RESUMEN
Three multicenter, randomized, double blind, parallel-group, placebo controlled studies involving 3,855 subjects established the safety and efficacy of an adapalene benzoyl peroxide topical gel in the treatment of acne for all skin types. The data from these 3 studies were pooled and the subgroup of self-identified black subjects was analyzed separately. Significantly more black subjects had IGA success with adapalene-BPO than with vehicle at week 12. Significantly more black subjects also had decreased total, inflammatory, and noninflammatory lesion counts with adapalene-BPO that were seen as early as week 1. Adapalene-BPO was well tolerated in the black subjects included in this analysis and no cases of treatment-related PIH were observed. Similar results were obtained for this subgroup as the overall population from the 3 studies. Based on the results from this analysis, adapalene-BPO is a safe and effective treatment for acne in black skin.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Peróxido de Benzoílo/uso terapéutico , Negro o Afroamericano , Naftalenos/uso terapéutico , Acné Vulgar/patología , Adapaleno , Administración Cutánea , Adolescente , Adulto , Peróxido de Benzoílo/administración & dosificación , Peróxido de Benzoílo/efectos adversos , Niño , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/uso terapéutico , Método Doble Ciego , Combinación de Medicamentos , Femenino , Geles , Humanos , Masculino , Persona de Mediana Edad , Naftalenos/administración & dosificación , Naftalenos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Adulto JovenRESUMEN
The purpose of this study was to investigate the anxiolytic effects of xanthohumol, a component of Humulus lupulus (hops), and its potential interaction with the benzodiazepine binding site on the y-aminobutyric acid (GABAA) receptor in the male Sprague-Dawley rat. This was a prospective, randomized, between-subjects experimental study. Fifty-five rats were assigned to 1 Sof 5 groups with 11 rats per group: control (vehicle), xanthohumol, midazolam, midazolam with xanthohumol, and flumazenil with xanthohumol. In this study the elevated plus maze measured the behavioral components of anxiety and motor movements. A 2-tailed multivariate analysis of variance and least significant difference post hoc test was used to determine if a significant difference existed. Our data suggest that xanthohumol does not produce anxiolysis by modulation of the GABAA receptor; however, there may be a possible interaction between xanthohumol and midazolam, or xanthohumol may influence the modulation of another neurotransmitter site in the central nervous system. Alone, xanthohumol does not show significant modulation of the benzodiazepine receptor. Additional research should investigate if xanthohumol acts as a benzodiazepine GABAA partial agonist or antagonist or if it modulates another neurotransmitter system in the central nervous system.
Asunto(s)
Ansiolíticos/farmacología , Flavonoides/farmacología , Humulus , Aprendizaje por Laberinto/efectos de los fármacos , Propiofenonas/farmacología , Receptores de GABA-A/fisiología , Animales , Masculino , Ratas , Ratas Sprague-DawleyRESUMEN
Improving skin barrier function and moisturizing without irritation are important components of managing patients with atopic dermatitis. This study evaluated the safety and tolerability of a body wash and moisturizer regimen for infants and toddlers with atopic dermatitis. This was an open-label study involving 56 children (3-36 months old) with a history of atopic dermatitis. The skin care regimen (Cetaphil Restoraderm Skin Restoring Body Wash and Cetaphil Restoraderm Skin Restoring Moisturizer; Galderma Laboratories, L.P.) was used at least once daily, but no more than twice daily, for 4 weeks. The primary variable of interest was the worst postbaseline scores for local tolerability (expressed as success or failure) using a 4-point scale for each component (erythema, edema, scaling and dryness, rash, and signs of discomfort upon application). Assessments of moisture content of the stratum corneum and transepidermal water loss were also performed. Fifty-three children completed the study. The percentage of subjects with no erythema increased from 33.9% to 50.0% by Week 4. The percentage of subjects with no scaling or dryness increased from 58.9% to 85.2% at Week 4. A statistically significant increase in corneometry from baseline (p < 0.001) and a statistically significant decrease in transepidermal water loss (p = .009) were observed. The body wash and moisturizer regimen was safe and well tolerated and improved hydration and skin barrier function in infants and toddlers as young as 3 months of age with a history of atopic dermatitis.
