Efficacy and safety of adalimumab in Chinese patients with moderate-to-severe plaque psoriasis: results from a phase 3, randomized, placebo-controlled, double-blind study.

BACKGROUND: This phase 3 trial is the first to evaluate the efficacy and safety of treatment with the systemic TNF-α inhibitor, adalimumab, for Chinese patients with moderate-to-severe plaque psoriasis. METHODS: In the 12-week, double-blind, placebo-controlled Period A, patients were randomized 4 : 1 to receive adalimumab 40 mg every-other-week (following a single 80 mg dose), or placebo every-other-week. In the subsequent 12-week, open-label, Period B, all patients received adalimumab 40 mg every-other-week starting at week 13, following a single, blinded dose at week 12 of adalimumab 80 mg or matching placebo (for patients receiving placebo or adalimumab in Period A respectively). In Period A, efficacy was analysed for all randomized patients and safety for all patients receiving ≥1 dose of the study drug. RESULTS: For the 425 patients in this study (87 placebo; 338 adalimumab), a higher percentage randomized to adalimumab achieved the primary endpoint of ≥75% improvement from baseline in PASI score (PASI 75) at week 12: placebo 11.5% (10/87); adalimumab 77.8% (263/338; P < 0.001). Physician's Global Assessment of clear to minimal was achieved at week 12 by 14.9% placebo (13/87) and 80.5% adalimumab (272/338; P < 0.001). For patients who received adalimumab at any time during the study (All-adalimumab Population), treatment-emergent adverse events (AEs) were reported by 63.4%; the most common was upper respiratory infection (16.1%). Serious AEs were reported by 3.5% of the All-adalimumab Population, and serious infectious AEs by 1.2%, which include lung infection, pneumonia and tuberculosis [2 (0.5%) patients each]. There was one death (chronic heart failure). CONCLUSION: In these Chinese patients with moderate-to-severe psoriasis, a significantly greater percentage treated with adalimumab compared with placebo achieved efficacy endpoints at week 12 and efficacy was sustained to week 24. Safety results were consistent with the known adalimumab safety profile; no new safety signals were identified in the 24 weeks of treatment.

A multicentre, randomized, single-blind comparison of topical clindamycin 1%/benzoyl peroxide 5% once-daily gel versus clindamycin 1% twice-daily gel in the treatment of mild to moderate acne vulgaris in Chinese patients.

BACKGROUND: Acne vulgaris affects up to 54% of Chinese adolescents. Combination therapy has become the recommended standard of care for acne. OBJECTIVE: The aim of this study was to compare the efficacy and safety of clindamycin (1%) and benzoyl peroxide (5%) (CDP/BPO) gel once daily vs. clindamycin (1%) (CDP) monotherapy gel twice daily in Chinese patients with mild to moderate acne. METHODS: 1020 patients (aged 12-45 years) with mild to moderate acne were randomized (1 : 1); 1016 patients were treated with CDP/BPO (n = 500) or CDP (n = 516) for a 12-week treatment period. Efficacy assessments were performed at baseline, and at weeks 1, 2, 4, 8 and 12; and primarily included change in total lesion count (inflammatory and non-inflammatory lesions), and proportion of patients with a minimum 2-grade improvement in Investigator's Static Global Assessment (ISGA) score. Patient safety and local tolerability were also evaluated. RESULTS: Patients in CDP/BPO group showed a greater per cent reduction in total lesion count compared with patients in CDP group at week 12 (delta = -0.05; 95% CI = -0.09, -0.02; P = 0.003); statistically significant reduction in lesion count was noted as early as week 1 and continued through week 12. A greater proportion of patients in CDP/BPO group showed a ≥2-grade improvement in ISGA score at week 12 compared with CDP group (30.2% vs. 22.7%; P = 0.018). Overall, the incidence of adverse events (AEs) was higher in the CDP/BPO group (14.4%) than in the CDP group (7.9%); the most commonly reported events were generally related to application site reactions (erythema, pruritus and swelling). Incidence of drug-related AEs was 8.6% in CDP/BPO group and 1.2% in CDP group. Both groups showed trends towards reduction in investigator and subject rated local tolerability scores. CONCLUSION: CDP/BPO gel demonstrated superior efficacy over CDP gel along with acceptable safety and tolerability in Chinese patients with mild to moderate acne. GOV NUMBER: NCT01915732.

Reconstitution of myocardial lymphatic vessels after acute infarction of rat heart.

We investigated the regeneration of cardiac lymphatic vessels and capillaries in the infarcted myocardiac zones after acute myocardial infarction in rats. The anterior descending artery of the heart was ligated for infarction and both immunohistochemistry and immunofluorescence were used to detect pathological changes of lymphatic vessels in infarcted zone (IZ), infarcted margin zone (MZ) and remote margin zone (RMZ) on days 7, 14, 21, and 28 after surgery. Dynamic variation of lymphatic vessels existed in IZ, MZ and RMZ at different stages after surgery. At day 7, lymphatic vessels and capillaries were not seen in the IZ, very thin lymphatic capillaries were obviously increased in the inner layer of the margin zone, and enlarged and increased lymphatic capillaries were found in the outer layer of margin zone. At 14 days, a few sparsely arranged lymphatic capillaries were observed in the IZ without marked changes in the MZ. At 21 days, constricted regenerating lymphatic capillaries in MZ were decreased, and lymphatic vessels exhibited sprouting towards the IZ. At 28 days, more lymphatic capillaries emerged in the IZ, and the morphology and number of lymphatic vessels and capillaries had returned to normal. There were no marked changes of lymphatic vessels and capillaries in RMZ compared to control myocardium at the 4 time points. This study demonstrates varied remodeling of lymphatic vessels and capillaries in the IZ and MZ after acute myocardial infarction, and these changes in lymphatic vessels likely play an important role for recovery of infarcted myocardiac function.

Lack of evidence for OSMR and RET gene mutations in a Chinese family with friction melanosis.

BACKGROUND: Friction melanosis (FM) is a common dermatological disorder. Although cases have been reported, familial FM is rare. FM and macular amyloidosis (MA) have been hypothesized to be identical clinical conditions, and cutaneous lichen amyloidosis (CLA) is linked to mutations in the OSMR (oncostatin M receptor) or RET (receptor tyrosine kinase) genes. AIM: To evaluate the OSMR and RET gene mutations in a Chinese family with FM. Methods. We investigated a family with FM with six affected members in four successive generations. All 17 exons of the OSMR and 19 exons of the RET genes were screened for mutation by PCR, and restriction enzyme digestion assays for RET codon 634 mutations were performed for selected members of the family. RESULTS: Based on the pedigree characteristics, we suggest an autosomal dominant mode of inheritance in this FM family. We did not detect any mutations in the OSMR or RET genes. CONCLUSIONS: We report a rare case of familial FM. Genes other than OSMR and RET may be involved in the pathogenesis of this family.