• Korean Journal of Clinical Pharmacy
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• v.33 no.3
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• pp.178-185
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• 2023

Objective: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease. Both tralokinumab and dupilumab have been recommended in the European Guideline for the treatment of adult patients with severe AD. In Korea, dupilumab has been approved for patients with moderate to severe AD, and reimbursed for those with severe AD. Since there is no clinical trial directly comparing tralokinumab and dupilumab, we conducted indirect comparison to assess the clinical usefulness in patients with AD. Methods: We selected clinical trials for indirect comparison through a systematic literature review. Individual patient data were available for the tralokinumab clinical trial, and aggregated data were available for the dupilumab clinical trial. Therefore, we employed the Matching-Adjusted Indirect Comparison (MAIC) method. The treatment efficacy was assessed based on whether patients achieved a 75% reduction on the Eczema Area and Severity Index (EASI 75) after drug administration. Results: The difference in the proportion of patients achieving EASI 75 between tralokinumab and dupilumab was 4.7% (95% CI: -7.9 to 17.3). Considering the non-inferiority margin for the EASI 75 achievement rate is -10%, tralokinumab is deemed non-inferior to dupilumab as the lower bound of the CI for the difference in the EASI 75 achievement rate between tralokinumab and dupilumab was within -10%. Conclusion: We conducted a MAIC analysis comparing tralokinumab and dupilumab based on EASI 75 achievement. The findings of this study show that tralokinumab is non-inferior to dupilumab and can be implemented in Korean clinical settings with a therapeutic position comparable to dupilumab.

• Korean journal of dermatology
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• v.56 no.10
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• pp.581-593
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• 2018

Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disease that affects both children and adults. AD is the cause of considerable morbidity including severe pruritus and impaired quality of life. Treatments for active disease include avoidance of triggering factors, barrier repair, topical medications including topical corticosteroids (TCs) and topical calcineurin inhibitors (TCIs), phototherapy, antibacterial agents, and systemic immunosuppressants including cyclosporine. Until recently, the only Food and Drug Administration (FDA)-approved systemic treatment options for patients with moderate-to-severe AD were steroids and cyclosporine. Systemic steroids are not recommended by current guidelines and are commonly associated with disease rebound. Instead, clinicians choose from several off-label immunosuppressants. In 2018, the Korean FDA approved dupilumab for adults with moderate-to-severe AD whose disease is not adequately controlled with topical therapies. The implementation of treatment guidelines for AD is challenging. Herein, we review the several treatment modalities for AD and recommend a treatment algorithm.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.35 no.1
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• pp.91-104
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• 2022

Objectives : The objective of this study is to report a case of a male atopic dermatitis patient accompanying seborrheic capitis and nummular eczema improved by Korean medicine therapy and lifestyle modification. Methods : A male patient was hospitalized for eczematous lesions in the head, face, and both hands which relapsed on March 2021. For 15 days, he took Korean medicine therapy including acupuncture, Bangpungtongseongsan-gagam, pharmacopuncture, and wet dressing with Hwangryunhaedok-tang. Simultaneously, lifestyle correction also conducted during administration. On the other hand, corticosteroid and antihistamine were prescribed from internal medicine of our hospital for the first 10 days because of severe skin lesions. As an outpatient, he was continuously treated by the same Korean medicine therapy except herbal decoction weekly for about 7 months after discharge. To assess symptoms, scoring atopic dermatitis(SCORAD) index, taking photos, and numerical rating scale(NRS) were used. Results : After 15 days of hospitalization, the SCORAD index decreased to 30.0, which was about a half of the initial SCORAD index(61.2). NRS score also dropped from 6 to 3. Despite stopping western medicine administration, skin lesions and subjective symptoms of the patient were steadily improved without aggravation. For 7 months of continued outpatient treatment, atopic dermatitis were steadily ameliorated despite temporary aggravation and improvement of symptoms, and seborrheic capitis was not relapsed. The final SCORAD index and NRS on November 9th, 2021 were 24.7 and 1, respectively. Conclusions : These results suggests that Korean medicine therapy contributes to improving SCORAD index, subjective symptoms, and skin lesions of the patient. Furthermore, lifestyle modification is also important as much as proper treatment for caring atopic dermatitis patients.

