Registrars and GPs to prescribe apremilast

The Pharmaceutical Benefits Advisory Committee has recommended amendments to the PBS subsidy criteria for apremilast (Otezla) to allow accredited dermatology registrars to initiate treatment for the psoriasis drug in consultation with a dermatologist.

At its intracycle meeting the PBAC also recommended that PBS criteria be amended to allow GPs to prescribe apremilast as maintenance treatment in consultation with a dermatologist or accredited dermatology registrar.

“The PBAC advised that the changes to the initial treatment criteria for apremilast to include dermatology registrar prescribing should flow-on to ciclosporin for the treatment of severe psoriasis,” the Committee said in a meeting summary statement.

Apremilast was first listed on the PBS in January 2021 for the treatment of patients with severe chronic psoriasis.

Melanoma protein discovery by SA researchers

A protein that I overexpressed in melanoma cells may guide decisions on treatment and prognosis, according to South Australian researchers.

A team from the University of South Australia’s Centre for Cancer Biology has identified the desmoglein-2 (DSG-2) protein and found melanoma patients who express it are two-and-a-half times more likely to die within 10 years.

Preliminary lab work has uncovered how to block the protein using nanotechnology and research efforts will now look at ways to better isolate those patients most at risk.

“By injecting a cancer-cell-seeking molecule intravenously, we can find the melanoma cells with high levels of DSG-2 and attack them, reducing their severity,” lead researcher Professor Claudine Bonder said.

“We’re confident that we can identify the subgroup of patients that have elevated expressions of DSG-2 on their cancer cells. We’re also confident that we can block this protein on the melanoma, giving patients a better outcome,” she said.

Healthcare staff anxious and bullied over PPE provision

One in five frontline healthcare workers received no training on the use of personal protective equipment (PPE) for COVID-19 when the pandemic was at its height in 2021, and only half received formal training in the workplace, according to a survey of Victorian healthcare staff.

Responses from 2258 healthcare workers (80% women, 49% doctors and 40% nurses) revealed a wide range of problems with PPE provision in 2021, including a lack of PPE training (20%), lack of fit testing, insufficient PPE (25%) and reuse or extended use of PPE (47%).

More than three quarters (77%) of staff reported workplace bullying by management for being ‘troublemakers’ when they raised issues over PPE, and y more than one fifth (22%) reported moderate to severe anxiety related to the lack of training and provision of PPE.

Similarly, about half of staff (48%) reported confusion and concern  about inconsistent and frequently changing PPE guidelines that failed to recognise the airborne transmission of SARS-CoV-2
“The lack of bargaining power for many respondents limited their agency to resolve matters further exacerbating physical, psychological and financial impacts,” said the authors of the study published in PLOS One.