Intensity of Local Skin Reactions During 5-Fluorouracil Treatment Related to the Number of Actinic Keratosis Lesions: A Post Hoc, Exploratory Analysis

Background: Currently available topical treatments for actinic keratosis (AK) adversely affect patients’ quality of life because of long treatment durations and long-lasting local skin reactions (LSRs), which may result in poor treatment adherence and patient outcomes. Ingenol mebutate gel, a recently introduced treatment for AK, is administered for 2 or 3 days, and LSR’s are predicable in onset and duration. Objectives: The objective of the study was to estimate the value of ingenol mebutate gel’s shorter treatment duration and tolerability profile to potential patients, versus existing topical treatments (imiquimod 3.75%, imiquimod 5% and diclofenac 3%) in the United States. Methods: The open-ended Contingent Valuation (CV) approach was used to estimate incremental willingness-to-pay (WTP) for ingenol mebutate gel rather than treatment with imiquimod 5%, imiquimod 3.75% and diclofenac 3%. Profiles for each therapy differed in regards to treatment duration, time-to-LSR resolution, and price. Subjects were asked to state their maximum out-of-pocket WTP to receive ingenol mebutate gel instead of each of the three alternatives. Results: 103 subjects provided usable answers. Between 48% and 63% of subjects were willing to pay extra to gain access to treatment with the ingenol mebutate gel profile instead of the comparators, and the mean incremental WTP ranged from $475 to $518. Subjects with experience of topical treatment stated higher WTP for accessing ingenol mebutate gel. Subjects whose most bothersome AK area was the full scalp or forehead also claimed higher WTP for ingenol mebutate gel. Conclusions: Patients diagnosed with AK indicated an unmet need for fast-acting topical treatment with shorter LSR resolution time.

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Evaluation of Different Approaches in Managing Local Skin Reactions With the Use of Ingenol Mebutate 0.015% and 0.05% During the Treatment of Actinic Keratosis

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.4.supp.64 ◽

2020 ◽

Vol 4 (5) ◽

pp. s65

Author(s):

Scott Freeman ◽

Miriam Bettencourt ◽

Meg Corliss ◽

Nikeshia Dunkelly-Allen ◽

Karen A Veverka

Keyword(s):

Actinic Keratosis ◽

Ingenol Mebutate ◽

Skin Reactions ◽

Local Skin

Abstract not available.

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16258 Evaluation of different approaches in managing local skin reactions with the use of ingenol mebutate 0.015% and 0.05% during the treatment of actinic keratosis

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2020.06.320 ◽

2020 ◽

Vol 83 (6) ◽

pp. AB58

Author(s):

Scott Freeman ◽

Miriam S. Bettencourt ◽

Meg Corliss ◽

Nikeshia Dunkelly-Allen ◽

Karen A. Veverka

Keyword(s):

Actinic Keratosis ◽

Ingenol Mebutate ◽

Skin Reactions ◽

Local Skin

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Local skin reactions following the administration of topical ingenol mebutate for actinic keratosis

Dermatology Online Journal ◽

10.5070/d3239036499 ◽

2017 ◽

Vol 23 (9) ◽

Author(s):

Alberto Conde-Taboada ◽

Bárbara Mercado ◽

Beatriz Aranegui ◽

Elena González-Guerra ◽

Eduardo López-Bran

Keyword(s):

Actinic Keratosis ◽

Ingenol Mebutate ◽

Skin Reactions ◽

Local Skin

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OP0288 ANTI-IL1 TREATMENT IN COLCHICINE RESISTANT PEDIATRIC FMF PATIENTS-REAL LIFE DATA FROM THE HELIOS REGISTRY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1313 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 179.1-180

Author(s):

E. Sag ◽

F. Akal ◽

E. Atalay ◽

U. Kaya Akca ◽

S. Demir ◽

...

Keyword(s):

