scholarly journals Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway

Dermatology ◽  
2021 ◽  
pp. 1-13
Author(s):  
Julia-Tatjana Maul ◽  
Florian Anzengruber ◽  
Curdin Conrad ◽  
Antonio Cozzio ◽  
Peter Häusermann ◽  
...  
Keyword(s):  
Topical Treatment ◽  
Systemic Treatment ◽  
Severe Disease ◽  
Treatment Options ◽  
Maintenance Phase ◽  
Current Treatment ◽  
Induction Phase ◽  
Individual Choice ◽  
Proactive Management ◽  
The Individual

Topical treatment is crucial for the successful management of plaque psoriasis. Topicals are used either as a stand-alone therapy for mild psoriasis or else in combination with UV or systemic treatment for moderate-to-severe disease. For the choice of a suitable topical treatment, the formulation matters and not just the active substances. This expert opinion paper was developed via a non-structured consensus process by Swiss dermatologists in hospitals and private practices to illustrate the current treatment options to general practitioners and dermatologists in Switzerland. Defining treatment goals together with the patient is crucial and increases treatment adherence. Patients’ personal preferences and pre-existing experiences should be considered and their satisfaction with treatment and outcome regularly assessed. During the induction phase of “classical” mild-to-moderate psoriasis, the fixed combination of topical calcipotriol (Cal) 50 μg/g and betamethasone dipropionate (BD) 0.5 mg/g once daily is frequently used for 4–8 weeks. During the maintenance phase, a twice weekly (proactive) management has proved to reduce the risk of relapse. Of the fixed combinations, Cal/BD aerosol foam is the most effective formulation. However, the individual choice of formulation should be based on a patient’s preference and the location of the psoriatic plaques. Tailored recommendations are given for the topical management of specific areas (scalp, facial, intertriginous/genital, or palmoplantar lesions), certain symptoms (hyperkeratotic or hyperinflammatory forms) as well as during pregnancy or a period of breastfeeding. As concomitant basic therapy, several emollients are recommended. If topical treatment alone does not appear to be sufficient, the regimen should be escalated according to the Swiss S1-guideline for the systemic treatment of psoriasis.

scholarly journals Glasdegib plus low-dose cytarabine for acute myeloid leukemia: Practical considerations from advanced practitioners and pharmacists

2020 ◽  
pp. 107815522097373
Author(s):  
Valerie Relias ◽  
Ali McBride ◽  
Matthew J Newman ◽  
Shilpa Paul ◽  
Seyyedeh Saneeymehri ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Treatment Options ◽  
Treatment Delivery ◽  
Need For Treatment ◽  
Proactive Management ◽  
The Individual ◽  
Low Dose Cytarabine ◽  
Acute Myeloid

Objective Acute myeloid leukemia (AML) is primarily a disease of older adults. These patients may not be candidates for intensive treatment, and there has been an ongoing need for treatment options for this group. We review the use of glasdegib, a hedgehog-pathway inhibitor available for use in combination with low-dose cytarabine (LDAC). Data Sources: PubMed and relevant congress abstracts were searched using the term “glasdegib”. In addition, based on our experience with glasdegib, we considered treatment aspects of particular relevance to pharmacists and advanced practitioners. Data Summary: In a randomized phase II study, the combination of glasdegib plus LDAC demonstrated superior overall survival versus LDAC alone (hazard ratio 0.51, 80% confidence interval 0.39–0.67, p = 0.0004). The trial reported adverse events (AEs) of special relevance for older patients, such as hematologic events, gastrointestinal toxicity, and fatigue, as well as AEs associated with Hh-pathway inhibitors (alopecia, muscle spasms, dysgeusia). Educating patients about typical AEs can facilitate adherence as well as early AE identification and proactive management. For LDAC, which is a long-established therapy in AML, various stages of delivery need consideration, with attention to individual circumstances. Practical measures such as dispensing a longer supply can reduce the number of return clinic visits, providing a meaningful difference for many patients. Conclusions Pharmacists and advanced practitioners play important roles in treatment with glasdegib plus LDAC. Ultimately, framing plans for treatment delivery within the individual circumstances of each patient may enable them to stay on therapy longer, giving them the greatest potential to achieve benefit.

