ABSTRACT
After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.
ABSTRACT
BACKGROUND: The past 5 years have seen a proliferation of new treatments for atopic dermatitis (AD). We analyzed recent drug survival data for cyclosporine in this setting. Because the Spanish National Healthcare system requires patients with AD to be treated with cyclosporine before they can be prescribed other systemic treatments, drug survival for cyclosporine may be shorter than in other diseases. MATERIAL AND METHOD: Multicenter, observational, prospective cohort study using data from the Spanish Atopic Dermatitis Registry (BIOBADATOP). Data from the Spanish Registry of Systemic Treatments in Psoriasis (BIOBADADERM) were used to create a comparison cohort. RESULTS: We analyzed data for 130 patients with AD treated with cyclosporine (median drug survival, 1 year). Median cyclosporine survival in the psoriasis comparison group (150 patients) was 0.37 years. Drug survival was significantly longer in AD than in psoriasis (P<.001). CONCLUSION: Drug survival of cyclosporine in the BIOBADATOP registry is similar to that described in other series of patients with AD and longer than that observed in the BIOBADADERM psoriasis registry.
Subject(s)
Dermatitis, Atopic , Psoriasis , Humans , Cyclosporine/therapeutic use , Dermatitis, Atopic/drug therapy , Immunosuppressive Agents/therapeutic use , Prospective Studies , Psoriasis/drug therapy , Registries , Treatment OutcomeABSTRACT
BACKGROUND: The past 5 years have seen a proliferation of new treatments for atopic dermatitis (AD). We analyzed recent drug survival data for cyclosporine in this setting. Because the Spanish National Healthcare system requires patients with AD to be treated with cyclosporine before they can be prescribed other systemic treatments, drug survival for cyclosporine may be shorter than in other diseases. MATERIAL AND METHOD: Multicenter, observational, prospective cohort study using data from the Spanish Atopic Dermatitis Registry (BIOBADATOP). Data from the Spanish Registry of Systemic Treatments in Psoriasis (BIOBADADERM) were used to create a comparison cohort. RESULTS: We analyzed data for 130 patients with AD treated with cyclosporine (median drug survival, 1 year). Median cyclosporine survival in the psoriasis comparison group (150 patients) was 0.37 years. Drug survival was significantly longer in AD than in psoriasis (P<.001). CONCLUSION: Drug survival of cyclosporine in the BIOBADATOP registry is similar to that described in other series of patients with AD and longer than that observed in the BIOBADADERM psoriasis registry.
Subject(s)
Dermatitis, Atopic , Psoriasis , Humans , Cyclosporine/therapeutic use , Dermatitis, Atopic/drug therapy , Immunosuppressive Agents/therapeutic use , Prospective Studies , Psoriasis/drug therapy , Registries , Treatment OutcomeABSTRACT
BACKGROUND: In recent years, remarkable improvements in our understanding of atopic dermatitis (AD) have revolutionized treatment perspectives, but access to reliable data from clinical practice is essential. MATERIALS AND METHOD: The Spanish Atopic Dermatitis Registry, BIOBADATOP, is a prospective, multicenter database that collects information on patients of all ages with AD requiring systemic therapy with conventional or novel drugs. We analyzed the registry to describe patient characteristics, diagnoses, treatments, and adverse events (AEs). RESULTS: We studied data entries for 258 patients who had received 347 systemic treatments for AD. Treatment was discontinued in 29.4% of cases, mostly due to a lack of effectiveness (in 10.7% of cases). A total of 132 AEs were described during follow-up. Eighty-six AEs (65%) were linked to a systemic treatment, most commonly dupilumab (39AEs) and cyclosporine (38AEs). The most common AEs were conjunctivitis (11patients), headache (6), hypertrichosis (5), and nausea (4). There was 1severe AE (acute mastoiditis) associated with cyclosporine. CONCLUSIONS: Initial findings on AEs from the Spanish BIOBADATOP registry are limited by short follow-up times precluding comparisons or calculation of crude and adjusted incidence rates. At the time of our analysis, no severe AEs had been reported for novel systemic therapies. BIOBADATOP will help answer questions on the effectiveness and safety of conventional and novel systemic therapies in AD.
