News in brief: Two novel therapies for molluscum contagiosum; Biologic has sustained efficacy in severe chronic plaque psoriasis; Call to ban human sunscreen testing

Tuesday, 19 Jul 2022

Two novel therapies for molluscum contagiosum

After years of telling patients with molluscum contagiosum (MC) to ‘wait it out’ for the viral blisters to resolve spontaneously, clinicians may soon have two new effective therapies, according to a paper in JAMA Dermatology.

While MC blisters typically  self resolve within a year, recent studies with a novel film formulation of cantharidin, 0.7%, showed that 50% of children achieved the primary end point of complete clearance by day 84 compared with 15% in a placebo group.

Furthermore, the new product known as VP-102 was associated with a reduction of overall MC burden and a 76% reduction in lesion count compared with 0.3% in the control group, wrote Dr Vikash Oza, dermatologist at New York University Grossman School of Medicine.

A second novel therapy – berdazimer gel, 10.3% (Novan) – releases nitric oxide on application and is presumed to be associated with a direct antimicrobial effect that promotes a localised innate immune response, he noted.

In a trial involving 891 children with MC, 32% of patients receiving berdazimer gel applied daily achieved complete clearance at day 84 compared with 20% of those receiving placebo, he noted.

The drawback of modest efficacy and need for prolonged daily application is countered by the potential for families to have a home treatment option for their child with MC he said.

Biologic shows sustained efficacy in severe chronic plaque psoriasis

The biologic IL-17 inhibitor secukinumab has shown high drug survival and sustained effectiveness in patients with severe chronic plaque psoriasis (CPP) in an Australian study.

Led by Dr Peter Foley of the Skin Health Institute, Melbourne, the SUSTAIN study assessed outcomes with secukinumab in 110  biologic-naïve and 184 biologic-experienced patients with CPP.

In a 21-month analysis the drug survival rates in biologic-naïve vs biologic-experienced patients were 0.92 vs. 0.86 (9 months) and 0.82 vs. 0.68 (21 months), respectively, according to findings published in the Australasian Journal of Dermatology.

The proportion of biologic-naïve  patients with PASI 75/90/100 responses was 100/87.7/38.4 at nine months and 100/81.0/41.7 at 21 months

For biologic-experienced patients the proportion with PASI 75/90/100 responses was 98.5/61.5/27.2  at nine months and 98.4/62.0/24.2 at 21 months.

The mean Dermatology Life Quality Index (DLQI) in biologic-naïve vs. experienced patients was 2.2 vs. 3.1  at nine months and 1.4  vs. 3.1 at 21 months.

The study investigators said the findings showed that in real world routine clinical practice patients with CPP showed a high drug survival rate and sustained effectiveness with secukinumab treatment.

The study was supported by Novartis.

Ban human sunscreen testing: Australian experts

Using human volunteers to test sunscreen effectiveness is unethical and inaccurate and should be phased out, according to Australian scientists and cancer experts.

The recommendation from the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA), Cancer Council Victoria and RMIT University is backed by a review that suggests in vitro tests could replace human in vivo tests for sunscreen effectiveness.

Currently criteria for SPF scores require volunteers to wear sunscreen and be exposed to artificial solar UV to measure the time taken for sunburn erythema to occur.

ARPANSA Chief Radiation Health Scientist Dr Rick Tinker said the standards used by groups such as the FDA and TGA presented ethical challenges because they required people to be exposed to carcinogenic UV radiation.

“We shouldn’t be risking people’s long-term health to test the effectiveness of sunscreens,” he said.

The paper also found that human erythema tests were subjective, inaccurate, time consuming and inconsistent because of different skin types.

However Australian scientists have now developed a prototype sensor that changes colour when exposed to UV radiation, which they say could be customised for human-free sunscreen testing by mimicking the skin. They say they are working with ARPANSA to develop the required human-free sunscreen testing methods and protocols, potentially within this decade.

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