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Biomedical subjects

Jennifer Clay Cather

Publications and source records attributed to Jennifer Clay Cather.

At least 19 recordsLinked to original sources
PubMed2005

Combining traditional agents and biologics for the treatment of psoriasis.

Psoriasis patients deserve long-term control of their disease with optimal safety. Traditional agents (methotrexate, cyclosporine, retinoids, and photochemotherapy [PUVS]), although providing excellent short-term control, may produce acute or chronic toxicities, thus limiting their usage. Dermatologists are well versed in combination and rotational therapies for psoriasis, using these and other agents. With the advent of biologic therapies (three currently approved, and others pending), the potential for safer long-term psoriasis control is being realized. A review of the literature, plus our personal experience in using combinations of traditional agents and biologics, is presented.

Acitretin↗
PubMed2005

Efalizumab: continuous therapy for chronic psoriasis.

Efalizumab is a humanised monoclonal antibody targeting the CD11a subunit of lymphocyte function-associated antigen-1, specifically developed for psoriasis. Indicated for patients with moderate-to-severe plaque psoriasis, efalizumab is FDA-approved in the US for patients aged > or = 18, as well as being approved in several other European countries. Clinical studies have proven the efficacy of efalizumab for a majority of patients, improving quality of life with continuous maintenance therapy by means of weekly subcutaneous self-injections. Controlled trials have demonstrated the safety and tolerability of efalizumab. Clinical trials have established that approximately 30% of patients can achieve a PASI-75 response within 12 weeks of initiating treatment, with further clinical benefit noted with continued therapy up to 24 and even 36 months of therapy. Efalizumab may thus potentially offer patients a safe option for long-term safe control in managing their disease.

Antibodies, Monoclonal↗
PubMed2003

Etanercept: An overview.

Etanercept, a competitive inhibitor of TNF-alpha, is currently FDA approved for psoriatic arthritis and rheumatoid arthritis. The molecular structure of etanercept, its mechanism of action, and results of clinical trials involving patients with psoriasis will be reviewed.

Arthritis, Psoriatic↗
PubMed2003

Investigational therapies for psoriasis.

As the pathogenesis of psoriasis is better understood, specific targeted therapies are being developed. In addition to alefacept, etanercept, efaluzimab, and infliximab, discussed in separate articles in this issue, numerous other investigational therapies are currently in clinical trials, some of which will likely be approved in the future. We review the most promising of these therapies and their mechanisms of action.

Antibodies, Monoclonal↗
PubMed2003

Modulating T cell responses for the treatment of psoriasis: a focus on efalizumab.

An improved understanding regarding the pathophysiology of psoriasis, coupled with advances in molecular research, has prompted the development of targeted biologic treatments for patients with plaque psoriasis. T lymphocytes play an important role in initiating the immune system and the inflammatory responses that result in the development and maintenance of psoriatic plaques. Efalizumab (anti-CD11a, Raptiva; Genentech, Inc.) is a mAb that targets the T cell adhesion molecule, leukocyte function-associated antigen-1 (LFA-1). By binding to CD11a - the alpha-subunit of LFA-1 - LFA-1 is prevented from binding with its ligand, intercellular adhesion molecule-1 (ICAM-1). This inhibits various T cell processes believed to be important in the pathogenesis of psoriasis, including T cell activation, T cell adhesion to endothelial cells and T cell migration. Clinical trials demonstrate that efalizumab, given subcutaneously once-weekly, provides clinical benefit, including improved quality of life, in patients with moderate-to-severe plaque psoriasis. Efalizumab is associated with an early onset of action, with improvement noted as early as 14 days. Studies with extended treatment suggest that continuing efalizumab therapy is more beneficial in maintaining and improving responses. Relapse of psoriasis is usually seen within 60 - 70 days after discontinuation of therapy, and rebound in approximately 5% of patients (i.e., flare to > 125% of baseline) is noted. Efalizumab is associated with acute adverse events during the first and second injections, which decrease in incidence with each subsequent injection. Data indicate that efalizumab can be safely administered for extended periods of time. Given the efficacy, early onset of clinical benefit, the safety profile and the convenience of once-weekly subcutaneous home dosing, efalizumab offers an interesting new therapeutic option for the treatment of psoriasis and the potential for improved and potentially safer long-term, continuous 'maintenance' therapy.

Animals↗
PubMed2002

Update on botulinum toxin for facial aesthetics.

The use of botulinum toxin has revolutionized the treatment of facial lines with an incomparable safety record over the past 14 years. The most common used injection sites are shown in Fig. 9. With the recent FDA approval for Botox in the treatment of glabellar lines, its use will likely increase dramatically. It is essential that practitioners have a detailed and specific knowledge of the facial and neck musculature to be injected to minimize untoward side effects, especially in the early days of new users' learning curve. The specifics of the dilutions and units per amount used for the various different commercial forms of botulinum toxin types A and B need to be understood fully and standardized together with the potential for antigenicity with the higher protein load of type B. In addition, specific indications for the use of botulinum toxin as adjunctive therapy for specific facial surgical procedures (i.e., blepharoplasty, surgical brow lift, and laser resurfacing) will become better understood. [figure: see text] Finally, even though the anatomy of the facial musculature is well described, individual differences in men and women, in different population groups, and in tissue qualities, such as turgor and elasticity [87], are important factors to be considered before undertaking botulinum toxin injections. It is likely that the use of specific measuring devices, such as digital imaging, will further help define the use of botulinum toxin for different muscle groups and facial aesthetic indications.

Botulinum Toxins, Type A↗