Subject(s)
Dermatitis, Atopic , Humans , Dermatitis, Atopic/drug therapy , Dermatitis, Atopic/epidemiology , Prospective Studies , Cyclosporine/therapeutic use , Administration, Cutaneous , Registries , Treatment Outcome , Severity of Illness IndexSubject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , Conjunctivitis/epidemiology , Dermatitis, Atopic/drug therapy , Pruritus/drug therapy , Adolescent , Adult , Aged , Antibodies, Monoclonal, Humanized/adverse effects , Conjunctivitis/chemically induced , Conjunctivitis/immunology , Dermatitis, Atopic/complications , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/immunology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pruritus/diagnosis , Pruritus/immunology , Quality of Life , Retrospective Studies , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
Antecedentes y objetivo: Los ensayos pivotales de omalizumab en urticaria crónica espontánea (UCE) tienen un periodo de tratamiento de entre 12 y 24 semanas. Sin embargo, muchos pacientes en práctica clínica requieren periodos de tratamiento más prolongados. Por ello el objetivo es presentar un algoritmo de manejo del fármaco. Materiales y métodos: El documento de consenso que detallamos nace de la puesta en común, aceptación, revisión y confrontación de la literatura reciente del grupo de trabajo de UCE "Xarxa d'Urticària Catalana i Balear" (XUrCB). Resultados: Se inicia el tratamiento a dosis autorizada y se ajusta la dosis en intervalos trimestrales en función del Urticaria Activity Score de los últimos 7 días (UAS7) y/o el Urticarial Control Test (UCT). Conclusiones: El algoritmo propuesto pretende servir de guía respecto a cómo ajustar dosis, cómo y cuándo parar el fármaco y el modo de reintroducirlo en casos de recaída
Background and objective: Pivotal trials with omalizumab for treatment of chronic spontaneous urticaria (CSU) are generally run over 12 to 24weeks. However, in clinical practice, many patients need longer treatment. In this article, we present an algorithm for treatment with omalizumab. Material and methods: The consensus document we present is the result of a series of meetings by the CSU working group of "Xarxa d'Urticària Catalana i Balear" (XUrCB) at which data from the recent literature were presented, discussed, compared, and agreed upon. Results: Treatment with omalizumab should be initiated at the authorized dose, and is adjusted at 3-monthly intervals according to the Urticaria Activity Score Over 7 days, the Urticaria Control Test, or both. Conclusions: The algorithm proposed is designed to provide guidance on how to adjust omalizumab doses, how and when to discontinue the drug, and how to reintroduce it in cases of relapse
Subject(s)
Humans , Urticaria/drug therapy , Omalizumab/administration & dosage , Algorithms , Consensus , Dosage/methods , Histamine H1 Antagonists/administration & dosage , Dose-Response Relationship, DrugABSTRACT
BACKGROUND AND OBJECTIVE: Pivotal trials with omalizumab for treatment of chronic spontaneous urticaria (CSU) are generally run over 12 to 24weeks. However, in clinical practice, many patients need longer treatment. In this article, we present an algorithm for treatment with omalizumab. MATERIAL AND METHODS: The consensus document we present is the result of a series of meetings by the CSU working group of "Xarxa d'Urticària Catalana i Balear" (XUrCB) at which data from the recent literature were presented, discussed, compared, and agreed upon. RESULTS: Treatment with omalizumab should be initiated at the authorized dose, and is adjusted at 3-monthly intervals according to the Urticaria Activity Score Over 7days, the Urticaria Control Test, or both. CONCLUSIONS: The algorithm proposed is designed to provide guidance on how to adjust omalizumab doses, how and when to discontinue the drug, and how to reintroduce it in cases of relapse.