Asunto(s)
Dermatitis Atópica/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Crema para la Piel/efectos adversos , Jabones/efectos adversos , Preescolar , Edema/inducido químicamente , Eritema/inducido químicamente , Exantema/inducido químicamente , Femenino , Humanos , Lactante , Masculino , Cuidados de la Piel/métodos , Resultado del Tratamiento , Pérdida Insensible de Agua/efectos de los fármacosRESUMEN
Topical retinoids are believed to increase inflammatory lesions within the first few weeks of treatment. We evaluated data from several clinical trials for evidence of a signal for retinoid aggravation of inflammatory lesions using a psychometric method and the proportion of participants who demonstrated varying degrees of increased lesion counts. We first determined the validity of a psychometric method based on Stevens' power law called the visual logarithmic scale (VLS) used to evaluate the perceived changes in inflammatory lesions. There was concurrence between the VLS model and the dermatologists' visual assessment of a flare in 80.0% (32/40) of participants (P=.0258). A subsequent analysis was performed using data from clinical trials to assess the occurrence of flares using the VLS model or percentage-based definitions (5%, 10%, or 20% increase) following the first week of treatment with various adapalene gel formulations. In this analysis, no evidence of worsening or a flare was seen by either the VLS model or percentage-based definitions. The VLS model is valid for assessing the changes in acne severity. Topical retinoid treatment was not associated with a flare as measured by either the VLS model or the proportion of participants who showed an increase in inflammatory lesions.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Acné Vulgar/patología , Psicometría , Retinoides/uso terapéutico , Administración Tópica , Humanos , Retinoides/administración & dosificación , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
BACKGROUND: Triple combination (TC) cream is a stable combination of fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05% and is currently the only hydroquinone-containing drug approved by the Food and Drug Administration for the treatment of melasma. OBJECTIVE: To evaluate the safety and efficacy of TC cream when used sequentially with intense pulsed light (IPL) treatments in patients with moderate to severe melasma. MATERIALS & METHODS: This was a 10-week, split-face study in which 56 patients with symmetrical melasma lesions were treated with TC cream on one side of the face and an inactive control cream on the other side of the face. Patients also had two IPL treatments at weeks 2 and 6. (Topical treatment was suspended during IPL treatments ± 1 day.) RESULTS: Melasma severity was significantly less with TC cream and IPL than with inactive cream and IPL at weeks 6 (p=.007) and 10 (p=.002). Improvement in melasma was greater with TC cream and IPL than with inactive cream and IPL according to investigator and patient evaluations at weeks 6 and 10 (p<.001 for both time points). Treatment with TC cream and IPL was well tolerated. CONCLUSION: The results of this study suggest that TC cream and IPL treatment is an effective and safe treatment option for patients with melasma.
Asunto(s)
Fluocinolona Acetonida/administración & dosificación , Hidroquinonas/administración & dosificación , Terapia por Luz de Baja Intensidad , Melanosis/terapia , Tretinoina/administración & dosificación , Adulto , Anciano , Antiinflamatorios/administración & dosificación , Terapia Combinada , Femenino , Humanos , Queratolíticos/administración & dosificación , Masculino , Melanosis/patología , Persona de Mediana Edad , Protectores contra Radiación/administración & dosificaciónRESUMEN
BACKGROUND: Psoriasis is a hyperproliferative and inflammatory skin disorder that affects roughly 2 percent of the worldwide population. Clobetasol propionate is the most common corticosteroid used to treat moderate-to-severe psoriasis but the potential for side effects limits its long-term use. Topical vitamin D, which is used to treat mild-to-moderate psoriasis, has been shown to be safe when used daily for up to 52 weeks. To date, very few studies exist evaluating the use of clobetasol propionate in a regimen with calcitriol to manage moderate-to-severe disease over time. OBJECTIVES: To evaluate the efficacy and assess safety of a regimen of sequential topical treatments with clobetasol propionate 0.05% spray for up to four weeks followed by calcitriol 3 µg/g ointment for eight weeks in the management of moderate-to-severe plaque psoriasis. METHODS: This was a multi-center, open-label study in subjects aged 18-80 years with moderate-to-severe plaque psoriasis at baseline. Subjects applied clobetasol propionate 0.05% spray twice daily for up to four weeks. At the end of four weeks, if the subject's overall disease severity (ODS) was assessed as clear, almost clear, mild or moderate, subjects started treatment with calcitriol 3 µg/g ointment twice daily. Twice-daily treatment with calcitriol 3 µg/g ointment continued for eight weeks (until week 12) or unless the subject's ODS was assessed as severe or returned to the baseline score, at which time it was discontinued. Subjects were evaluated at baseline and at weeks 2, 4, 8 and 12. RESULTS: Of the 305 subjects enrolled, 170 subjects completed the full 12-week study with no major protocol deviations and comprised the per-protocol (PP) study population. Treatment success, defined as at least one grade improvement in ODS at week 12 compared to baseline, was achieved in 84.1 percent of subjects. The percent body surface area affected (% BSA) decreased from 7.1 percent at baseline to 3.9 percent at week 12 (P<0.001). The sequential treatment regimen was well tolerated with no unexpected adverse events. Most reported adverse events and cutaneous irritations were mild in severity. CONCLUSIONS: The results of this study indicate that the 12-week regimen of clobetasol propionate 0.05% spray treatment for four weeks immediately followed by an eight-week treatment phase with calcitriol 3 µg/g ointment is efficacious and safe for the management of moderate-to-severe plaque psoriasis.
