Dupilumab for treatment of atopic dermatitis in patients living with HIV: a case series

2021 ◽  
Author(s):  
Kelsey B. Nusbaum ◽  
Benjamin H. Kaffenberger ◽  
Michela M. Paradiso BS ◽  
Jennifer A. Sopkovich ◽  
Hala Daou ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Case Series ◽  
Living With Hiv

scholarly journals Novel agents for atopic dermatitis in patients over 50 years of age: A case series

2021 ◽  
Author(s):  
Lisa Kiely ◽  
Stephanie Bowe ◽  
Cathal O'Connor ◽  
Mary Bennett ◽  
John Bourke ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Case Series ◽  
Novel Agents

scholarly journals Streptococcus pyogenes Infective Endocarditis – Association with Injection Drug Use: Case Series and Review of the Literature

2021 ◽  
Author(s):  
Melanie T Rebechi ◽  
Emily L Heil ◽  
Paul M Luethy ◽  
Sarah A Schmalzle
Keyword(s):  
Infective Endocarditis ◽  
Streptococcus Pyogenes ◽  
People Who Inject Drugs ◽  
Local Population ◽  
Case Series ◽  
Duke Criteria ◽  
Group A ◽  
Polymicrobial Bacteremia ◽  
Predominantly Female ◽  
Living With Hiv

Abstract Background Streptococcus pyogenes, or Group A Strep (GAS), is not considered a typical cause of infective endocarditis (IE), but has anecdotally been observed in unexpectedly high rates in people who inject drugs (PWID) at our institution. Methods All cases of possible or definite GAS IE per Modified Duke Criteria in adults at an academic hospital between 11/15/2015 and 11/15/2020 were identified. Medical records were reviewed for demographics, comorbidities, treatment, and outcomes related to GAS IE. Literature on cases of GAS IE was reviewed. Results 18 cases of probable (11) or definite (7) GAS IE were identified; mean age was 38 years, and the population was predominantly female (56%) and Caucasian (67%), which is inconsistent with local population demographics. Sixteen cases were in people who inject drugs (PWID) (89%), 14 were also homeless, six were also living with HIV (33%), and two were also pregnant. Antibiotic regimens were variable due to polymicrobial bacteremia (39%). One patient underwent surgical valve replacement. Four patients (22%) died due to complications of infection. Literature review revealed 42 adult cases of GAS IE, only 17 of which were in PWID (24%). Conclusions The 16 cases of possible and definite GAS IE in PWID over a five-year period in a single institution reported nearly doubles the number of cases in PWID from all previous reports. This suggests a potential increase in GAS IE particularly in PWID and PLWH, which warrants further epidemiologic investigation.

Atopic Dermatitis: Case Series of Individualized Homoeopathic Treatment

2021 ◽  
Vol 11 (11) ◽  
pp. 115-123
Author(s):  
Mousumi Das
Keyword(s):  
Atopic Dermatitis ◽  
Family History ◽  
Case Series ◽  
Calcineurin Inhibitors ◽  
Loss Of Function ◽  
Key Words Atopic Dermatitis ◽  
Topical Calcineurin Inhibitors ◽  
History Of ◽  
Allergic Disorders ◽  
Positive Results

Atopic dermatitis is a common, chronic, intensely pruritic, relapsing inflammatory skin disease that affects both children and adults. Atopic dermatitis is often the originating of a series of allergic disorders, mentioned as the "atopic march".There are numerous risk factors correlated with AD development. However, only two have always been related, and they are (1) family history of atopy and (2) loss of function mutations in the FLG gene. Topical anti-inflammatory therapy with topical corticosteroids or topical calcineurin inhibitors treatment are available in conventional therapy but sometimes it has been reported that patients are also benefited from Homoeopathic treatment. Four patients who presented at the outpatient department at National Institute of Homoeopathy, Saltlake, Kolkata with Atopic dermatitis and a family history of asthma, allergic rhinitis were treated with constitutional homoeopathic medicine. Details of consultations, treatment and assessment are summarized. A constitutional treatment thus eliminates the symptoms locally and internally as well as long-lasting relief from complaints. Common remedies include Mercuris Solubilis, Sulphur. This case series shows positive results of homoeopathy in the treatment of Atopic dermatitis. Key words: Atopic dermatitis, Family history, Individualized Homoeopathic treatment, Case series, repertorisation.