Subject(s)
Algorithms , Anti-Allergic Agents/therapeutic use , Omalizumab/therapeutic use , Urticaria/drug therapy , Anti-Allergic Agents/administration & dosage , Chronic Disease , Humans , Omalizumab/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Acanthoma/pathology , Scrotum/pathology , Testicular Neoplasms/pathology , Pruritus/etiology , Epidermolysis Bullosa Simplex/pathology , Diagnosis, DifferentialSubject(s)
Anti-Allergic Agents/administration & dosage , Chronic Disease/drug therapy , Omalizumab/administration & dosage , Urticaria/drug therapy , Adult , Age Factors , Dose-Response Relationship, Drug , Drug Resistance , Female , Humans , Middle Aged , Retrospective Studies , Treatment Outcome , Urticaria/pathologySubject(s)
Acanthoma/diagnosis , Genital Diseases, Male/diagnosis , Neoplasms, Multiple Primary/diagnosis , Pruritus/etiology , Scrotum/pathology , Skin Neoplasms/diagnosis , Acanthoma/complications , Acanthoma/pathology , Condylomata Acuminata/diagnosis , Diagnosis, Differential , Genital Diseases, Male/complications , Genital Diseases, Male/pathology , Humans , Male , Middle Aged , Molluscum Contagiosum/diagnosis , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/pathology , Skin Neoplasms/complications , Skin Neoplasms/pathologyABSTRACT
BACKGROUND: The knowledge about chronic spontaneous urticaria (CSU) phenotypes is based on its clinical characteristics, associated comorbidities, course of the disease, and its response to the available effective drugs. Genotype expression and its further correlation with CSU phenotypes are still unknown. We describe the cutaneous transcriptome of patients suffering a severely active CSU refractory to antihistamine treatment. METHODS: Through the bioinformatic analysis of the whole Human Genome with Oligo Microarrays and quantitative real-time polymerase chain reaction (qPCR), relevant genes expressed in nonlesional (NLS-CSU) and lesional skin (LS-CSU) and peripheral blood were identified in 20 patients suffering from severely active CSU and 10 healthy controls (HCs). RESULTS: From 39 genes differentially expressed in NLS-CSU when compared with HCs, 31 (79.48%) were confirmed by qPCR corresponding to genes involved in epidermal homeostasis and dermal repair. From the analysis comparing LS-CSU with NLS-CSU, a selection of 142 genes was studied with qPCR, and 103 (72.53%) were confirmed. Differentially expressed genes in the phenomenon of wheal development are involved in a variety of biological functions as, epidermal differentiation, intracellular signal function, transcriptional factors cell cycle differentiation, inflammation, or coagulation. Differentially expressed genes that uniformly increase or decrease along the skin worsening until the wheal appearance is shown. CONCLUSION: The skin of CSU patients with a severely active disease shows an overall immunological skin involvement showing a peculiar gene profile.
Subject(s)
Gene Expression Profiling , Skin/immunology , Urticaria/immunology , Adult , Aged , Aged, 80 and over , Chronic Disease , Computational Biology , Female , Humans , Male , Middle Aged , Prospective Studies , Urticaria/genetics , Young AdultABSTRACT
INTRODUCCIÓN: Bajo el concepto de urticaria se incluye un grupo heterogéneo de entidades clasificadas según su evolución en urticaria aguda (duración inferior a 6 semanas) y urticaria crónica (duración igual o superior a 6 semanas). Las formas crónicas incluyen la urticaria crónica espontánea y las urticarias inducibles. Disponemos de un número limitado de herramientas para la monitorización de las distintas formas clínicas de urticaria y para la valoración de su impacto en la calidad de vida. Recientemente se ha creado el cuestionario Urticaria Control Test como herramienta para valorar el control de la urticaria, disponible tanto en alemán, el idioma original, como en inglés americano. OBJETIVO: Realizar la adaptación transcultural al castellano de las versiones larga y corta del Urticaria Control Test garantizando su equivalencia con la versión original. MATERIAL Y MÉTODOS: Metodología de traducción directa, traducción inversa y entrevistas cognitivas siguiendo los principios de buena práctica de la International Society for Pharmacoeconomics and Outcomes Research. RESULTADOS: La primera versión del cuestionario en español, obtenida por traducción directa de la versión original, fue sometida a entrevistas cognitivas, realizándose modificaciones en 3 preguntas. Al valorar los autores originales la nueva versión obtenida por retrotraducción, se modificó únicamente una pregunta, ya que consideraron que con el cambio había perdido el enfoque global de la cuestión original. Se realizó una tercera versión, que fue sometida a mínimas modificaciones, obteniéndose la versión definitiva. CONCLUSIONES: Este trabajo facilita la utilización en castellano del cuestionario Urticaria Control Test en un paso previo a su validación