Asunto(s)
Antiinflamatorios/administración & dosificación , Calcitriol/administración & dosificación , Clobetasol/administración & dosificación , Psoriasis/tratamiento farmacológico , Vitaminas/administración & dosificación , Administración Cutánea , Antiinflamatorios/efectos adversos , Calcitriol/efectos adversos , Clobetasol/efectos adversos , Progresión de la Enfermedad , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Masculino , Factores de Tiempo , Resultado del Tratamiento , Vitaminas/efectos adversosRESUMEN
The purpose of this study was to assess the cosmetic appearance of commonly marketed facial cosmetics when used after the application of metronidazole gel 1%. An observational. open-label, single-site study was conducted with women (N=30) aged 20 to 75 years and diagnosed with moderate papulopustular rosacea (investigator global severity score of 3). After cleansing the face with a gentle skin cleanser, participants applied metronidazole gel 1% once daily before applying their usual facial foundation. Two surveys were conducted: (1) investigator assessment of cosmetic appearance; and (2) participant assessment of cosmetic appearance. The investigator also evaluated erythema, disease severity, and tolerability at baseline and week 2. Adverse events were collected. The 28 per-protocol (PP) participants had a mean age (standard deviation [SD]) of 54.0 (10.3) years and a mean duration (SD) of rosacea of 15.4 (13.2) years. The median response score for both the investigator and participant assessments of cosmetic appearance was 10 (best) for each survey question. Signs and symptoms of rosacea did not increase with use of metronidazole gel 1% and the participants' selected cosmetic regimen. At baseline all 28 participants were classified as having moderate erythema. At week 2, 18 (64%) participants were classified as having moderate erythema and 10 (36%) mild. At baseline all 28 (100%) participants were classified as having moderate rosacea according to the investigator global severity score. At week 2, 10 (36%) participants were classified as mild and 18 (64%) moderate. In addition, few participants reported cutaneous irritation during the study. At week 2, 10 participants had dryness, 2 had itching, 8 had scaling, and 2 had stinging/burning. According to surveys completed by the investigator and the participants themselves, most participants had a good cosmetic appearance with their facial foundation cosmetics that were applied after metronidazole gel 1%. The use of various cosmetic regimens after application of metronidazole gel 1% did not cause rosacea symptoms to worsen and treatment was well-tolerated.
