Orange Coast Memorial Medical Center

Introduction: Lebrikizumab is a novel monoclonal antibody that binds with high affinity and a slow off-rate to interleukin (IL)-13, thereby blocking the downstream effects of IL13 with high potency. ADmirable (NCT05372419) is an ongoing, open-label, Phase 3b clinical trial of lebrikizumab in patients with moderate-to-severe atopic dermatitis (AD) and skin of color (SoC). These are the first primary results of any Phase 3 clinical trial studying patients with AD and SoC, a historically underrepresented patient population. Methods: At baseline and Week 2, patients received 500-mg lebrikizumab loading doses followed by 250-mg every 2 weeks through Week 16. Concomitant topical therapy was allowed. Patients receiving protocol-defined rescue therapy were discontinued. Key eligibility criteria included: ≥12 years of age, self-reported race other than White, Fitzpatrick Phototype IV-VI, and moderate-to-severe AD. This study includes new objective measures of pigment such as PDCA-Derm™. Endpoints are summarized as observed (primary analysis) and using non-responder imputation/multiple imputation (NRI/MI; supporting analysis). Results: At baseline (N=90), patients had a mean (SD) age of 40.7 (19.6) years, AD disease duration of 19.7 (16.1) years, Eczema Area and Severity Index (EASI) of 26.4 (12.2), and Pruritus Numeric Rating Scale (NRS) of 7.0 (2.2). Forty-three percent of patients were female and 16% were adolescent. Most patients had an Investigator’s Global Assessment (IGA) of 3 (69%). Patients self-reported their race as Black/African American (78%), Asian (11%), American Indian/Alaskan Native (7%), and Native Hawaiian or Other Pacific Islander (4%). Patients had Fitzpatrick Phototypes of IV (43%), V (24%), and VI (32%). At Week 16, 69.2% (54/78) of patients achieved a 75% improvement in EASI (NRI/MI, 66.9%), 44.9% (35/78) achieved a 90% improvement in EASI (NRI/MI, 42.5%), 44.9% (35/78) achieved an IGA 0/1 with ≥2-point improvement (NRI/MI, 44.1%), and 58.1% (36/62) reported ≥4-point Pruritus NRS improvement (NRI/MI, 55.4%). Approximately 50% of patients reported itch improvement within 6 weeks. Using PDCA-Derm™, hypopigmentation and hyperpigmentation improved in 33.3% (4/12) and 63.0% (29/46) of patients, respectively (as observed). Most treatment emergent adverse events (TEAE) were mild-to-moderate in severity. No TEAEs lead to discontinuation and no cases of treatment-related conjunctivitis were reported. No serious adverse events were observed. Conclusion: Lebrikizumab improved signs and symptoms of disease, including post-inflammatory pigment discoloration, in patients with AD and SoC and demonstrated a favorable safety profile.

Accurate diagnosis of sCJD remains challenging in developing countries such as Vietnam, as clinical and research efforts focus on treatable diseases. Several cases of sCJD have been diagnosed in Vietnam but data from formal analyses are lacking. This is the first systematic analysis of patients with sCJD in Vietnam. This was a systematic retrospective review of medical records from patients with probable sCJD (N = 31) seen between April 2021 to April 2024 at four tertiary care centers. Clinical, laboratory, neuroimaging, and EEG findings were included in the analysis. Data from 16 men and 15 women with sCJD were analyzed. The average age of onset was 63.4years (range 50-83years). Twenty-one of the patients had died after a mean survival of 7.6months (range 3-20months). All patients initially presented with rapidly progressive dementia. Other associated symptoms included myoclonus (77%), extrapyramidal symptoms (80%), pyramidal symptoms (58%), akinetic mutism (55%), visual disturbance (45%), and cerebellar ataxia (32%). Neuroimaging revealed abnormal fluidattenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) sequences in 28/31 patients. EEG revealed periodic sharp wave complexes (PSWCs) in 26/31 patients. Only 12 patients had been tested for 14-3-3 protein in CSF and all were positive. Clinical, neuroimaging, laboratory, and EEG features are consistent with global findings.

This case series examines 4 Greenlandic Inuit mummies from approximately the 16th century for evidence of atherosclerosis.