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Biomedical subjects

Jon Hanifin

Publications and source records attributed to Jon Hanifin.

5 recordsLinked to original sources
PubMed2006

Efalizumab for severe atopic dermatitis: a pilot study in adults.

BACKGROUND: Severe atopic dermatitis (AD) often cannot be adequately controlled with topical agents. The continuous use of current systemic therapies for AD is limited by end-organ toxicities. A safe and effective systemic therapy for patients with recalcitrant AD is greatly needed. OBJECTIVE: To evaluate the potential safety and efficacy of efalizumab, an inhibitor of T cell activation and migration, in adults with severe AD. METHODS: An investigator-initiated, prospective, open-label, pilot study was conducted involving ten subjects with severe AD. Subjects received an initial conditioning subcutaneous dose of efalizumab of 0.7 mg/kg followed by 1.0 mg/kg weekly for another 11 weeks for a total of 12 doses. The primary efficacy outcome was the change in the mean Eczema Area and Severity Index (EASI) score from baseline as measured at week 12. Monitoring of adverse events continued for 8 weeks after discontinuation of therapy. RESULTS: EASI scores improved from a mean baseline score of 37.1 +/- 13.5 to 17.6 +/- 14.5 at week 12 (52.3% improvement; P < .0001). Six out of ten subjects reached at least a 50% improvement in EASI score by week 12. Pruritus levels decreased from 6.9 cm +/- 1.8 cm to 4.9 cm +/- 2.5 cm utilizing a visual analogue score (P < .015). Overall, efalizumab was well tolerated. There were three significant adverse events during the course of this study, including thrombocytopenia, viral gastroenteritis, and a subject with worsening of disease beyond baseline levels after drug discontinuation. LIMITATIONS: It is difficult to apply these findings to larger populations of patients with AD because this study lacked a control group and involved a small number of subjects with very severe disease. Long-term efficacy and safety of efalizumab in this population is not known. CONCLUSIONS: Efalizumab therapy resulted in significant clinical improvements in six of ten subjects with severe AD. Efalizumab may serve as a good alternative to current systemic immunosuppressants used for AD; however, double-blind placebo-controlled studies are needed to test its efficacy and safety.

Adult↗
PubMed2006

Proceedings of the 4th Georg Rajka International Symposium on Atopic Dermatitis, Arcachon, France, September 15-17, 2005.

The 4th Georg Rajka International Symposium on Atopic Dermatitis presented a comprehensive view of our current understanding and management of atopic dermatitis (AD). These proceedings highlight contributions related to the history of AD doctrines; genetic and epigenetic background; epidemiology; maturation of the immune system; infection and innate-adaptive immunity; epidermal inflammation, including neurogenic inflammation and pruritus; animal models; skin barrier; evidence-based therapy and education programs; prognostic and severity markers; and allergy testing. Several studies in animal models and human subjects point to impaired skin barrier function as a primary defect that facilitates the effect of environmental factors and immune dysregulation found in AD. The new frontier in AD therapy should, in the near future, reflect our better understanding of the skin barrier. The influence of environmental factors on the skin and other epithelial barriers in the perinatal period needs to be better understood to implement appropriate prevention programs.

Animals↗
PubMed2004

Pimecrolimus cream 1%: a potential new treatment for chronic hand dermatitis.

A multicenter, randomized, vehicle-controlled, 3-week study was conducted in patients with chronic hand dermatitis (HD) of various etiologies and locations to identify subgroups particularly responsive to twice-daily application of pimecrolimus cream 1% with overnight occlusion. A total of 294 patients were randomized to the study. By the final visit on day 22, there was a trend toward greater clearance in patients who received pimecrolimus than in those treated with vehicle cream. An analysis of treatment success by various stratification factors was performed, and it was found that palmar involvement had notable impact on response (P = .033). Patients in the pimecrolimus group continued to improve throughout the study; however, in the vehicle group, improvement plateaued after 15 days. Pimecrolimus was well tolerated, with a low rate of application-site reactions such as burning. Pimecrolimus cream 1%, when used twice daily with overnight occlusion, may be of benefit in the management of chronic HD.

Administration, Topical↗
PubMed2003

A cross-sectional survey of complementary and alternative medicine use in patients with atopic dermatitis.

BACKGROUND: Studies from Europe reveal that a large percentage of patients with atopic dermatitis use some form of complementary and alternative medicine for the treatment of their skin disease. There are no studies from the United States that examine the prevalence and types of complementary and alternative medicine use among patients with atopic dermatitis. OBJECTIVE: The goal of this study was to determine the prevalence of complementary and alternative medicine use and the patterns of this use among atopic dermatitis patients referred to a university clinic. METHODS: Using a self-administered questionnaire, investigators performed a cross-sectional survey of 70 consecutive patients diagnosed with atopic dermatitis. RESULTS: Of the patients surveyed, 50.4% used some form of complementary and alternative medicine for the management of their skin disease. Common motivating factors were dissatisfaction with conventional treatment and frustration with the chronic nature of the condition. Vitamin supplementation and herbal creams were the most common alternative treatments used. CONCLUSION: The significant percentage of patients seeking alternative care for atopic dermatitis underscores the need for physicians to be familiar with alternative therapies for skin disease.

Adolescent↗