Efgartigimod did not improve pemphigus remission on prednisone, and pustular psoriasis carries a threefold mortality risk

The edition in brief

In the phase 3 ADDRESS trial of 222 adults with moderate-to-severe pemphigus, subcutaneous efgartigimod plus prednisone did not raise complete remission on minimal steroid in pemphigus vulgaris at 30 weeks compared with prednisone alone (35.5% vs 30.3%, OR 1.19, 0.60 to 2.41), and steroid use was similar, even though IgG and desmoglein antibodies fell quickly. In England, 991 people with generalised pustular psoriasis among 25.8 million had over three times the all-cause mortality of matched controls (aHR 3.19) and nearly ten times the sepsis mortality; prevalence rose by more than half from 2008 to 2022 and onset was earlier in Asian people. A survey of 296 people alive more than five years after stage IV melanoma found about 40% with persistent treatment effects and 40% with raised distress. A proteomic model separated metastasising from non-metastasising cutaneous squamous cell carcinomas with 89% accuracy in archival samples, an early research finding. In a 57-patient phase 2 trial, deuruxolitinib 8 mg twice daily regrew more scalp hair than 16 mg once daily in severe alopecia areata.