Long‐term off‐label dupilumab in pediatric atopic dermatitis: A case series

2018 ◽  
Vol 36 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Alison D. Treister ◽  
Peter A. Lio
Keyword(s):  
Atopic Dermatitis ◽  
Case Series ◽  
Off Label

scholarly journals An Alternative Approach to Atopic Dermatitis: Part I—Case-Series Presentation

2004 ◽  
Vol 1 (1) ◽  
pp. 49-62 ◽  
Author(s):  
Hiromi Kobayashi ◽  
Kuniaki Takahashi ◽  
Nobuyuki Mizuno ◽  
Haruo Kutsuna ◽  
Masamitsu Ishii
Keyword(s):  
Atopic Dermatitis ◽  
Herbal Medicine ◽  
Conventional Therapy ◽  
Complex Disease ◽  
Case Series ◽  
Line Treatment ◽  
Second Line ◽  
Substantial Portion ◽  
Alternative Approach ◽  
Evidential Basis

Atopic dermatitis (AD) is a complex disease of obscure pathogenesis. A substantial portion of AD patients treated with conventional therapy become intractable after several cycles of recurrence. Over the last 20 years we have developed an alternative approach to treat many of these patients by diet and Kampo herbal medicine. However, as our approach is highly individualized and the Kampo formulae sometimes complicated, it is not easy to provide evidence to establish usefulness of this approach. In this Review, to demonstrate the effectiveness of the method of individualized Kampo therapy, results are presented for a series of patients who had failed with conventional therapy but were treated afterwards in our institution. Based on these data, we contend that there exist a definite subgroup of AD patients in whom conventional therapy fails, but the ‘Diet and Kampo’ approach succeeds, to heal. Therefore, this approach should be considered seriously as a second-line treatment for AD patients. In the Discussion, we review the evidential status of the current conventional strategies for AD treatment in general, and then specifically discuss the possibility of integrating Kampo regimens into it, taking our case-series presented here as evidential basis. We emphasize that Kampo therapy for AD is more ‘art’ than technology, for which expertise is an essential pre-requisite.

scholarly journals Kaposi’s sarcoma in persons living with HIV/AIDS: a case series in a tertiary referral hospital

2018 ◽  
Vol 93 (4) ◽  
pp. 524-528
Author(s):  
Carla Andréa Avelar Pires ◽  
Marcos Antonio Neves Noronha ◽  
Julius Caesar Mendes Soares Monteiro ◽  
Albert Luiz Costa da Costa ◽  
José Maria de Castro Abreu Júnior
Keyword(s):  
Kaposi's Sarcoma ◽  
Case Series ◽  
Kaposi’S Sarcoma ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Persons Living With Hiv ◽  
Living With Hiv ◽  
Hiv Aids

scholarly journals Increasing Number and Proportion of Adverse Obstetrical Outcomes among Women Living with HIV in the Ottawa Area: A 20-Year Clinical Case Series

2016 ◽  
Vol 2016 ◽  
pp. 1-9
Author(s):  
Sarah Buchan ◽  
Katherine A. Muldoon ◽  
Johanna N. Spaans ◽  
Louise Balfour ◽  
Lindy Samson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Clinical Case ◽  
Case Series ◽  
Preterm Births ◽  
Estimating Equation ◽  
Equation Modeling ◽  
Women Living With Hiv ◽  
Obstetrical Outcomes ◽  
Women With Hiv ◽  
Living With Hiv