• The Journal of Korean Medicine
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• v.22 no.2
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• pp.10-21
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• 2001

Objectives : Atopic dermatitis(AD) assume an remarkable clinical aspect and it s diagnosis almost depends on clinical symptoms. Therefore, we aimed to study the clinical diagnostic standard of AD for more accurate treatment. We repert as follows; Methods : For 6 months from March to August in 2000 we selected fifty outpatients who were prognosis of AD in the department of dermatology, Oriental medical hospitol, Dong-eui University. Results and Conclusions : 1. We classified of the grade, the condition of AD patient was slight and severe, by the sum of total by the clinical index of AD (diagnostic features). 2. By consulting previous oriental medical theories, we divided symptom-complex of AD into two type ; one was damp-heat type and the other was deficiency of blood- wind-dryness type. 3. Male to female ratio was 17 : 33 and the third stage, more than half of the patients were adolescents. 4. According to the results of symptom-complex of AD patients, on the first examination damp-heat type was more than deficiency of blood-wind-dryness type and in progressing treatment, the condition has been change to deficiency of blood-wind-dryness type. 5. In the lesions of AD, arm and knee were most serious skin lesions and in symptoms of AD, pruritus was most complained, and in progressing treatment, erosion and erythema were greatly improved. 6. When we measured the levels of serum Total IgE, that of thirty eight patientswere higher than that of normal, but elevation of serum IgE levels was not correlated with the severity of AD.

• Clinical and Experimental Pediatrics
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• v.58 no.3
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• pp.96-101
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• 2015

Purpose: Atopic dermatitis (AD) is a chronic inflammatory relapsing skin disorder. Vitamin D plays a pivotal role in the development of AD, and interleukin (IL) 31 is known to be related to pruritus in AD. The aim of our study was to determine whether 25-hydroxyvitamin D (25(OH)D) levels are related to IL-31 levels or to the severity of AD. Methods: We enrolled 91 children with AD and 32 control subjects without history or symptoms of allergic diseases. Blood was drawn to evaluate complete blood cell count, total eosinophil count (TEC), and total IgE, specific IgE to common allergens, 25(OH)D, and IL-31 levels. Serum 25(OH)D and IL-31 levels were measured using high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively. The scoring atopic dermatitis (SCORAD) index was used to evaluate the severity of AD. Results: The mean 25(OH)D level was significantly lower in the AD group than in the control group; 25(OH)D decreased greatly in the moderate and severe AD groups compared with the mild AD group. Children with atopic sensitization showed significantly lower 25(OH)D levels than nonatopic children. However, serum IL-31 levels were not related to AD group, SCORAD index, or 25(OH)D levels. The SCORAD index was inversely correlated with serum 25(OH)D level and positively correlated with TECs and total IgE levels. Children with moderate and severe AD had significantly higher TECs than children with mild AD. Conclusion: Vitamin D is related to the severity of AD independently of IL-31.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.27 no.3
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• pp.40-55
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• 2014

Objectives : The purpose of this study is to confirm the effects of external applications(CLANCHE SM A Clinic) containing herbal extracts on patient with atopic dermatitis. Methods : A total of 24 patients who visited Semyung Oriental Medical Center from January 15th, 2014 to February 20th, 2014 were included in the study. In this study, the patients were treated with external applications(CLANCHE SM A Clinic) containing herbal extracts. For 4 weeks of gross examination and instrumental assesment were made before and after the study. Results : 1. In the primary endpoint, SCORAD index showed a statistically significant decline. 2. In the secondary endpoint, index of skin hydration and index of TEWL showed statistical significance. 3. In the secondary endpoint, index of skin pH showed no statistically significant result. 4. To evaluate the safety of the products for the human body, vital sign check were conducted and showed no statistically significant result. And There were no severe adverse events during this study. Therefore, it is suggested that the safety of the products, if used for certain period, should be safe for the human body. 5. In global assesment of efficacy, both experimenter and subjects evaluated external applications were effective. Conclusions : According to the above experiments, it is suggested that external applications(CLANCHE SM A Clinic) containing herbal extracts should be effective for the atopic dermatitis.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.2
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• pp.104-112
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• 2018

Objectives : The purpose of this study is to examine whether the topical preparations containing 12 herbal extracts is effective for patients with atopic dermatitis. Methods : We retrospectively reviewed the medical records of 11 patients who were prescribed topical preparations containing 12 herbal extracts on the outpatient clinic of 4 hospitals; Noble Korean Medicine Clinic, Amar Korean Medicine Clinic, Chung-Yeon Korean Medical Hospital, Donggwangju Chung-Yeon Korean Medical Hospital. Results and Conclusions : A total of 11 patients were included in the selection and exclusion criteria. The OSI mean value before treatment and at the last treatment day decreased significantly from $37.03{\pm}16.75$ to $13.32{\pm}9.83$, and the mean value of EASI decreased from $13.33{\pm}12.85$ to $2.78{\pm}5.00$, which was statistically significant. No safety concerns were reported. The results of this study confirmed the possibility that the topical preparations can be effective in moderate to severe infants, adolescents, and adult atopic dermatitis patients.

