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New England Journal of Medicine 05/2013; 368(18):e23. · 53.30 Impact Factor
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Journal of the American Academy of Dermatology 01/2013; 68(1):187-8. · 3.99 Impact Factor
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JAMA The Journal of the American Medical Association 09/2012; 308(12):1264-5. · 30.03 Impact Factor
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Acta Dermato-Venereologica 09/2012;
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JAMA The Journal of the American Medical Association 07/2012; 308(4):403-4. · 30.03 Impact Factor
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ABSTRACT: Background The reported efficacy and safety of some biologic agents for psoriasis vary between Caucasians and Asians. Few reports of etanercept exist in psoriasis patients within the Asia-Pacific region. Objectives The study aims to report our clinical experience of etanercept in the treatment of patients with moderate-to-severe psoriasis in Taiwan. Methods A retrospective analysis of 59 patients with moderate-to-severe psoriasis who received etanercept was conducted in a tertiary referral center. Results Etanercept therapy resulted in a reduction of mean Psoriasis Area and Severity Index (PASI) of 47% at week 12 and 61% at week 24. After 12 weeks of treatment, 48%, 26%, and 3.4% of the patients achieved at least PASI50, 75 and 90 response, respectively. At week 24, the proportion of patients achieving at least PASI50, 75 and 90 response was 59%, 37%, and 14%, respectively. Etanercept efficacy in achieving PASI75 improvement was, however, lower than that reported in previous pivotal placebo-controlled trials. No cases of active tuberculosis, viral hepatitis or malignancies were observed during the observation period. Conclusion Our case series demonstrated the efficacy and safety of etanercept for the management of moderate-to-severe psoriasis in Taiwan.
International journal of dermatology 02/2012; · 1.18 Impact Factor
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ABSTRACT: To determine the efficacy of excimer light in the treatment vitiligo and to assess parameters affecting therapeutic results.
This retrospective study analyzed 227 patches of vitiligo in 142 patients. Treatment was performed twice weekly and treatment efficacy was assessed by two independent dermatologists. Patients who received less than 24 treatment sessions were excluded from the analysis of predictive factors for response.
Sixty-eight (30.0%) patches achieved more than 50% repigmentation, and 42 (18.5%) achieved more than 75% repigmentation. The mean treatment numbers to achieve any repigmentation and more than 50% repigmentation were 19.41 and 34.93, respectively. Fewer treatment sessions number, segmental lesions and absence of melasma were significant predictors for poor treatment response in multivariate analysis. Lesions on the hands/feet needed the highest dose and scalp lesions needed the highest number of treatment sessions to produce initial repigmentation.
Excimer light is a valuable treatment modality for both segmental and non-segmental vitiligo even in patients who have failed previous treatments. The number of treatment sessions needed to produce initial pigmentation may be higher than 30 for scalp lesions. There is a need to find other combination methods, both medical and surgical, to enhance its therapeutic efficacy.
Photodermatology Photoimmunology and Photomedicine 02/2012; 28(1):6-11. · 1.30 Impact Factor
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Acta Dermato-Venereologica 11/2011; 92(3):284-5.
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ABSTRACT: The use of anti-tumor necrosis factor (TNF)-α therapy in patients with psoriasis who are hepatitis B virus (HBV) carriers is usually not recommended, and routine antiviral prophylaxis is suggested for those who need the treatment. We report our experience on the safety of anti-TNF-α therapy in patients with psoriasis who are HBV carriers in our clinic using HBV viral load as a guide for HBV treatment. Between 2007 and 2011, seven HBV carriers receiving TNF-α inhibitors for psoriasis in our clinic were collected retrospectively. The HBV viral load and aminotransferase levels were regularly monitored. Two of the seven patients were inactive HBV carriers, and the other five patients had chronic hepatitis B. Only one patient received antiviral agents before the anti-TNF-α treatment. The mean duration of the anti-TNF-α treatment was 26.6 months (range, 14-45 months). These patients were followed up from the start of the anti-TNF-α therapy for a mean duration of 28.9 months (range, 14-45 months). HBV reactivation was observed in three patients, one of whom required antiviral treatment. No HBV reactivation-related hepatitis was observed. In conclusion, prevention of HBV reactivation by monitoring of HBV viral load is cost-effective and may decrease the risk of developing drug resistance from routine anti-HBV prophylaxis treatment. It can be considered as an alternative in psoriasis patients treated by TNF-α inhibitors, especially in areas with a high HBV burden and in hepatitis B e-antigen-negative patients who have a lower risk of viral reactivation.
The Journal of Dermatology 11/2011; 39(3):269-73. · 1.49 Impact Factor
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Journal of the American Academy of Dermatology 10/2011; 65(4):e115-7. · 3.99 Impact Factor
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The Journal of Dermatology 09/2011; 39(4):422-4. · 1.49 Impact Factor
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Clinical Infectious Diseases 08/2011; 53(4):377-8, 396-8. · 9.15 Impact Factor
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Journal of the American Academy of Dermatology 06/2011; 64(6):e121-3. · 3.99 Impact Factor
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ABSTRACT: Topical use of systemic agents to treat cutaneous disorders is widely applied. However, there is a lack of articles summarizing the relevant literature in a systematic way.
We sought to review the published literature regarding topical use of systemic drugs that were categorized according to their mode of actions. Only drugs that are not yet commercially available in a topical preparation are included.
A PubMed search was performed, using as key words "topical," "extemporaneous," "compounding," and names of each generic drug, to identify all clinical reports (1966-2009).
Although many systemic drugs are used topically, randomized controlled trials were limited to a few agents.
Many of the reports consist only of small case series or are anecdotal in nature. As the level of evidence is limited, larger prospective trials are needed before firm conclusions can be drawn.
Extemporaneous compounding helps physicians to individualize treatment to the patient's specific needs and to create topical preparations that are not otherwise commercially available. However, comparative effectiveness studies are needed to determine whether or not topical use of systemic therapeutics is more beneficial than existing therapies.
Journal of the American Academy of Dermatology 05/2011; 65(5):1048.e1-22. · 3.99 Impact Factor
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New England Journal of Medicine 04/2011; 364(14):e28. · 53.30 Impact Factor
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Acta Dermato-Venereologica 05/2010; 90(3):329-30.
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Acta Dermato-Venereologica 01/2010; 90(1):100-1.
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ABSTRACT: A capillary electrophoresis (CE) method coupled with electrochemiluminescence (ECL) detection for the analysis of glyphosate (GLY) and its major metabolite aminomethylphosphonic acid (AMPA) is presented. Complete separation of GLY and AMPA was achieved in 8 min using a background electrolyte of 20 mM sodium phosphate (pH 9.0) and a separation voltage of 21 kV. ECL detection was performed with an indium tin oxide (ITO) working electrode bias at 1.6 V (vs. a Pt-wire reference) in a 30 0mM sodium phosphate buffer (pH 8.0) containing 3.5mM Ru(bpy)3 2+ (where bpy=2.2'-bipyridyl). Linear correlation (r>or=0.997) between ECL intensity and analyte concentration was obtained in the ranges 0.169-16.9 and 5.55-111 microg ml(-1) for GLY and AMPA, respectively. The limits of detection (LODs) for GLY and AMPA in water were 0.06 microg ml(-1) and 4.04 microg ml(-1), respectively. The developed method was applied to the analysis of GLY in soybeans. The LOD of GLY in soybean was 0.6 microg g(-1). Total analysis time including sample pretreatment was less than 1h.
Journal of Chromatography 01/2008; 1177(1):195-8. · 4.53 Impact Factor
