The edition · Dermatology
Switching back and forth between ustekinumab and its biosimilar left drug levels unchanged
Three switches between ABP 654 and reference ustekinumab met every pharmacokinetic margin; low-dose extended-release minocycline beat doxycycline in rosacea; and kidney transplant recipients died of keratinocyte cancer at 34 times the general rate.
The edition in brief
A randomised double-blind trial of 453 patients with moderate-to-severe plaque psoriasis found that alternating three times between the biosimilar ABP 654 and reference ustekinumab gave drug exposure within the prespecified similarity margins (AUC ratio 0.93, Cmax ratio 0.95), with similar efficacy, antidrug antibodies and adverse events to staying on the reference product. A meta-analysis of three randomised trials (643 patients) found minocycline 40 mg extended-release was more likely than modified-release doxycycline to achieve treatment success in moderate-to-severe rosacea (OR 2.51) and reduced inflammatory lesions by about 4.6 more, with similar adverse events. An Australian and New Zealand registry of 21 503 kidney transplant recipients found skin cancer mortality 11 times the general population's, driven by keratinocyte cancer (34.5 times), and highest where ultraviolet exposure is high. A UK feasibility study of 20 patients with palmoplantar pustulosis found upadacitinib reduced PP-PASI from 20.3 to 4.6 over eight weeks against historic placebo; this is an open-label signal, not a treatment recommendation. Today's pearl covers photosensitivity with the tetracyclines.
Low-dose extended-release minocycline outperformed doxycycline in moderate-to-severe rosacea
For persistent papulopustular rosacea, low-dose extended-release minocycline 40 mg is a better-performing alternative to doxycycline where it is available.
Kidney transplant recipients died of keratinocyte cancer at 34 times the general rate
Put every kidney transplant recipient on scheduled skin surveillance and fast-track excision of suspicious lesions.
Upadacitinib showed a large early signal in palmoplantar pustulosis in a small open-label study
Upadacitinib looks promising in palmoplantar pustulosis, but the evidence is an eight-week open-label signal; wait for a randomised trial.
Doxycycline burns; minocycline pigments
Warn about sunburn with doxycycline and look for pigmentation and lupus-like symptoms with long-term minocycline.
Repeated switching between ustekinumab and its biosimilar kept drug exposure and response the same
Switching stable psoriasis patients between ABP 654 and reference ustekinumab, even more than once, is supported by randomised pharmacokinetic and clinical data; other biosimilars need their own switching data.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for dermatology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free