Background. The prevalence and associated risks with adverse obstetrical outcomes among women living with HIV are not well measured. The objective of this study was to longitudinally investigate the prevalence and correlates of adverse obstetrical outcomes among women with HIV.Methods. This 20-year (1990–2010) clinical case series assessed the prevalence of adverse obstetrical outcomes among pregnant women with HIV receiving care at The Ottawa Hospital (TOH). General estimating equation modeling was used to identify factors independently associated with adverse obstetrical outcomes, while controlling for year of childbirth clustering.Results. At TOH, there were 127 deliveries among 94 women (1990–2010): 22 preterm births, 9 births with low birth weight, 12 births small for gestational age, and 4 stillbirths. Per year, the odds of adverse obstetrical outcomes increased by 15% (OR: 1.15, 95% CI: 1.03–1.30). Psychiatric illness (AOR: 2.64, 95% CI: 1.12–6.24), teen pregnancy (AOR: 3.35, 95% CI: 1.04–1.46), and recent immigrant status (AOR: 7.24, 95% CI: 1.30–40.28) were the strongest correlates of adverse obstetrical outcomes.Conclusions. The increasing number and proportion of adverse obstetrical outcomes among pregnant women with HIV over the past 20 years highlight the need for social supports and maternal and child health interventions, especially among adolescents, new immigrants, and those with a history of mental illness.

scholarly journals Weight gain in patients with severe atopic dermatitis treated with dupilumab: a case series

2020 ◽  
Author(s):  
Emma Kristin Johansson ◽  
Lina Ulrika Ivert ◽  
Baltzar Bradley ◽  
Maria Lundqvist ◽  
Maria Bradley
Keyword(s):  
Atopic Dermatitis ◽  
Weight Gain ◽  
Weight Change ◽  
Rating Scale ◽  
Case Series ◽  
Interleukin 4 ◽  
Rank Test ◽  
Severe Atopic Dermatitis ◽  
Night Sleep

Abstract Background Dupilumab, targeting the interleukin-4α receptor and inhibiting the action of interleukin-4 and interleukin-13, was recently approved for treatment of moderate to severe atopic dermatitis. There is limited data on long-term effects and safety among patients with severe atopic dermatitis treated with dupilumab. Weight gain was observed among patients treated with dupilumab in our clinic. The aim was to describe weight change in a case series of patients with severe atopic dermatitis treated with dupilumab from baseline to follow-up after 12 months, and to analyze if weight change was associated with effect of treatment, reported appetite, and/or disturbed night sleep due to itching. Methods All patients with atopic dermatitis receiving systemic treatment at the Unit of Dermatology, Karolinska University Hospital, have been registered and monitored consecutively since January 2017. This case series constituted all patients who started treatment on dupilumab or methotrexate between 10 January 2017 and 30 June 2019 with at least 6 months of follow-up within the study period. The following variables were monitored at start of and during treatment: Eczema Severity Score Index, Patient-Oriented Eczema Measure, visual analogue scale for pruritus 10cm, Montgomery-Åsberg Depression Rating Scale, Dermatology Life Quality Index, and weight. Data analyses were performed using two-sample Wilcoxon-Mann-Whitney rank-sum test, or the Wilcoxon matched-pairs sign-rank test with a p-value <0.05 considered as statistically significant. Results Patients treated with dupilumab (n=12) gained weight (mean 6.1 kg, range [0.1–18.0], p=0.002) after one year on treatment. The majority of patients showed a good response to treatment with dupilumab (n=11); at follow-up at 6, 9, or 12 months, they reached EASI-90 (n=6), EASI-75 (n=4), or EASI-50 (n=1). There was no significant association between weight gain and treatment response, reported appetite, or disturbed night-sleep due to itch. Patients treated with methotrexate showed no significant weight change (n=8). Conclusions To our knowledge, this is the first report on a possible association between weight gain and dupilumab treatment; the extent of the association is yet to be seen, as is the mechanism behind this finding.