scholarly journals Treatment of psoriasis in general practice

2020 ◽  
pp. 82-84
Author(s):  
T Jacobs ◽  
CM Kgokolo
Keyword(s):  
Cardiovascular Disease ◽  
General Practice ◽  
Inflammatory Disease ◽  
Systemic Therapy ◽  
Topical Treatment ◽  
Severe Disease ◽  
Treatment Options ◽  
Chronic Inflammatory Disease ◽  
Biological Agents ◽  
Moderate Disease

Psoriasis is a prevalent chronic inflammatory disease. Beyond skin and joint manifestations, psoriasis has numerous associated comorbidities, including metabolic and cardiovascular disease. There are many treatment options available, from topical treatment for mild psoriasis, phototherapy for moderate disease, to systemic therapy or biological agents for severe disease. This article aims to focus on the treatment for the majority of patients where topical agents alone are generally appropriate.

scholarly journals Advanced Gastric Cancer: Current Treatment Landscape and a Future Outlook for Sequential and Personalized Guide: Swiss Expert Statement Article

2021 ◽  
pp. 1-10
Author(s):  
Alexander R. Siebenhüner ◽  
Sara De Dosso ◽  
Daniel Helbling ◽  
Christoforos Astaras ◽  
Petr Szturz ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Current Treatment ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Her 2 ◽  
The Impact

<b><i>Background:</i></b> Gastric cancer is a leading cause of cancer-related deaths worldwide. Several treatment possibilities have been investigated, but only a few show clinically meaningful results. <b><i>Summary:</i></b> Systemic treatment options for advanced gastric cancer (aGC) have evolved over the recent years, implementing the growing molecular knowledge of this heterogeneous disease. Molecular profiling (at least for HER-2-expression, microsatellite instability status, <i>Epstein-Barr virus</i> expression, and programmed death ligand-1 expression/combined positive score [CPS]) is recommended for all therapy-fit patients prior to the start of a systemic treatment and is crucial for decisions on treatment strategy and drug selection. Various examples like the application of trastuzumab in the HER-2-positive subgroup underline the benefits of this approach starting from the first-line setting. A combination of platinum and fluoropyrimidine remains the first-line chemotherapy backbone in the treatment of advanced gastric cancer. Triplet combinations adding taxanes to the doublet regimen are reserved for certain scenarios. Unfortunately, almost all patients who receive first-line treatment (with or without anti-HER-2 blockade) progress and &#x3c;70% are eligible for a second-line therapy. The addition of monoclonal antibodies has substantially improved outcomes in this setting. As such, ramucirumab has led to significant and clinically meaningful advancements in the second-line treatment. Furthermore, immuno-oncology with checkpoint inhibition and immune stimulation has evolved in the field of aGC. Recent first-line data show a significant survival benefit in aGC patients with a CPS ≥ 5 under immunochemotherapy. Nonetheless, the impact of immunotherapy combinations and immunochemotherapy remains an area of investigation. <b><i>Key Message:</i></b> In this review, we highlight recent improvements in the treatment landscape of advanced gastric cancer, the heterogeneity of this disease, and possible personalized targets.

scholarly journals Breast cancer with brain metastases: current treatment options

2021 ◽  
Vol 67 (5) ◽  
pp. 614-623
Author(s):  
Sergei Banov ◽  
Sergei Gutorov ◽  
Irina Koliadina ◽  
Aleksandr Smolin ◽  
Evgenii Kriukov ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trials ◽  
Brain Metastases ◽  
Scientific Literature ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Current Treatment ◽  
Extracranial Metastases ◽  
Constant Improvement ◽  
Systemic Therapies

Breast cancer is the main cause of brain metastases in women. The incidence of brain metastases in breast cancer continues to increase, which is mainly associated with improved systemic therapy, which ensures the control of extracranial metastases and an increase in survival. The management brain metastases of breast cancer remain a challenge, despite the constant improvement of local and systemic therapies. This review of the scientific literature presents the latest data from clinical trials of local and systemic treatment of patients with brain metastatic of breast cancer.

