Safety of low-dose oral minoxidil in older patients
Authors of a study published in JAAD described the safety and tolerability of low-dose oral minoxidil (LDOM) in patients aged 65 or older. A total of 321 patients were included in the review, with a mean dose of 1 mg and a mean duration of 24.3 months. Forty-two patients (10.5%) took LDOM every other day.
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Adverse events (AEs) were detected in 17% of cases, with hypertrichosis being the most frequent (13.4%). Systemic AEs were reported in 5.8% of cases. A reduction of LDOM dose was required in 5.8% of cases and withdrawal in 2.8% of cases, with tachycardia being the most frequent cause of withdrawal. Patients with prior hypertension had a higher frequency of overall AEs and dizziness, specifically those receiving angiotensin receptor blockers or beta-blockers. Patients with a history of arrhythmia experienced more tachycardia (78% vs. 1.6%) as well as those who took LDOM every other day (7.1% vs. 1.4%). LDOM showed a favorable safety profile in patients aged 65 or older despite slightly more frequent AEs than in the general population. The authors suggested similar dose recommendations to those in younger patients, noting that a daily regimen, instead of every other day, would most likely be safer.
DermWorld Insights and Inquiries: Metastatic uveal melanoma — Tebentafusp unobfuscated
Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. The five-year mortality from metastatic UM is 30%; 40% fatality rates occur in patients 10 to 15 years following the primary diagnosis. Current metastatic UM (mUM) therapy includes surgery, radio-embolization, chemoembolization, percutaneous hepatic melphalan infusion, systemic chemotherapy, and immunotherapy. Immune check point inhibitors (anti-PD1/PD-L1, anti-CTLA4) have limited efficacy in patients with mUM. Studies of tebentafusp, a novel ImmTAC, have shown a significant and meaningful impact on overall survival in previously untreated patients with mUM. Given the high rate of cutaneous AEs, including acute toxicity and depigmentation, dermatologists will also likely be consulted on patients being treated for mUM. Keep reading!
New focused atopic dermatitis guidelines update available
The Journal of the American Academy of Dermatology recently published a focused update for the care of atopic dermatitis in adults resulting from the emergence of new novel therapies to treat AD since the previous guidelines update. The new guidelines strongly recommend the use of tapinarof cream, roflumilast cream, lebrikizumab, and nemolizumab with concomitant topical therapy to manage AD in adults. Read the updated guidelines.
FDA approves dupilumab to treat patients with bullous pemphigoid
The FDA recently approved dupilumab for the treatment of adult patients with bullous pemphigoid (BP), the first approved biologic to treat this condition. FDA approval is based on data from the ADEPT phase 2/3 study in which patients were randomized to receive dupilumab 300 mg or placebo added to standard-of-care oral corticosteroids (OCS). During treatment, all patients underwent an OCS tapering regimen if control of disease activity was maintained. Disease remission was experienced by 18.3% of patients compared to 6.1% in the placebo group. Clinically meaningful itch reduction was experienced by 38.3% of patients compared to 10.5%.
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