Asunto(s)
Cosméticos/administración & dosificación , Fármacos Dermatológicos/administración & dosificación , Metronidazol/administración & dosificación , Rosácea/tratamiento farmacológico , Administración Cutánea , Adulto , Anciano , Cosméticos/efectos adversos , Cosméticos/química , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/uso terapéutico , Eritema/etiología , Femenino , Geles , Humanos , Metronidazol/efectos adversos , Metronidazol/uso terapéutico , Persona de Mediana Edad , Rosácea/patología , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
High-potency topical corticosteroids are the cornerstone of psoriasis therapy. Although highly effective, long-term use of topical steroids can cause adverse side effects. Additionally, steroids alone do not address the multiple pathophysiologic factors that cause the disease. Psoriasis regimens that utilize high-potency steroids combined with nonsteroid-containing products such as vitamin D analogs have been used for many years to manage the disease, not only for the short-term treatment of the disease but also for long-term treatment to minimize the recurrence of symptoms. We report an open-label, multicenter study designed to evaluate a weekday/ weekend treatment regimen involving calcitriol ointment 3 microg/g and clobetasol propionate spray 0.05% for moderate plaque psoriasis. Participants applied calcitriol ointment 3 microg/g twice daily on the weekdays and clobetasol propionate spray 0.05% twice daily on the weekends for up to 4 weeks. Participants were evaluated at baseline, week 2, and week 4. The results of this study demonstrate that a 4-week regimen of calcitriol ointment 3 microg/g treatment on weekdays and clobetasol propionate spray 0.05% on weekends is effective and well-tolerated for the treatment of moderate plaque psoriasis.
Asunto(s)
Calcitriol/uso terapéutico , Clobetasol/uso terapéutico , Psoriasis/tratamiento farmacológico , Administración Cutánea , Adolescente , Adulto , Anciano , Calcitriol/administración & dosificación , Calcitriol/efectos adversos , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Esquema de Medicación , Quimioterapia Combinada , Femenino , Glucocorticoides/administración & dosificación , Glucocorticoides/efectos adversos , Glucocorticoides/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Satisfacción del Paciente , Psoriasis/patología , Resultado del Tratamiento , Vitaminas/administración & dosificación , Vitaminas/efectos adversos , Vitaminas/uso terapéutico , Adulto JovenRESUMEN
Psoriasis is a chronic condition with serious quality-of-life ramifications. Dermatologists seek alternative treatments of patients with plaque psoriasis that provide both efficacy and safety while minimizing exposure to high-potency steroids that can have adverse effects following long-term use. We report an open-label, multicenter study designed to evaluate a morning/evening (AM/PM) treatment regimen involving clobetasol propionate spray 0.05% and calcitriol ointment 3 microg/g for moderate plaque psoriasis. Participants applied clobetasol propionate spray 0.05% in the morning and calcitriol ointment 3 microg/g in the evening for up to 4 weeks. Participants were evaluated at baseline, week 2, and week 4. The results of this study indicate that a 4-week regimen of clobetasol propionate spray 0.05% treatment in the morning and calcitriol ointment 3 microg/g in the evening is efficacious and without unexpected safety issues for the management of moderate plaque psoriasis.
Asunto(s)
Calcitriol/administración & dosificación , Clobetasol/administración & dosificación , Glucocorticoides/administración & dosificación , Psoriasis/tratamiento farmacológico , Vitaminas/administración & dosificación , Administración Cutánea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Psoriasis/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Melasma is often recalcitrant to treatment. Triple combination (TC) cream is an effective and approved treatment for melasma. OBJECTIVE: We sought to determine the efficacy and safety of continuous therapy followed by a maintenance treatment regimen during a period of 24 weeks with a TC cream containing hydroquinone 4%, tretinoin 0.05%, and fluocinolone acetonide 0.01%. METHODS: Seventy patients with melasma were treated with a TC cream daily for 12 weeks, after which, if clear or almost clear, they applied the cream twice per week for 12 more weeks. For patients who were not clear or almost clear after 12 weeks, daily treatment was continued. RESULTS: In all, 25 patients completing the study per protocol were treated daily for 24 weeks (cohort A); 6 patients were treated daily for 12 weeks followed by 12 weeks of maintenance therapy (cohort B); and 21 patients were treated daily for 12 weeks, relapsed during the maintenance phase, and returned to daily dosing (cohort C). Pigmentation was significantly reduced at weeks 12 and 24 and global melasma severity improved at week 24 in cohorts A and C compared with baseline. Adverse events occurred in 53% of patients and were primarily mild in severity. LIMITATIONS: This was an open-label trial. CONCLUSION: About half of patients treated with a TC cream for melasma were able to begin maintenance therapy twice per week after 12 weeks; however, relapses occurred in most of these patients, requiring resumption of daily therapy. The cream is safe in the treatment of moderate to severe melasma for up to 24 weeks when used intermittently or continuously. Significant reductions in melasma severity scores were seen at weeks 12 and 24 when compared with baseline scores in all evaluable study groups.