scholarly journals Up-to-Date Tailored Systemic Treatment in Pancreatic Ductal Adenocarcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Caroline Y. K. Fong ◽  
Emma Burke ◽  
David Cunningham ◽  
Naureen Starling
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Tumour Microenvironment ◽  
Current Treatment ◽  
Ductal Adenocarcinoma ◽  
Molecular Features ◽  
Future Clinical Practice ◽  
To Come ◽  
Potential Methods

Despite intensive research efforts, pancreatic ductal adenocarcinoma is still regarded as an aggressive and life-limiting malignancy. Combination chemotherapy regimens that underpin the current treatment approach in the advanced setting have led to incremental survival gains in recent years but have failed to confer patients with a median overall survival that exceeds 12 months from diagnosis. Research has since focussed on understanding the role and interplay between various components of the desmoplastic stroma and tumour microenvironment, in addition to developing targeted therapies based on molecular features to improve the prognosis associated with this malignancy. This review will summarise the available systemic treatment options and discuss potential methods to refine the resolution of patient selection to enhance responses to currently available therapies. Furthermore, it will explore newer approaches anticipated to come to the fore of future clinical practice, such as agents targeting the DNA damage response and tumour microenvironment as well as immunotherapy-based combinations.

scholarly journals Glioblastoma patients in Slovenia from 1997 to 2008

2014 ◽  
Vol 48 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Uros Smrdel ◽  
Viljem Kovac ◽  
Mara Popovic ◽  
Matjaz Zwitter
Keyword(s):  
Median Survival ◽  
Systemic Treatment ◽  
Performance Status ◽  
Treatment Options ◽  
Current Treatment ◽  
Tumour Resection ◽  
Good Performance Status ◽  
Primary Brain Tumour ◽  
Younger Age ◽  
Functional Surgery

Abstract Background. Glioblastoma is the most common primary brain tumour. It has a poor prognosis despite some advances in treatment that have been achieved over the last ten years. In Slovenia, 50 to 60 glioblastoma patients are diagnosed each year. In order to establish whether the current treatment options have any influence on the survival of the Slovenian glioblastoma patients, their data in the period from the beginning of the year 1997 to the end of the year 2008 have been analysed. Patients and methods. All patients treated at the Institute of Oncology Ljubljana from 1997 to 2008 were included in the retrospective study. Demographics, treatment details, and survival time after the diagnosis were collected and statistically analysed for the group as a whole and for subgroups. Results. From 1997 to 2008, 527 adult patients were diagnosed with glioblastoma and referred to the Institute of Oncology for further treatment. Their median age was 59 years (from 20 to 85) and all but one had the diagnosis confirmed by a pathologist. Gross total resection was reported by surgeons in 261 (49.5%) patients; good functional status (WHO 0 or 1) after surgery was observed in 336 (63.7%) patients, radiotherapy was performed in 422 (80.1%) patients, in 317 (75.1%) of them with radical intent, and 198 (62.5 %) of those received some form of systemic treatment (usually temozolomide). The median survival of all patients amounted to 9.7 months. There was no difference in median survival of all patients or of all treated patients before or after the chemo-radiotherapy era. However, the overall survival of patients treated with radical intent was significantly better (11.4 months; p < 0.05). A better survival was also noticed in radically treated patients who received additional temozolomide therapy (11.4 vs. 13.1 months; p = 0.014). The longer survival was associated with a younger age and a good performance status as well as with a more extensive tumour resection. In patients treated with radical intent, having a good performance status, and receiving radiotherapy and additional temozolomide therapy, the survival was significantly longer, based on multivariate analysis. Conclusions. We observed a gradual increase in the survival of glioblastoma patients who were treated with radical intent over the last ten years. Good functional surgery, advances in radiotherapy and addition of temozolomide all contributed to this increase. Though the increased survival seems to be more pronounced in certain subgroups, we have still not been able to exactly define them. Further research, especially in tumour biology and genetics is needed.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

Initiation of Clozapine Therapy in a Patient With Preexisting Leukopenia: A Discussion of the Rationale of Current Treatment Options

2001 ◽  
Vol 13 (4) ◽  
pp. 233-237 ◽  
Author(s):  
Roger Boshes ◽  
Theo Manschreck ◽  
Jean Desrosiers ◽  
Steven Candela ◽  
Meredith Hanrahan-Boshes
Keyword(s):  
Treatment Options ◽  
Current Treatment ◽  
Clozapine Therapy
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