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New Drug Offers Hope To Millions With Severe Eczema

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There’s hope around the corner for those who suffer from eczema, an infuriatingly itchy skin condition with no cure and little consensus on the best course of treatment.

There’s hope around the corner for those who suffer from eczema, an infuriatingly itchy skin condition with no cure and little consensus on the best course of treatment.

The inflammatory skin condition has been historically difficult to treat because the medicines on the market just aren’t that effective, especially for moderate to severe cases. They also have serious side effects and can be toxic. 

But now a new medicine called Dupilumab has shown great promise in current clinical trials. Up to 38 percent of trial participants were completely cleared or almost cleared of their inflamed red and scaly skin patches after a 16-week course of treatment. As a group, they experienced significant decreases in itchiness, severity of rash and improvements in depression, anxiety and quality of life.  

The medicine, which can be self-administered via injection, had already been designated a “breakthrough therapy” by the FDA, which means it’s on the fast-track to government approval. 

An estimated three percent of all U.S. adults have moderate to severe eczema that requires systemic therapy, according to the National Eczema Association. And because there is no reliably safe, convenient and effective way to treat their skin lesions, the need for something like Dupilumab is huge ― especially if long-term trials validate its safety. 

Oregon Health & Science University researcher Dr. Eric Simpson, lead investigator of the phase three clinical trial, said that if all goes well, the FDA will make their decision on Dupilumab by the end of March. If approved, the drug, which is made by Sanofi and Regeneron, will hit the market shortly after that. 

How fast is this track? Typically, new drugs can take up to two years to approve after a successful phase three trial. 

The drug also had a significant impact on patients’ psychological state.

Serious eczema can lead to profound misery in people who have the condition. They sometimes experience social isolation because others don’t understand that eczema isn’t contagious. The itch can be so intense that people struggle to sleep or concentrate at work or school. But trial participants who received the real medicine reported improvements in sleep, anxiety, depression and quality of life after going through the trial. 

“When you have the disease in a moderate to severe way, it really affects every aspect of your life,” said Dr. Emma Guttman-Yassky, a professor of dermatology and immunology at the Icahn School of Medicine in New York, and one of the investigators that recruited and cared for participants in the trial.

“We heard many times that patients even considered suicide because their disease was so bad. Some said they were about to destroy their marriage, and one patient was about to close his law office,” she continued. “But this drug basically enabled them to have a life.”

The status quo for eczema patients

Currently, people with moderate to severe eczema have only a few options for treatment, and they’re either extremely toxic, have serious side effects or are very inconvenient.

Phototherapy uses ultraviolet rays to help improve skin symptoms, but patients have to access the treatment by visiting a clinic at least a few times a week — making it very difficult for full-time workers or students to fit therapy into their schedule. Another drawback is that some patients can’t tolerate the heat and sweating caused by phototherapy units. 

Oral steroids, which are another way to control symptoms, produce side effects like severe mood swings, personality change, extreme fatigue, low sex drive and changes in body fat distribution. Guttman-Yassky also noted that if a patient stops oral steroids, the eczema symptoms rebound with a vengeance ― so much so that she doesn’t bother prescribing this medication anymore.

Immunosuppressants are another way to combat eczema symptoms, but they are toxic and can cause an increased risk of certain kinds of cancers and kidney and liver damage.  

How Dupilumab works

Dupilumab targets a single axis in the immune system that contributes to the development of eczema. It is a biologic therapy, which means it is made of substances derived from living organisms, and in this case those substances are used to alter the body’s immune system. In contrast, Simpson explained, the immunosuppressants that are currently available to eczema patients depress the entire immune system.

“The data shows so far that [Dupilumab] is not going to have any toxicity on any organ,” said Simpson. “And with the more targeted treatment, the thought is that you’re suppressing less of the immune system, so you’re not at risk for any immune suppression side effects like infections.”

Although the trials don’t indicate whether Dupilumab should be taken for the rest of a person’s life or for only a short period of time, Guttman-Yassky predicts that because eczema is a lifelong disease, the medicine will require lifelong administration.

“Not only are we excited about the drug because we think it’ll be wonderful for our patients, but I think it’ll open the door for more therapeutic development,” she concluded. “We saw with psoriasis that once you have one successful drug, you’ll have others.”

24 Hours Across Africa

Zimbawe’s doctor goes missing after masterminding strike

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Fearless Zimbabwe’s minister of health has called on the government to address insecurity lapses that has lead to the disappearance Peter Magombeyi, the head of a doctor’s union, who disappeared on Saturday.

Fears are rising over the fate of Zimbabwe medical doctor Dr Peter Magombeyi after he sent a message to say he had been abducted in that country by unknown persons – apparently for demanding a “living wage”.

An AFP report earlier on Sunday quoted the Zimbabwe Hospital Doctor’s Association (ZHDA) as saying Magombeyi had not been heard from since he sent a WhatsApp message on Saturday night saying he had been “kidnapped by three men”.

Zimbabwe doctors, who earn a miserly equivalent of about R3 000 are on strike to press for better wages, equipment and medicines in state hospitals.

The ZHDA has reportedly accused state security forces of abducting the doctor because of his role in organising work stoppages.

This week some doctors said the death of deposed Robert Mugabe, 95, in a Singapore hospital on 6 September was an indication of how bad health services in Zimbabwe

“Dr Magombeyi’s crime is only to ask for a living wage for his profession. This is a reflection of the troubles born out of refusal to implement Political Reforms.”

The Zimbabwe government led by Emmerson Mnangagwa has not publicly commented on the doctor’s disappearance

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24 Hours Across Africa

Turkey: Group calls for immediate action against Femicide

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Emine Dirican, a beautician from Istanbul, tried to be a good wife. But her husband hated that she worked, that she socialized, even that she wanted to leave the house sometimes without him.

She tried to reason with him. He lashed out.

“One time, he tied me — my hands, my legs from the back, like you do to animals,” recalls Dirican, shuddering. “He beat me with a belt and said, ‘You’re going to listen to me, you’re going to obey whatever I say to you.’ “

She left him and moved in with her parents. In January, he showed up, full of remorse and insisting he had changed. She let him in.

In her mother’s kitchen, he grabbed her by the hair, threw her to the floor and pulled out a gun.

“He shot me,” she says. “Then he went back to my mom and he pulled the trigger again, but the gun was stuck. So he hit her head with the back of the gun.”

Her father, who was in another room in the house, heard the gunshots and ran over. Dirican almost bled to death after a bullet ripped through a main artery in one of her legs.

“I was telling my father, ‘Daddy, please, I don’t want to die.’ “

Femicide — killing women because of their gender — is a longstanding issue in Turkey. Nearly 300 women have been killed so far this year, according to the Istanbul-based advocacy group We Will Stop Femicide, which has been tracking gender-related deaths since Turkish authorities stopped doing so in 2009.

Source Npr news

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