Asunto(s)
Fluocinolona Acetonida/administración & dosificación , Hidroquinonas/administración & dosificación , Melanosis/tratamiento farmacológico , Tretinoina/administración & dosificación , Administración Tópica , Adolescente , Adulto , Anciano , Esquema de Medicación , Combinación de Medicamentos , Femenino , Fluocinolona Acetonida/efectos adversos , Humanos , Hidroquinonas/efectos adversos , Masculino , Melanosis/patología , Persona de Mediana Edad , Pomadas , Pigmentación de la Piel , Tretinoina/efectos adversos , Adulto JovenRESUMEN
Melasma is a common disorder affecting a significant percentage of the population, particularly those with skin of color. Therapy with hydroquinone, a depigmenting agent, as a single agent or in combination with other agents has been used with variable success. A triple-combination (TC) cream combining hydroquinone 4% with tretinoin 0.05% and fluocinolone acetonide 0.01% was developed for the treatment of melasma. We studied the use of TC cream for 24 weeks and had tissue samples for all time points in 62 patients with moderate to severe melasma. The atrophogenic potential of TC cream was evaluated through serial histopathologic examination of skin biopsies. No statistically significant histopathologic signs of atrophy of the epidermis or dermis were noted at any time point throughout the study. There was a marked reduction in epidermal melanin in treated subjects; however, we did not observe any significant difference in baseline and treated samples in the amount of perivascular inflammatory infiltrate, dermal mucin, keratinocyte and melanocyte atypia, or mast cells, consistent with findings of previous studies where topical retinoids were used. An increase in the mean number of blood vessels per square millimeter of tissue was observed in 2 study cohorts between baseline and week 24. These results suggest that the risk of skin atrophy with 24-week use of TC cream for the treatment of melasma is very low.
Asunto(s)
Fármacos Dermatológicos/efectos adversos , Fluocinolona Acetonida/efectos adversos , Hidroquinonas/efectos adversos , Melanosis/tratamiento farmacológico , Piel/patología , Tretinoina/efectos adversos , Administración Cutánea , Adulto , Atrofia , Fármacos Dermatológicos/administración & dosificación , Combinación de Medicamentos , Femenino , Fluocinolona Acetonida/administración & dosificación , Humanos , Hidroquinonas/administración & dosificación , Masculino , Persona de Mediana Edad , Tretinoina/administración & dosificaciónRESUMEN
Topical corticosteroids are widely used in the treatment of psoriasis. This study was conducted to compare the efficacy and safety of clobetasol propionate (CP) 0.005% spray to calcipotriene 0.005%-betamethasome diproprionate 0.064% (C-BD) ointment in patients with moderate to severe plaque psoriasis. Assessments were made at baseline, week 2, week 4 (end of treatment) and week 8 (4 weeks posttreatment). An assessment for Overall Disease Severity (ODS) found that 75% of CP spray-treated patients achieved a rating of clear or almost clear after 4 weeks of treatment compared to 45% of C-BD ointment-treated patients (P=.003). Adverse events were reported by less than one-third of patients from each treatment group (31% for CP spray and 33% for C-BD ointment).
