Terbinafine for onychomycosis: Continuous- vs. pulse-dose
A study published in the Journal of Drugs in Dermatology compared the clinical cure rates associated with continuous- versus pulse-dose terbinafine regimens for toenail onychomycosis. Sixty patients with onychomycosis, between 15 and 65 years of age, were divided into a continuous treatment group receiving 250 mg terbinafine once daily for 12 weeks and a pulse treatment group receiving 250 mg twice daily terbinafine for one week repeated every four weeks for 12 weeks.
Each patient was followed up at weeks four, eight, and 12. Efficacy of the continuous treatment group was significantly greater at 76.67% compared with 26.67% in the pulse treatment group. The authors conclude that continuous dosing of terbinafine may reduce morbidity and lead to greater patient satisfaction compared with pulse dosing.
DermWorld Insights and Inquiries: NSA (neutrophilic sebaceous adenitis) secrets revealed
If asked what the acronym NSA means, most of us — dermatologists included — would respond, “National Security Agency.” News of security leaks (think Edward Snowden or Jack Teixeira) are in the headlines, but neutrophilic sebaceous adenitis (NSA) may be a stealth disorder to many clinicians. Learning of a novel disorder and watching it evolve in the literature over time is fascinating. NSA was first reported by Renfro et al in 1993. I remembered their case report because of its striking clinical presentation and unique histologic findings. NSA usually manifests as arciform lesions of the face and upper trunk, most frequently in younger men, and often photo-induced. Occasionally, there are systemic symptoms. Although I have never seen this entity in vivo (unless I have missed the diagnosis — which is always possible), its appearance in the literature is increasing and is worthy of our attention. Keep reading!
AAD releases updated guidelines for atopic dermatitis
The Academy recently published updated guidelines of care for the management of
atopic dermatitis in adults with phototherapy and systemic agents in JAAD. These are the third in a series of revised guidelines the AAD is producing on the condition. View the AD guidelines and access guideline highlights.
FDA approves secukinumab for hidradenitis suppurativa
The FDA has approved secukinumab (Cosentyx) for the treatment of adults with moderate-to-severe hidradenitis suppurativa (HS). Secukinumab is the first IL-17A inhibitor approved for the treatment of HS and the second biologic approved for this indication. Adalimumab (Humira) was approved for HS treatment in 2015.
[Oral oxybutynin chloride for HS patients? Read more.]
In two clinical trials, at week 16, data showed that an at least 50% decrease in abscess and inflammatory nodule count as determined by Hidradenitis Suppurativa Clinical Response (HiSCR50) was achieved by a higher proportion of patients dosed with Cosentyx 300 mg every two weeks compared with placebo.
FDA approves interchangeable biosimilar for plaque psoriasis
The FDA has approved ustekinumab-auub (Wezlana) as a biosimilar to and interchangeable with ustekinumab (Stelara) for moderate-to-severe plaque psoriasis who are candidates for phototherapy or systemic therapy and active psoriatic arthritis starting at six years of age.
[Biosimilar substitution laws passed in 50 states, but details vary. Read more.]
A biosimilar is a biological product that is highly similar to, and has no clinically meaningful differences from, a biological product already approved by the FDA (also called the reference product). An interchangeable biosimilar is a biosimilar that has been shown to meet other requirements under the law and may be substituted for the reference product without consulting the prescriber. The substitution may occur at the pharmacy, subject to state pharmacy laws which vary by state, a practice commonly called “pharmacy-level substitution” — similar to how generic drugs are substituted for brand name drugs.
What is keeping biosimilars out of reach and when will they be available? Read more.
MIPS data validation and audit to begin
CMS’s MIPS data validation and audit (DVA) for the 2022 performance year will begin November 2023. MIPS-eligible clinicians and groups randomly selected are required to provide substantive, primary source documents as requested by CMS.
If you are selected for the MIPS DVA, an email will be sent to the security official in your Health Care Quality Information Systems Access, Roles, and Profile (HARP) account. Ensure your contact information is up to date in the HARP system. You will have 45 days from the date of the notice to provide the requested information; failure to comply could result in a payment adjustment.
MIPS participants selected for DVA can expect notification of selection and initial requests for information starting November 2023 through March 2024. Learn more.
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