Introduction
Patients with moderate-to-severe atopic dermatitis (AD) who are most likely to respond to the Janus kinase (JAK) 1/2 inhibitor baricitinib (BARI) are known to have an impacted body ...surface area (BSA) ≤ 40% and severe itch (numerical rating scale NRS ≥ 7, collectively termed ‘BARI itch-dominant’ patients. Our objective is to build on our previous work by providing a body region-specific, clinical characterization of the BARI itch-dominant patient at baseline and their response to BARI 4 mg.
Methods
BREEZE-AD7 was a phase 3 trial in adults with moderate-to-severe AD receiving placebo or 2 mg or 4 mg BARI in combination with topical corticosteroids. Assessing only data from BARI itch-dominant patients, we summarized the baseline characteristics and conducted body region-specific analyses on Eczema Area and Severity Index (EASI) data in order to report the response to placebo versus BARI 4 mg within this patient subtype.
Results
BARI 4 mg was highly effective across all body regions; at week 16, 75% improvement was seen in EASI scores (EASI75), and response rates with BARI 4 mg (head/neck, 58.3%; trunk, 69.2%; upper extremities, 61.5%; lower extremities, 87.5%) all exceeded those with placebo (head/neck: 37.5%; trunk, 40.6%; upper extremities, 18.8%; lower extremities, 40.6%) as well as the overall EASI75 rates of the intent-to-treat (ITT) population (BARI, 48.0%; placebo, 23.0%). At baseline, most BARI itch-dominant patients presented with involvement of all regions (mean regional BSA 22.7%–40.3%), highest in the head and neck, mean EASI region scores of 15.7–24.0, and considerably severe sign ratings (mean EASI sub-scores: 1.4–2.3, out of 3), especially for erythema.
Conclusion
BARI itch-dominant patients exhibit AD involvement across all body regions and considerable sign severity, especially erythema. In response to BARI 4 mg, EASI quickly improved across regions, substantially more so in this subtype than in the ITT population.
Background
People with genital psoriasis may avoid close social interactions (hugs, handshakes, kisses, touching others, or being touched), which can have a significant impact on quality of life. ...Ixekizumab, an interleukin 17A antagonist, demonstrated rapid and persistent improvement in moderate‐to‐severe genital psoriasis through 52 weeks in a phase 3 trial (IXORA‐Q).
Objectives
To evaluate general touch avoidance (TA) in patients with moderate‐to‐severe genital psoriasis treated with ixekizumab through 52 weeks in the IXORA‐Q trial.
Methods
In IXORA‐Q (NCT02718898), adult patients received 80 mg ixekizumab every 2 weeks (IXE Q2W, N = 75) or placebo (PBO, N = 74) for 12 weeks. At Week 12, all patients received open‐label 80 mg ixekizumab every 4 weeks (IXE Q4W) through Week 52, with an opportunity to escalate dosing to Q2W at Weeks 24, 28, or 40. Patients used a numeric rating scale (NRS) to self‐report the degree of TA experienced over the past 2 weeks (score of 0 not at all to 10 very much). Outcomes included TA NRS score change from baseline and the proportion of patients achieving a TA NRS score of 0 through Week 52. Correlations between TA NRS scores and psoriasis outcomes were also examined.
Results
Mean (standard deviation) baseline TA NRS score was 2.7 (3.3) for IXE Q2W and 3.0 (3.5) for PBO. Among patients with a baseline TA NRS score >0, mean (standard deviation) change from baseline at Week 52 (where a lower score indicates greater improvement) and the proportion of patients who achieved a TA NRS score of 0 at Week 52 were −4.4 (3.2) 78.0% for patients treated continuously with ixekizumab (Q2W then Q4W, N = 41) and −4.1 (3.6) 62.5% for PBO/IXE Q4W (N = 40). TA NRS score improved in parallel with the majority of psoriasis outcomes examined, with the strongest positive association between the TA NRS score and Dermatology Life Quality Index total score.
Conclusions
Among patients with moderate‐to‐severe genital psoriasis, ixekizumab treatment achieves continued sustained improvement in general TA to 52 weeks.
Maternal urinary cell free fetal DNA in relation to gestational age Shaban, Mona Mohamed; Salah Eldin, Noha Mohamed; Kandil, Hisham Omar ...
Middle East Fertility Society Journal/Middle East Fertility Society Journal,
December 2016, 2016-12-00, 2016-12-01, Letnik:
21, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Objectives: To evaluate the presence of cell-free fetal DNA in the maternal urine in relation to gestational age as a potential source for non-invasive prenatal diagnosis. Material and methods: One ...hundred and sixty normal pregnant women were included in the study; 80 women pregnant with male fetuses and 80 women pregnant with female fetuses. Maternal urine of all patients was examined at 12, 16 and 20wks’ gestation for the SRY gene (sex-determining region Y) as a cffDNA (cell free fetal DNA) marker and Ribonuclease P RNA component H1 (RPPH1) as a total cfDNA (cell free DNA) marker using a quantitative real-time PCR assay. Results: SRY gene was detected in maternal urine of those pregnant with male fetuses starting from 16weeks in 25% (20/80) of cases only and in 80% of cases (64/80) at 20weeks, but it was not detected at 12weeks. All women female fetuses were negative for SRY gene. Conclusions: Cell free fetal DNA in maternal urine was not detected in early gestational age using SRY gene alone despite the use of extraction kit specific for extraction of Free-circulating nucleic acids and highly sensitive reported PCR technique. Further studies should be done to evaluate whether cell free fetal DNA in maternal urine can be detected after reaching a certain threshold in blood.
In this report, we present a case of a woman admitted in her first trimester of pregnancy with significant intraperitoneal haemorrhage from a left tubal stump remnant occurring concurrent to a viable ...intrauterine pregnancy. The patient was resuscitated and treated successfully with laparoscopic removal of her stump remnant to achieve haemostasis. However, despite extensive investigation, the pathology of her haemorrhagic stump remained inconclusive. Stump ectopic pregnancy is an established phenomenon, although it presents a diagnostic challenge when occurring as a heterotopic pregnancy. Further, persisting trophoblastic tissue is a rare but established feature of incomplete removal of ectopic pregnancy post salpingectomy. Here, we discuss challenges of diagnosis in such cases and present a case report of a presumed stump remnant heterotopic pregnancy from spontaneous conception.
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