Asunto(s)
Antiinflamatorios/uso terapéutico , Betametasona/análogos & derivados , Calcitriol/análogos & derivados , Clobetasol/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Administración Tópica , Adulto , Antiinflamatorios/administración & dosificación , Antiinflamatorios/efectos adversos , Betametasona/administración & dosificación , Betametasona/efectos adversos , Betametasona/uso terapéutico , Calcitriol/administración & dosificación , Calcitriol/efectos adversos , Calcitriol/uso terapéutico , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Quimioterapia Combinada , Femenino , Glucocorticoides , Humanos , Masculino , Persona de Mediana Edad , Pomadas , Satisfacción del Paciente , Psoriasis/patología , Calidad de VidaRESUMEN
Moderate to severe psoriasis often requires systemic treatment, but even biologic medications do not always induce complete clearing in patients. In many instances, physicians supplement biologic treatment with topical agents as adjunctive therapy to obtain additional clearing of plaques. To evaluate the effectiveness of the addition of a superpotent corticosteroid--clobetasol propionate spray 0.05%--to various psoriasis treatments, a phase 4, multicenter, open-label, community-based trial was conducted. In this study, clobetasol propionate spray 0.05% applied twice daily was added on to a variety of existing stable treatments including systemic biologic agents in participants with moderate, severe, or very severe plaque psoriasis. The decision to add clobetasol propionate spray 0.05% to stable psoriasis therapy was determined by each investigator based on his/her evaluation of a participant's needs. A total of 159 participants from the trial adhered to stable (> or = 3 months' duration) therapeutic regimens that included a biologic treatment. In this population, at the end of the study period, 81.0% of participants with moderate disease at baseline, 79.5% of participants with severe disease at baseline, and 58.8% of participants with very severe disease at baseline were rated as clear or almost clear (target plaque severity [TPS]). Worst skin tolerability response was assessed postbaseline and included erythema (20.3% mild, 8.9% moderate, 1.9% severe), peeling (26.6% mild, 7.0% moderate, 1.3% severe), dryness (34.8% mild, 8.9% moderate, 1.3% severe), and stinging (25.3% mild, 3.8% moderate, 0.6% severe). Telangiectasia and skin atrophy were reported in 1.3% of participants each at some point during the study (postbaseline). Pruritus was reported in 7.6% of participants and folliculitis was reported in 1.9% of participants. Eight participants experienced adverse events (AEs) that were regarded as probably related to the study medication (clobetasol propionate spray 0.05%). Because those participants who entered the study already were receiving one medication (the biologic agent), it is believed that most of the reported AEs were due to the addition of clobetasol propionate spray 0.05%, and those AEs associated with the biologic agent and/or the combination of the two may be underreported. Although the results of this study are intriguing, further research is needed to evaluate if the addition of topical therapies, such as superpotent corticosteroids, are effective and safe options for treating psoriasis plaques when control with biologic therapy is not fully effective on its own.
Asunto(s)
Antiinflamatorios/uso terapéutico , Productos Biológicos/uso terapéutico , Clobetasol/uso terapéutico , Psoriasis/tratamiento farmacológico , Administración Cutánea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antiinflamatorios/administración & dosificación , Antiinflamatorios/efectos adversos , Productos Biológicos/administración & dosificación , Productos Biológicos/efectos adversos , Clobetasol/administración & dosificación , Clobetasol/efectos adversos , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/fisiopatología , Calidad de Vida , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
A variety of topical retinoids is available for the treatment of acne vulgaris. Selection of the appropriate treatment depends not only on efficacy but also on how well the patient can tolerate different formulations. The goal of this study was to evaluate the efficacy and tolerability of daily adapalene 0.1% gel compared to daily tazarotene 0.1% cream and to demonstrate the noninferiority of adapalene 0.1% gel when compared to tazarotene 0.1% cream in treating acne. This represents 2 arms of a 3-arm study. Subjects 12 to 35 years of age with acne vulgaris (N=202) participated in a 12-week, randomized, evaluator-blinded study of once-daily therapy with adapalene 0.1% gel versus tazarotene 0.1% cream. The primary measure of efficacy was the reduction in total lesion counts posttreatment. Subjects treated with adapalene 0.1% gel achieved similar reductions in total lesion counts at week 12 compared to the subjects treated with the tazarotene cream, which demonstrates the noninferiority of adapalene treatment compared to tazarotene (median difference: -1.18%; lower confidence limit [LCL]: -9.26). At week 2, the number of patients that experienced erythema and scaling with tazarotene 0.1% cream was greater when compared to adapalene 0.1% gel and statistically significant. By week 12, the percentage of subjects reporting cutaneous irritation had returned to or near baseline levels and was similar between treatment arms for all parameters assessed. Adapalene gel was associated with fewer treatment-related adverse events than tazarotene cream (36% versus 58%, respectively), and less than half as many adverse events that were "definitely" related to study treatment than tazarotene cream (20% versus 45%, respectively). Daily therapy with adapalene 0.1% gel was shown to be noninferior to tazarotene 0.1% cream in total acne lesion reductions, and during initial stages of treatment, demonstrated better tolerability with respect to erythema and scaling.