Organon 2010: is a medical textbook after 200 years still up to date?

The question, proposed by the German Central Union of homeopathic Doctors, is the pivotal subject addressed in a series of lectures and discussions being held all over Germany in 2010, to celebrate the bicentenary of homeopathy´s first medical textbook. Hahnemann´s Organon of the Healing Art is the basis for classical homeopathy. Reading its 6th and posthumous edition is part of the education of 90% of the homeopaths, as indicated by a survey carried out at the 60th Homeopathic World Medical Congress (Berlin 2005). This might be odd to conventional doctors, used to read the latest editions of textbooks and journals, but Hahnemann´s therapeutics seems to be ahead of his time, in that classical homeopathy can be at least as effective as current standard pharmacotherapy. For instance, classical homeopathy for children suffering from atopic eczema showed comparable results to conventional treatment in usual care. Moreover, randomized controlled double blind trials using the dynamization scale introduced by the 6th edition (fifty-millesimal or Quinquagintamillesimal dynamization and its products, the Q-potencies) showed that homeopathically individualized Q-potencies were superior to placebo for fibromyalgia or attention deficit hyperactivity disorder in children, and not inferior to the antidepressant fluoxetine in a sample of patients with moderate to severe depression. More studies using the clinical-pharmaceutical protocol of the Organon are of course needed, but so far its use by trained physicians have yield to challenging results, keeping up with what is recommended in most recent clinical textbooks for the treatment of some chronic diseases.

Depression, Anxiety, and Suicidal Ideation in Patients with Atopic Eczema in a Prospective Study in Leipzig, Germany

<b><i>Background:</i></b> Atopic eczema (AE) is known to be associated with depression and anxiety. We aimed at investigating the occurrence of selected psychological comorbidities in patients with AE under treatment in our university dermatological department. <b><i>Methods:</i></b> Monocentric prospective examination of adult AE patients using PO-SCORAD (Patient-Oriented Severity Scoring of AD), EASI (Eczema Area and Severity Index), POEM (Patient-Oriented Eczema Measure), DLQI (Dermatologic Life Quality Index), LSNS-6 (Lubben Social Network Scale 6), CES-D (Center for Epidemiologic Studies Depression Scale), HADS-D and -A (Hospital Anxiety and Depression Scale), and GAD-7 (Generalized Anxiety Disorder Scale-7) was carried out. We looked for correlations between AE severity and psychosocial comorbidities. Data were compared with age- and sex-matched controls from nonatopic subjects. Statistics: Mann-Whitney U test and Spearman’s rank correlation were used. <b><i>Results:</i></b> Eighty-four patients (44 women, median age 35.0 years, range: 19.4–92.8 years) were included. PO-SCORAD was 40.4 [23.4–55.4] (median [interquartile range]), EASI 9.3 [3.4–18.9], POEM 16 [8–24], and DLQI 10 [4–18]. Compared with 161 from the healthy LIFE-Adult cohort controls, our patients with AE had significantly higher scores for HADS, GAD-7, and CES-D (<i>p</i> &#x3c; 0.001, respectively), but there was no increase in the LSNS score (18 vs. 19; <i>p</i> = 0.067). Within the group of AE patients, there was a significant correlation of the subjective skin severity and the depression and anxiety values: POEM significantly correlated with GAD-7, CES-D, and HADS-A and -D (<i>p</i> &#x3c; 0.001). PO-SCORAD significantly correlated with GAD-7 and CES-D (<i>p</i> &#x3c; 0.05). EASI correlated neither with HADS-A or -D nor with CES-D. Patients with suicidal thoughts, plans, or attempts in the last 12 months had significantly more severe AE than those without (POEM 25 [15.3–26] vs. 15 [7–23]; <i>p</i> = 0.013, and PO-SCORAD 51.6 [40.2–63] vs. 20.5 [20.7–52]; <i>p</i> = 0.014). <b><i>Conclusion:</i></b> Patients with AE being currently under treatment in our department had significantly increased scores indicating depression and anxiety. Suicidal tendency was increased in patients with severe AE. <b><i>Key Message:</i></b> AE patients may develop depression, anxiety, and suicidal ideation. Patient-oriented scores may help identifying high-risk patients.

Comparing abrocitinib and dupilumab in the treatment of atopic dermatitis: a plain language summary

Atopic dermatitis (AD, also called atopic eczema) is a long-term skin disease that causes intensely itchy, red skin. Healthcare providers can prescribe medicated creams and ointments to reduce the signs and symptoms of AD. However, these treatments are not always enough to provide relief. A new medicine called abrocitinib, which is taken every day as a tablet, reduces part of the body’s immune response that happens in AD. The clinical study described in this plain language summary, called JADE COMPARE, investigated how well and how safely 16 weeks of treatment with abrocitinib worked in adults with AD compared to placebo (‘dummy treatment’) and a medicine that is already approved for AD, called dupilumab. The study showed that abrocitinib was better than placebo in improving the signs and symptoms of AD after 16 weeks. In addition, patients who were taking abrocitinib 200 mg for 2 weeks experienced greater relief from itch than patients who were taking abrocitinib 100 mg, placebo, or dupilumab. More people who took abrocitinib 200 mg reported side effects than those taking abrocitinib 100 mg, placebo, or dupilumab, but most of these side effects were mild or moderate.