for adults (particularly women) and an underestimate for children. PSA equating to 0.5% TBSA appears to be suitable for adults. Patient variables including sex and BMI result in variation of HSA as a percentage of TBSA. The heterogeneity of the included studies and the lack of data for children are the major limitations of this study.
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Review Meta Analysis
Overall treatment success after treatment of primary superficial basal cell carcinoma: a systematic review and meta-analysis of randomized and nonrandomized trials.
Several noninvasive treatment modalities are available for superficial basal cell carcinoma (sBCC). ⋯ Pooled estimates from randomized and nonrandomized studies showed similar tumour-free survival at 1 year for imiquimod and PDT. The PDT tumour-free survival was higher in studies with repeated treatments. However, these results were largely derived from nonrandomized studies, and randomized studies with head-to-head comparison of imiquimod and PDT are lacking. There is a need for head-to-head comparison studies between PDT, imiquimod and other treatments with long-term follow-up to enable better recommendations for optimal sBCC treatment.