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Naftalenos/uso terapéutico , Ácidos Nicotínicos/uso terapéutico , Acné Vulgar/patología , Adapaleno , Adolescente , Adulto , Niño , Fármacos Dermatológicos/efectos adversos , Método Doble Ciego , Eritema/inducido químicamente , Eritema/patología , Femenino , Humanos , Masculino , Naftalenos/efectos adversos , Ácidos Nicotínicos/efectos adversos , Piel/patologíaRESUMEN
Topical retinoids, such as adapalene gel and tazarotene cream, are considered first-line therapy for the treatment of acne vulgaris. Dermatologists often initiate adapalene gel treatment first, due to its good tolerability, followed by a switch to tazarotene cream in an effort to improve or hasten efficacy outcomes. The goal of this study was to compare the efficacy and safety of 2 daily regimens for the treatment of acne: adapalene 0.1% gel for 12 weeks and adapalene 0.1% gel for 6 weeks followed by tazarotene 0.1% cream for 6 weeks. The primary efficacy outcome was the percent of reduction in total lesion counts posttreatment. Subjects ages 12 to 35 years with acne vulgaris were selected to participate in a 12-week, randomized, evaluator-blind study of once-daily therapy with adapalene 0.1% gel (n=101) or "switch therapy," adapalene 0.1% gel followed by tazarotene 0.1% cream (n=100). Adapalene-treated subjects achieved similar percent reductions in total lesion counts at week 12 compared to subjects receiving switch therapy, demonstrating the noninferiority of adapalene gel treatment (median difference: -3.57%; lower confidence limit [LCL]: -11.25). Adapalene gel was associated with fewer reports of cutaneous irritation, particularly for scaling and stinging/burning, and fewer treatment-related adverse events compared to switch therapy. The results of this study indicate that daily therapy with adapalene 0.1% gel for 12 weeks was noninferior to switch therapy.
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Fármacos Dermatológicos/uso terapéutico , Naftalenos/uso terapéutico , Ácidos Nicotínicos/uso terapéutico , Retinoides/uso terapéutico , Acné Vulgar/patología , Adapaleno , Administración Tópica , Adolescente , Adulto , Niño , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Método Doble Ciego , Eritema/inducido químicamente , Femenino , Geles , Humanos , Masculino , Naftalenos/administración & dosificación , Naftalenos/efectos adversos , Ácidos Nicotínicos/administración & dosificación , Ácidos Nicotínicos/efectos adversos , Retinoides/administración & dosificación , Retinoides/efectos adversos , Piel/patología , Encuestas y CuestionariosRESUMEN
Triple-combination (TC) cream is a stable combination of fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05%, and currently is the only US Food and Drug Administration-approved drug for the topical treatment of melasma. Furthermore, it is the only US Food and Drug Administration-approved product containing hydroquinone. Anecdotal evidence suggests that improvements in melasma can be achieved with a multifactor approach involving TC cream with a variety of procedures. A pilot study was designed to evaluate the efficacy and safety of sequential treatment with TC cream and a series of glycolic acid (GA) peels in participants with moderate to severe melasma. Participants were treated with TC cream for 2 weeks before the alternating sequential treatment cycles with TC cream and GA peels began. A total of six 2-week cycles of TC cream and 5 GA peels were used. Efficacy and safety evaluations were conducted at weeks 6 and 12. Investigator global assessment (IGA) ratings indicated that 1 of 20 participants (5%) had achieved treatment success (clear/almost clear) as early as week 6 and most participants had achieved treatment success by week 12 (65% [13/20]; P < .001 vs baseline). Objective absorption spectrometry measurements of the difference in melanin for involved versus uninvolved skin confirmed that hyperpigmentation was significantly reduced in participants at weeks 6 and 12 compared with baseline (P < .001 for both). Investigator and participant evaluations revealed that most participants (> or = 90%) showed improvement (excellent improvement, much improved, improved) by week 12 with alternating sequential treatment with TC cream and GA peels. Furthermore, the results of this study indicated that sequential treatment with TC cream and GA peels was well-tolerated.