Age At Onset ◽

Real Life ◽

First Line ◽

Research Support ◽

Skin Reactions ◽

Local Skin ◽

Extreme Stress ◽

On Demand ◽

Drug Registry ◽

Treatment Onset

Background:FMF is a prototype of autoinflammatory diseases associated with excess IL1 production. Anti-IL1 treatments are the first-line alternatives in colchicine resistant/intolerant FMF patients.Objectives:We aimed to investigate the efficacy and safety of anti-IL1 treatment in pediatric FMF patients in our local (HELIOS) registry.Methods:HELIOS (Hacettepe univErsity eLectronIc research fOrmS) is a web-based biological drug registry for pediatric rheumatology patients (helios.hacettepe.edu.tr). Data were recorded at biological treatment onset (month 0), at month 6 and yearly thereafter in patients. We have analysed the clinical features, disease activity parameters, treatment responses and safety outcomes in FMF patients treated with anti-IL1 agent.Results:Forty pediatric FMF patients were included to the study group (67% female).Thirty-four patients received continous anti-IL1 treatment. The mean age at the start of the colchicine was 5.55±3.87 years. Age at onset of the anti-IL1 treatment was 11.47±5.41 with a mean follow-up duration of 3.87±1.96 years. Apart from two patients, all of them had biallelic exon-10 mutations.We have also given anti-IL1 treatment on an on-demand basis in six adolescent patients. Five of them were having very severe attacks during menstrual periods and one was having attacks during extreme stress periods along with very high CRP levels. The quality of life has markedly improved and these patients no longer reveal any CRP elevation.Anakinra was used as the first-line anti-IL1 treatment. During the last visit, six patients were treated with anakinra and 28 patients were treated with canakinumab. Anti-IL1 treatment decreased the CRP levels, number and severity of the attacks. (Figure 1.) There were three hospitalizations reported due to mild infections. Eleven patients had local skin reactions, two patients had leukopenia with anakinra and one patient had thrombocytopenia with canakinumab. We have discontinued anti-IL1 treatment until the cytopenia subsided. We have switched to on-demand therapy in one patient, started the same treatment and gradually increased the dose in the other two patients. There were no malignancy or other severe adverse reactions.Figure 1.Conclusion:Anakinra and canakinumab are efficient and safe alternatives in colchicine resistant and intolerant pediatric FMF patients. We also for the first time, report on-demand use of anti-IL1 in pediatric FMF patients. We suggest that on-demand treatment should be considered under certain circumstances where the trigger is known and short-lasting (such as menstruation and periods of extreme stress)Acknowledgments:Authors would like to thank Elif Arslanoglu Aydin, Armagan Keskin, Kubra Yuksel and Emil Aliyev for their contribution to the HELIOS registryDisclosure of Interests:Erdal Sag Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Fuat Akal Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Erdal Atalay Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Ummusen Kaya Akca Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Selcan Demir Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Dilara Demirel Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Ezgi Deniz Batu Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Yelda Bilginer Grant/research support from: Novartis and SOBI financially supported the HELIOS registry during the establishment of infrastructure, Seza Özen Consultant of: Novartis, Pfizer, Speakers bureau: SOBI, Novartis

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Infection, immunity and the development of local skin reactions in rabbits infected with cyclically-transmitted stocks ofTrypanosoma congolense

Annals of Tropical Medicine and Parasitology ◽

10.1080/00034983.1983.11811755 ◽

1983 ◽

Vol 77 (6) ◽

pp. 569-582 ◽

Cited By ~ 15

Author(s):

A. G. Luckins ◽

P. F. Rae ◽

A. R. Gray

Keyword(s):

Skin Reactions ◽

Local Skin

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Effective Combination of Photodynamic Therapy and Imiquimod 5% Cream in the Treatment of Actinic Keratoses: Three Cases

BioMed Research International ◽

10.1155/2013/102698 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Laura Held ◽

Thomas Kurt Eigentler ◽

Ulrike Leiter ◽

Claus Garbe ◽

Mark-Jürgen Berneburg

Keyword(s):

Photodynamic Therapy ◽

Patient Adherence ◽

Proof Of Concept ◽

Treatment Area ◽

Skin Reactions ◽

Local Skin ◽

Once Daily ◽

Actinic Keratoses ◽

Effective Combination

Background. The therapy for actinic keratoses includes photodynamic therapy (PDT) and imiquimod 5% cream. The sequential use of both could result in better clinical outcomes.Objectives. To enhance efficacy of therapies while improving tolerability, convenience, and patient adherence with a scheme combining two concomitant or sequential AK treatments.Methods. All patients underwent one session of conventional PDT. Two weeks after, the PDT imiquimod 5% cream was applied to the treatment area once daily for three days per week. One course continued for four weeks followed by a clinical evaluation and decision about further treatment. Patients who had not cleared all of their AK lesions in the treatment area in course 1 participated in a second 4-week course of treatment.Limitations. Small size of population.Results. Three participants were enrolled. Two patients showed complete clinical clearance of AKs. The effect was also noted after long-term followup, at months seven and eleven. No subject discontinued for an adverse event. There were severe local skin reactions in two participants which were severe erythema, scaling, and crusting. One patient showed no response to the therapy.Conclusions. Photodynamic therapy followed by imiquimod was well tolerated and improved reduction of actinic keratoses. This initial proof-of-concept should be studied in larger clinical trials.

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