Effect of upadacitinib on atopic hand eczema in patients with moderate-to-severe atopic dermatitis:Results from two randomized phase 3 trials

BACKGROUND: Approximately 60% of patients with atopic dermatitis have involvement of the hands adding to the burden of disease.OBJECTIVE: This analysis aims to evaluate the effect of upadacitinib monotherapy on atopic hand eczema in patients with moderate-to-severe AD over 16 weeks in the Measure Up 1 and 2 studies.METHODS: Data from patients (ages 12-75) randomized 1:1:1 to receive upadacitinib 15 mg, 30 mg, or placebo once daily in the Measure Up 1 and 2 studies were analysed for impact on atopic hand eczema assessed using the Hand Eczema Severity Index (HECSI). The percent change from baseline in HECSI score was a prespecified additional endpoint at all visits. The proportion of patients with at least a 75% improvement in HECSI score (HECSI 75) was evaluated post hoc.RESULTS: Patients treated with upadacitinib 15 mg or 30 mg experienced greater improvement in HECSI score compared with placebo as early as Week 1, which was maintained through Week 16. At Week 16, the mean change from baseline in HECSI score for patients receiving upadacitinib 15 mg, 30 mg, and placebo was -68%, -74%, and -15% in Measure Up 1 and -68%, -74% and +21% (positive change indicates worsening for placebo) in Measure Up 2, respectively. A greater proportion of upadacitinib-treated patients achieved HECSI 75 compared with placebo at all timepoints beginning at Week 1 through Week 16.CONCLUSIONS: Upadacitinib 15 mg and 30 mg monotherapy provided rapid and sustained improvement in atopic hand eczema compared with placebo through Week 16 in patients with moderate-to-severe AD. At Week 16, the observed mean improvements in HECSI score in upadacitinib-treated patients were clinically meaningful based on previous interpretability studies. These results suggest that upadacitinib may be an effective treatment option for atopic hand eczema in patients with moderate-to-severe AD.</p

International Consensus Conference on Atopic Dermatitis II (ICCAD II * ): clinical update and current treatment strategies

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74915/1/j.1365-2133.148.s63.1.x.pd

28043 Roflumilast cream significantly improves chronic plaque psoriasis in patients with steroid-sensitive area involvement

Roflumilast cream is a nonsteroidal, selective phosphodiesterase-4 inhibitor in development for plaque psoriasis (PsO). A double-blind, phase 2b trial randomized adults with PsO to once daily roflumilast 0.3%, 0.15%, or vehicle for 12 weeks (NCT03638258).(1) Efficacy was assessed using Investigator Global Assessment (IGA), Worst Itch Numeric Rating Scale (WI–NRS), and Psoriasis Symptom Diary (PSD). This posthoc analysis reports efficacy and safety in patients with steroid-sensitive area involvement (plaques on the face, neck, or in intertriginous areas). Of 331 patients, 160 had steroid-sensitive area involvement. The primary endpoint in the study, IGA status clear/almost clear at Week 6 was met by 27.2% patients with steroid sensitive areas (P =.007 vs vehicle), 22.3% (P =.026), and 6.3% on roflumilast 0.3%, roflumilast 0.15%, and vehicle, respectively; relative to 30.1% (P =.026), 24.1% (P =.098), and 12.0% patients without steroid-sensitive areas. Among patients with baseline WI–NRS score ≥4, 73.5%, 55.6%, and 32.6% of those with steroid-sensitive areas and 45.9%, 72.7%, and 23.7% of those without steroid-sensitive areas achieved a 4-point reduction with roflumilast 0.3%, 0.15%, or vehicle at Week 12. PSD improvement from baseline at Week 12 for patients with steroid-sensitive areas was -48.3 (P ˂.001), -43.1 (P =.012), and -24.9, and for patients without steroid-sensitive areas -35.7 (P =.003), -44.6 (P ˂.001), and -17.1. Most treatment emergent adverse events were mild to moderate and there was no evidence of local irritation. Once-daily roflumilast cream was well tolerated with significant improvements in investigator and patient assessed PsO outcomes in patients with steroid-sensitive area involvement on the face, neck, or intertriginous areas

Megabank found? Flanks record sea level

On Leg 101, the first international voyage for the Ocean Drilling Program, the deep-sea drilling ship JOIOES Resolution (SEDCO/BP 471) left Miami, Fla., on Jan. 31 to investigate the geology of the Bahamas. (Leg 100 tested the Resolution's readiness. See July Geotimes.) Before returning to Miami on March 14, the crew had drilled 19 holes al 11 sites and recovered 46.2% of the cored section (about 1.5 of 3.1 km cored). The scientific party wanted to test conflicting hypotheses about the development of the modern shallow water carbonate banks and intervening deep -water throughs in the Bahamas, and to study the growth patterns of carbonate slopes and their response to sea-level fluctuations. Those objectives (the 'deep ' and the 'shallow') were selected beause recent advances in interpreting the micropaleontology of shallow-water carbonate platforms, coupled with data from previous sedimentological investigations and regional and site-specific seismic surveys, now permit consistent stratigraphic comparisons in the Bahamas

A spatiotemporal Data Envelopment Analysis (S-T DEA) approach:the need to assess evolving units

One of the major challenges in measuring efficiency in terms of resources and outcomes is the assessment of the evolution of units over time. Although Data Envelopment Analysis (DEA) has been applied for time series datasets, DEA models, by construction, form the reference set for inefficient units (lambda values) based on their distance from the efficient frontier, that is, in a spatial manner. However, when dealing with temporal datasets, the proximity in time between units should also be taken into account, since it reflects the structural resemblance among time periods of a unit that evolves. In this paper, we propose a two-stage spatiotemporal DEA approach, which captures both the spatial and temporal dimension through a multi-objective programming model. In the first stage, DEA is solved iteratively extracting for each unit only previous DMUs as peers in its reference set. In the second stage, the lambda values derived from the first stage are fed to a Multiobjective Mixed Integer Linear Programming model, which filters peers in the reference set based on weights assigned to the spatial and temporal dimension. The approach is demonstrated on a real-world example drawn from software development