Latest news with #clinicalStudy
Medscape
29-05-2025
- Health
- Medscape
Bariatric Surgery Linked With Psoriasis Improvement
Most patients with psoriasis experienced clinical improvement or remission after metabolic and bariatric surgery (MBS) in a systematic review. METHODOLOGY: Researchers conducted a systematic review of 14 studies that included 169 patients (mean age, 46.8 years; 74% women) with psoriasis who underwent MBS. Participants underwent various surgical procedures; gastric bypass was the most common (75.1%), followed by sleeve gastrectomy (17.8%), gastric banding (5.3%), and jejunoileal bypass (0.6%). Psoriasis treatments prior to surgery included topical treatments (46.2%), non-biologic systemic treatments (35.5%), and biologics (16.6%). At baseline, psoriasis severity was predominantly moderate (76.3%); 8.2% were severe and 15.6% were mild cases, based on psoriasis area and severity index and percent body surface area scores. TAKEAWAY: Average body mass index (BMI) decreased from 43.7 at baseline to 32.9after surgery, with BMI reduction ranging from 8 to 25 during follow-up periods of 4 months to 9 years. Psoriasis was either mild or had completely resolved in 97.2% of patients after bariatric surgery, whereas 2.4% experienced worsening of psoriasis. A total of 78.1% of patients continued psoriasis treatment post-surgery, but medications were downgraded to a lower category (such as systemic to topical treatments, or no treatment) in many patients. IN PRACTICE: 'MBS may improve psoriasis outcomes following surgery,' the study authors wrote. 'While initial findings are promising, further controlled trials are necessary to validate the long-term effects of MBS on psoriasis and explore its potential role as an adjunctive therapy.' SOURCE: The study was led by Miranda K. Branyiczky, BSc, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, and was published online on May 24 in the Journal of the American Academy of Dermatology . LIMITATIONS: Limitations were reporting bias, variability in outcome measures, and the inclusion of case reports or series. DISCLOSURES: This study did not receive any funding. One author reported receiving grants, research support, speaker fees, and honoraria from multiple pharmaceutical companies including AbbVie, Alumis, Amgen, Arcutis Biotherapeutics, Bristol Myers Squibb, Eli Lilly and Company, Janssen Pharmaceuticals, Novartis, and Pfizer.
Medscape
26-05-2025
- Health
- Medscape
Gender Gaps Found in Timing of RA Treatment Initiation
Gender-based differences were identified in the clinical characteristics and time to initiation of the first biologic or targeted synthetic disease-modifying antirheumatic drug (b/ts DMARD) among patients with rheumatoid arthritis (RA), with women experiencing a longer disease duration before treatment initiation than men. METHODOLOGY: Researchers conducted a multicenter observational study using data from a Spanish registry to assess gender differences in clinical characteristics and in the timing of b/tsDMARD initiation in patients with RA. They included 3384 patients with RA (78.1% women) who started their first b/tsDMARD between January 2000 and October 2023. The main outcomes included the time from RA diagnosis to initiation of the first b/tsDMARD and disease activity at treatment initiation, which were compared by sex. The analysis stratified treatment initiation periods according to the emergence and marketing of different drugs during the study: Up to December 2006, January 2007-December 2016, and after January 2017. TAKEAWAY: Women had a lower mean age at treatment initiation than men (54.8 vs 57.0 years; P < .001) but a longer disease duration (mean, 7.3 vs 6.7 years; P = .031). < .001) but a longer disease duration (mean, 7.3 vs 6.7 years; = .031). Men had a higher body mass index and more comorbidities, whereas women were more likely to have Sjögren syndrome and osteoporosis. At treatment initiation, women had a higher Disease Activity Score 28–Erythrocyte Sedimentation Rate than men; however, no difference was observed in Disease Activity Score 28–C-reactive protein. Gender differences in disease duration before treatment initiation were especially notable in women from 2017 onward (hazard ratio, 0.9; P = .026). A longer RA duration before treatment was observed in women, older patients, and those on other conventional synthetic DMARDs (excluding methotrexate), whereas smokers, individuals with obesity, and those receiving methotrexate or glucocorticoids began treatment earlier. IN PRACTICE: "The delay in treatment initiation in women despite a higher activity rate merits reflection," the authors of the study wrote. SOURCE: This study was led by Paloma Vela-Casasempere, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain. It was published online on May 14, 2025, in Arthritis Research & Therapy . LIMITATIONS: Only the covariates available in the registry were included in this study, potentially missing other confounding factors. Sex was recorded as a dichotomous variable (male/female), without accounting for self-identified gender. DISCLOSURES: The registry was supported by the Spanish Agency of Drugs and Medical Devices, Biogen, Bristol-Myers and Squibb, and others. Several authors reported receiving grants or contracts, consulting fees, honoraria, or travel support from various pharmaceutical companies, including Novartis and Pfizer.
Medscape
12-05-2025
- Health
- Medscape
Prior Acne Predicts Breakouts With JAK Inhibitors in AA
Younger patients with alopecia areata (AA) and those who have a history of acne were more likely to develop acne during Janus kinase inhibitor (JAKi) treatment in a study. METHODOLOGY: Researchers conducted a retrospective review of an institutional AA registry and analyzed 54 patients ages 12-78 years (53.7% women; average age, 38.8 years) with AA who received JAKi treatment. They reviewed demographics, medical history, alopecia history, acne history, current acne, and JAKi use. The JAKis used were baricitinib (n = 18), deuruxolitinib (n = 17), ritlecitinib (n = 17), upadacitinib (n = 1), and tofacitinib (n = 1). TAKEAWAY: Of all patients, 29 developed acne and 25 did not. Among those with acne, 16 (55%) had mild, nine (31%) had moderate, and four (14%) had severe disease. Overall, 32 (59.3%) patients had a history of acne, including 24 (83%) of the 29 who developed acne during JAKi treatment. Patients with prior acne history showed a significantly higher likelihood of developing acne during JAKi treatment (odds ratio [OR], 5.95; P = .027). Patients with acne on JAKi were also younger than those without acne (average, 33.6 vs 44.9 years; P = .0097). = .027). Patients with acne on JAKi were also younger than those without acne (average, 33.6 vs 44.9 years; = .0097). Acne onset typically occurred early in treatment, with 23 (79%) patients developing acne within 3 months; 17 (59%) experienced relapsing/remitting disease. Acne completely resolved in five (17%) patients. Most patients reported the same (54%) or worse acne severity (29%) after treatment initiation compared with previous acne severity. Among patients who developed acne, 62% pursued treatment options, with 67% reporting some improvement, while only 3% discontinued JAKi due to acne. IN PRACTICE: 'Younger patients and those with acne history are especially prone to acne on JAKi with similar severity to prior acne,' the study authors wrote. 'Dermatologists should investigate patient acne history prior to JAKi initiation,' they added, and those with a history 'should be counseled on risk of new-onset acne and informed that JAKi-associated acne has moderate responsiveness to conventional therapies.' SOURCE: The study was led by Emily R. Gordon, Columbia University Vagelos College of Physicians and Surgeons, New York City, and was published online on April 29 in JAAD International . LIMITATIONS: The study was limited by reliance on patient recall and self-assessment of acne severity. DISCLOSURES: The authors reported having no funding source or relevant conflict of interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Credit Lead image: E+/Getty Images Medscape Medical News © 2025 WebMD, LLC Cite this: Prior Acne Predicts Breakouts With JAK Inhibitors in AA - Medscape - May 12, 2025.