Asunto(s)
Quimioexfoliación/métodos , Fármacos Dermatológicos/administración & dosificación , Melanosis/tratamiento farmacológico , Administración Cutánea , Adulto , Fármacos Dermatológicos/efectos adversos , Combinación de Medicamentos , Quimioterapia Combinada , Femenino , Fluocinolona Acetonida/administración & dosificación , Fluocinolona Acetonida/efectos adversos , Estudios de Seguimiento , Glicolatos/administración & dosificación , Glicolatos/efectos adversos , Humanos , Hidroquinonas/administración & dosificación , Hidroquinonas/efectos adversos , Masculino , Persona de Mediana Edad , Pomadas , Proyectos Piloto , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Tretinoina/administración & dosificación , Tretinoina/efectos adversosRESUMEN
Topical therapy for rosacea aims to reduce inflammatory lesions and decrease erythema but can carry side effects such as stinging, pruritus, and burning. Metronidazole and azelaic acid gel 15% are U.S. Food and Drug Administration-approved for the treatment of rosacea. The current study was conducted to assess the cumulative irritation potential of 2 formulations of metronidazole 0.75% gel and 1% gel--and azelaic acid gel 15% over 21 days (N=36). Results of this study demonstrated a significantly greater poten tial for irritation from azelaic acid compared with metronidazole gel 0.75% (P < .0001), which had significantly greater potential for irritation compared with metronidazole gel 1% (P = .0054). Metronidazole gel 1% had a similar profile to white petrolatum.
Asunto(s)
Fármacos Dermatológicos/efectos adversos , Ácidos Dicarboxílicos/efectos adversos , Erupciones por Medicamentos/etiología , Metronidazol/efectos adversos , Rosácea/tratamiento farmacológico , Administración Tópica , Adulto , Fármacos Dermatológicos/administración & dosificación , Ácidos Dicarboxílicos/administración & dosificación , Femenino , Geles , Humanos , Masculino , Metronidazol/administración & dosificación , Persona de Mediana Edad , Método Simple CiegoRESUMEN
BACKGROUND: Natural killer (NK) cells are a third population of lymphocytes that can kill certain tumor cells. This killing is regulated by signals received through activating and inhibitory receptors. 2B4 (CD244), a member of the CD2 subset of Immunoglobulin superfamily, was identified as an activating receptor on NK cells. Interaction of 2B4 with its ligand CD48 or anti-2B4 mAb stimulates NK cell cytolytic function as well as production of INF-gamma. MATERIALS AND METHODS: A murine tumor model was used to study the in vivo role of 2B4. 2B4 and CD48 were activated in vivo by injecting anti-2B4 and anti-CD48 monoclonal antibodies. RESULTS: Activation of 2B4 or CD48 resulted in a five-fold reduction in tumor metastasis. IFN-gamma knockout mice had a two-fold increase in metastasis as compared to wild-type after 2B4 activation. CONCLUSION: Activation of 2B4 and CD48 reduces metastasis of B16F10 melanoma cells and this anti-tumor effect involves both cytolytic function and cytokine production.
Asunto(s)
Antígenos CD/inmunología , Células Asesinas Naturales/inmunología , Melanoma Experimental/inmunología , Glicoproteínas de Membrana/inmunología , Receptores Inmunológicos/inmunología , Animales , Antígenos CD28/inmunología , Interferón gamma/biosíntesis , Interferón gamma/inmunología , Interferón gamma/metabolismo , Activación de Linfocitos/inmunología , Melanoma Experimental/secundario , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Familia de Moléculas Señalizadoras de la Activación LinfocitariaRESUMEN
Two advanced formulations of clobetasol propionate (CP) 0.05% (Clobex Spray; Galderma Laboratories, L.P., Fort Worth, TX, USA and Olux Foam; Stiefel/Connetics Corp., Coral Gables, FL, USA) were compared in a study of 77 randomized patients with moderate to severe plaque psoriasis. At the end of the treatment period (2 weeks for CP foam or up to 4 weeks for CP spray per product labeling), patients treated with CP spray had a median 64% reduction in affected body surface area (BSA) compared to a median 25% reduction in patients treated with the CP foam (p = 0.004). Also at the end of the treatment period, 22% of CP spray-treated patients were completely clear compared to 5% of CP foam-treated patients (p = 0.04). Improvements in quality of life as determined by the Dermatology Life Quality Index were statistically significantly greater at all time points for patients treated with CP spray compared to patients treated with CP foam (p<0.04 for all). The majority of adverse events for both products were mild in severity. Thus, while both of these formulations contain the same active ingredient at the same concentration, differences in their efficacy were observed when each treatment was used within its approved labeling guidelines.