• Nutrition Research and Practice
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• v.10 no.4
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• pp.398-403
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• 2016

BACKGROUND/OBJECTIVES: Atopic dermatitis (AD), a chronic inflammatory skin disease, is accompanied by disruption of the epidermal lipid barrier, of which ceramide (Cer) is the major component. Recently it was reported that vitamin C is essential for de novo synthesis of Cer in the epidermis and that the level of vitamin C in plasma is decreased in AD. The objective of this study was to determine the associations among clinical severity, vitamin C in either plasma or epidermis, and Cer in the epidermis of patients with AD. SUBJECTS/METHODS: A total of 17 patients (11 male and 6 female) aged 20-42 years were enrolled. The clinical severity of AD was assessed according to the SCORAD (SCORing Atopic Dermatitis) system. Levels of vitamin C were determined in plasma and biopsies of lesional epidermis. Levels of epidermal lipids, including Cer, were determined from tape-stripped lesional epidermis. RESULTS: The clinical severity of patients ranged between 0.1 and 45 (mild to severe AD) based on the SCORAD system. As the SCORAD score increased, the level of vitamin C in the plasma, but not in the epidermis, decreased, and levels of total Cer and Cer2, the major Cer species in the epidermis, also decreased. There was also a positive association between level of vitamin C in the plasma and level of total Cer in the epidermis. However, levels of epidermal total lipids including triglyceride, cholesterol, and free fatty acid (FFA) were not associated with either SCORAD score or level of vitamin C in the plasma of all subjects. CONCLUSIONS: As the clinical severity of AD increased, level of vitamin C in the plasma and level of epidermal Cer decreased, and there was a positive association between these two parameters, implying associations among plasma vitamin C, epidermal Cer, and the clinical severity of AD.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.24 no.3
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• pp.84-107
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• 2011

Purposes : The purpose of present study is to detect the effects of ointment contained Takrisodok-Eum on the skin barrier's recovery of the Atopic dermatitis. Methods : A total of 44 patients who visited Semyung Oriental Medical Center from April 27th, 2011 to September 20th, 2011 were included in the study. In this study, the patients were treated with Takrisodok-Eum (experimental group) and positive control group. For 8 weeks of gross examination, hematological examination and instrumental asessment were made before and after the study to examine how well the products for experimental group with those for control group in recovering the damaged skin barriers by Atopic dermatitis. Results : 1. In the primary endpoint, SCORAD Index showed a statistically significant decline in experimental group. 2. In the secondary endpoint index of skin hydration, both the experimental group and the control group showed statistical significance. 3. In the secondary endpoint index of TEWL, the experimental group showed greater statistical significance than the control group. 4. In the secondary endpoint index of skin pH, skin pH showed a statistically significant decline in both the control group and the experimental group within the normal range. 5. In the secondary endpoint index of Total IgE, Eosinophil count, IL-10, IL-13, both the experimental group and the control group showed no statistical significance. 6. To evaluate the safety of the products for the human body, hematological examination and hematological biochemical examination, vital sign check were conducted; both control group and experimental group showed no abnormal level. And There were no severe adverse events during this study. Therefore, it is suggested that the safety of the products, if used for certain period, should be safe for the human body. Conclusions : According to the above experiments, it is suggested that Takrisodok-Eum should be effective for the Atopic dermatitis.

• Korean Journal of Veterinary Research
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• v.60 no.1
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• pp.19-24
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• 2020

This study assessed the effects of probiotics in canine atopic dermatitis (AD). We enrolled 11 client-owned dogs with AD and randomly allocated them to two groups. The probiotics group (n = 7) was prescribed with Bifidobacterium longum while the control group (n = 4) received a placebo powder once a day for 12 weeks. In both groups, the degree of skin lesions was evaluated based on the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4. We also measured the transepidermal water loss (TEWL). We assessed pruritus severity using the pruritus visual analog scale (PVAS). Alteration of consumed drug doses was converted into medication scores. All the evaluation indices were surveyed every 4 weeks. In the probiotics group, there was a significant decrease in the CADESI-4 score at 4, 8, and 12 weeks compared to that of the baseline score (p < 0.05). There was no significant difference in TEWL, PVAS, and medication score at each time point and between groups. Although these results showed that Bifidobacterium longum did not reduce pruritus, TEWL, and the dosage of drugs for canine AD, it was effective in improving skin lesions, therefore, probiotics could be considered in canine AD with severe skin symptoms.