October 11, 2023
IN THIS ISSUE / Oct. 11, 2023
Is clascoterone effective for mild hidradenitis suppurativa?
DermWorld Insights and Inquiries: Dermatologists should not be in the dark about kratom
Low-dose omalizumab for patients with chronic spontaneous urticaria
Is clascoterone effective for mild hidradenitis suppurativa?
A research letter published in JAAD evaluated the effect on hidradenitis suppurativa (HS) patients who received treatment with clascoterone. Patients with HS with stable disease or on no therapy without tunnels and with residual nodular disease used clascoterone twice daily on all affected areas. Most patients (83%) reported an improvement at 12 weeks, with less frequent flares, smaller lesions, and reduced perilesional erythema. The authors conclude that clascoterone could be beneficial for patients with mild HS because of its ability to target the androgen receptor, although further studies are warranted.
High dose intralesional steroids in hidradenitis suppurativa. Read more in DermWorld Insights and Inquiries.
DermWorld Insights and Inquiries: Dermatologists should not be in the dark about kratom
(“tranq”). This commentary focuses on kratom as a cause of photodistributed hyperpigmentation. Unfortunately, regular drug screens do not detect kratom. Patient disclosure is the foundation of screening for kratom misuse. Keep reading!
How often does scabies treatment fail?
A systematic review and meta-analysis published in the British Journal of Dermatology assessed the prevalence of treatment failure among patients with scabies. The overall prevalence of treatment failure was 15.2%, with the Western Pacific Region demonstrating the highest prevalence. Patients who received two doses of oral ivermectin experienced lower treatment failure rates (7.1%) compared with those who received a single dose (15.2%). Between 1983 and 2021, the overall prevalence of treatment failure increased by 0.27% annually, whereas that of permethrin treatment failure increased by 0.58% annually.
Experts discuss treatment options and tips for successfully diagnosing and treating lice and scabies. Read more in DermWorld.
Low-dose omalizumab for patients with chronic spontaneous urticaria
A study published in Acta Dermato-Venereologica assessed the treatment outcomes and long-term clinical course of patients with chronic spontaneous urticaria (CSU) treated with low-dose omalizumab. In this study of 179 patients with CSU treated with a low dose of omalizumab (150 mg/month), 158 patients (88%) achieved a complete response by the last injection. Of the 133 patients who achieved complete response at week 12, 88 were considered early responders. Early complete response was associated with mild baseline disease activity and the absence of atopic comorbidities. Additionally, smokers were significantly more likely to achieve a final complete response compared with nonsmokers.
What treatment is most effective for chronic spontaneous urticaria? Find out in DermWorld Weekly.
AADA prompts FDA to make vital changes to iPLEDGE program
The AADA is asking its members to contact the FDA to implement the recommended changes to the iPLEDGE risk management program, as it has been over six months since the vote to implement key changes to the program by two FDA joint advisory committees.
In March of 2023, the FDA held a public joint advisory committee meeting to provide advice and recommendations to the FDA on iPLEDGE, a risk management program to prevent exposure to isotretinoin during pregnancy. During the meeting, the FDA Advisory Committees supported the AADA’s recommendations, including removing the 19-day lockout period, reducing the monthly attestation requirement to at least every four months or longer for persons who cannot become pregnant, and allowing continued use of at home and non-CLIA pregnancy tests after the public health emergency.
To date, these recommended changes have not been implemented in iPLEDGE. Earlier this year, the FDA extended certain COVID-19-related flexibilities through Nov. 7, 2023, including accepting at-home pregnancy tests and other non-CLIA tests for the iPLEDGE Risk Evaluation and Mitigation Strategy (REMS). The FDA must act now to ensure appropriate access to isotretinoin.
Anyone can submit comments concerning new rules, regulations, or changes being considered by the FDA. The FDA considers suggestions made by the public and it often influences the agency’s future actions.
Sodium bicarbonate, lidocaine injections recalled
Hospira is recalling Lot Numbers GJ5007, 42290DK, and GH6567 of 4.2% Sodium Bicarbonate Injection, USP, 5 mEq/10mL vial; 1% Lidocaine HCl Injection, USP, 50 mg/5mL vial; and 2% Lidocaine HCl Injection, USP, 100 mg/5mL vial due to the potential for presence of glass particulate matter.
There is an unlikely probability for serious adverse events, including death, should a patient receive an injectable product found to contain particulate matter identified as glass. Potential complications related to injection of visible and subvisible inert particles include inflammation of a vein, granuloma, and blockage of blood vessels or life-threatening blood clot events. The frequency and severity of these adverse events could vary depending upon a variety of factors including the size and number of particles in the drug product, patient comorbidities (such as age, compromised organ function), and presence or absence of vascular anomalies.