INTRODUCTION: The clinical concept of urticaria embraces a heterogeneous group of conditions classified according to their clinical course as acute (lasting less than 6 weeks) or chronic (lasting 6 weeks or more). Chronic urticaria may be either spontaneous or induced. Few tools are available for monitoring the various clinical forms of this disease or for evaluating its impact on quality of life. The recently developed Urticaria Control Test to evaluate disease control is available in German, the original language, and American English. OBJECTIVE: To culturally adapt the long and short versions of the Urticaria Control Test to Castilian Spanish to ensure equivalence between the translated items and those of the original version. MATERIAL AND METHODS: To translate the Urticaria Control Test we followed the International Society for Pharmacoeconomics and Outcomes Research good practice guidelines, starting with forward translation and moving through back translation and cognitive debriefing steps. RESULTS: Three items were modified when the first Spanish version, translated from German, was discussed (cognitive debriefing). The revised translation was then translated back to German and sent to the Urticaria Control Test authors, who modified one item they considered had acquired a different focus through translation. A third Spanish version was then prepared and after minor proofreading changes was considered definitive. CONCLUSIONS: This study was the first step in making it possible to use the Urticaria Control Test questionnaire in Castilian Spanish. The next step will be to validate the translated questionnaire
Subject(s)
Humans , Male , Female , Cross-Cultural Comparison , Urticaria/diagnosis , Urticaria/epidemiology , Skin Tests/instrumentation , Skin Tests/methods , Skin Tests/statistics & numerical data , Surveys and Questionnaires , Algorithms , Skin Tests/standards , Skin Tests/trendsABSTRACT
INTRODUCTION: The clinical concept of urticaria embraces a heterogeneous group of conditions classified according to their clinical course as acute (lasting less than 6 weeks) or chronic (lasting 6 weeks or more). Chronic urticaria may be either spontaneous or induced. Few tools are available for monitoring the various clinical forms of this disease or for evaluating its impact on quality of life. The recently developed Urticaria Control Test to evaluate disease control is available in German, the original language, and American English. OBJECTIVE: To culturally adapt the long and short versions of the Urticaria Control Test to Castilian Spanish to ensure equivalence between the translated items and those of the original version. MATERIAL AND METHODS: To translate the Urticaria Control Test we followed the International Society for Pharmacoeconomics and Outcomes Research good practice guidelines, starting with forward translation and moving through back translation and cognitive debriefing steps. RESULTS: Three items were modified when the first Spanish version, translated from German, was discussed (cognitive debriefing). The revised translation was then translated back to German and sent to the Urticaria Control Test authors, who modified one item they considered had acquired a different focus through translation. A third Spanish version was then prepared and after minor proofreading changes was considered definitive. CONCLUSIONS: This study was the first step in making it possible to use the Urticaria Control Test questionnaire in Castilian Spanish. The next step will be to validate the translated questionnaire.
Subject(s)
Surveys and Questionnaires , Urticaria/psychology , Chronic Disease , Culture , Diagnostic Self Evaluation , Humans , Interviews as Topic , Quality of Life , Spain , Symptom Assessment , Translations , Treatment Outcome , Urticaria/drug therapyABSTRACT
La urticaria crónica espontánea, también conocida como urticaria crónica idiopática o urticaria crónica, es un proceso frecuente con una prevalencia estimada de entre el 0,5 y el 1% de la población general. Es un proceso que interfiere en la calidad de vida del paciente y ocasiona un notable impacto en los costes sanitarios directos e indirectos. La urticaria crónica es una entidad que plantea dificultades de manejo terapéutico. Se considera que los fármacos antihistamínicos H1 no sedantes son el tratamiento de primera elección. Su prescripción a las dosis recomendadas solo consigue una reducción de los síntomas en menos del 50% de los pacientes. Aunque las guías terapéuticas recomiendan incrementar las dosis en casos de respuestas no adecuadas, persiste un grupo de pacientes en los que no se consigue controlar la sintomatología. Existe, pues, la necesidad del desarrollo de nuevas alternativas terapéuticas cuya eficacia se establezca bajo criterios de medicina basada en la evidencia
Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient's quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed
Subject(s)
Humans , Urticaria/drug therapy , Autoimmune Diseases/drug therapy , Histamine Antagonists/pharmacokinetics , Chronic Disease/drug therapy , Treatment OutcomeABSTRACT
Chronic spontaneous urticaria, also known as chronic idiopathic urticaria or simply chronic urticaria, is a common disorder that has a prevalence in the general population that ranges between 0.5% and 1%. This condition negatively affects the patient's quality of life and has considerable impact on direct and indirect health-related costs. Chronic urticaria is difficult to manage. Nonsedating H1 antihistamines are the first line of therapy, but fewer than 50% of patients experience relief at recommended dosages. Although guidelines call for increasing the dosage when response is inadequate, some patients still do not achieve adequate control of symptoms. New treatment alternatives, with proven efficacy under the standards of evidence-based medical practice, must therefore be developed.