scholarly journals Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

2020 ◽  
Author(s):  
Jacques L Tamuzi ◽  
Ayele T Birhanu ◽  
Constance S Shumba ◽  
Olatunji Adetokunboh ◽  
Jeannine Uwimana-Nico ◽  
...  
Keyword(s):  
Clinical Management ◽  
Observational Studies ◽  
Case Reports ◽  
Case Series ◽  
People Living With Hiv ◽  
Related Field ◽  
High Burden ◽  
Screening Algorithm ◽  
Clinical Trials Registry ◽  
Living With Hiv

Abstract Background The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21 st century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field and play an important role in the present and future management of the co-infections. However, several gaps are remaining in the knowledge of the burden of COVID-19 on patients with TB and HIV, the diagnosis, and management of these patients. Objectives The study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB and to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Methods We conducted electronic search of potential eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and March, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB were managed in adult patients. We screened titles, abstracts and full articles for eligibility. As we anticipated heterogeneity in the literature, results were reported narratively. Main results After removing 69 duplicates, 24 out of 246 articles were assessed for eligibility, of which 9 studies were included for qualitative analysis. Among them, we included two case reports, four case series, one case-control and two retrospective observational studies. The studies have shown that TB may occur during or after SARS-CoV. In terms of severity, the proportion of severe/critical SARS, MERS and COVID cases with TB co-infection was higher than in patients with mild/moderate stages (P= 0.0008). Conclusion SARS/MERS-CoV/COVID-19 associated to HIV/TB or TB subjects had a higher risk of developing severe/critical than mild/moderate SARS/MERS-CoV/COVID-19. Diagnostic algorithms and clinical management were suggested for efficiently improving COVID-19/HIV/TB co-infections outcomes.

scholarly journals Apremilast as an Off-Label Therapeutic Agent

2021 ◽  
Vol 5 (3) ◽  
pp. 203-227
Author(s):  
Justin Marson ◽  
Mark Lebwohl
Keyword(s):  
Atopic Dermatitis ◽  
Psoriatic Arthritis ◽  
Combination Therapy ◽  
Hidradenitis Suppurativa ◽  
Case Reports ◽  
Case Series ◽  
Open Label ◽  
Off Label ◽  
Inflammatory Dermatoses ◽  
Randomized Control

Objective: To review the literature regarding the efficacy and safety of off-label use of apremilast in combination therapies for psoriasis and psoriatic arthritis and for other currently off-label inflammatory dermatoses. Methods: The Medline database was queried for all relevant articles published between 2014 and 2021 using exploded MeSH terms and keywords pertaining to the following themes: off-label, combination therapy, biologics, biologic therapy, methotrexate, and systemic psoriasis therapy. The Boolean term “AND” was used to find the intersection of these themes with the term “apremilast.” Results: 8 case series and 6 case reports investigated the use of apremilast in combination therapy for psoriasis and psoriatic arthritis. Addition of apremilast improved PASI scores by 31.8-77.4% among case series and 80-100% among case reports with adverse effects primarily consisting of gastrointestinal symptoms. 5 randomized-control trials (RCT), 9 open-label trials, 18 case series, and 30 case reports investigated the use of apremilast for off-label dermatoses. In RCTs, apremilast showed potential efficacy for atopic dermatitis and hidradenitis suppurativa. Open-label trials found apremilast efficacious for atopic dermatitis, allergic contact dermatitis, chronic pruritus, cutaneous sarcoidosis, discoid lupus erythematosus, hidradenitis suppurativa, lichen planus, prurigo nodularis, rosacea, and vitiligo. Limitations: Small sample size and short follow duration up for available randomized-control and open-label trials. Current data from case series/reports potentially limits generalizability of findings. Conclusion: Apremilast's safety profile makes it a potential efficacious, non-biologic systemic agent for monotherapy and combination therapy for a wide range of inflammatory dermatoses.

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