Dermatología en Costa Rica

Thursday, June 12, 2025

Mirdametinib para Neurofibromas plexiformes inoperables

FDA Approves Mirdametinib for Patients With NF1 Who Have Symptomatic Plexiform Neurofibromas

The US Food and Drug Administration (FDA) approved mirdametinib (Gomekli), a kinase inhibitor, for adult and paediatric patients aged 2 years and older with neurofibromatosis type 1(NF1) who have symptomatic plexiform neurofibromas not amenable to complete resection.

Efficacy of mirdametinib was

click to scroll down to continue reading the article

article continues here

evaluated in ReNeu (NCT03962543), a multicentre, single-arm trial in 114 patients age 2 years and older (58 adults, 56 pediatric patients) with symptomatic, inoperable NF1-associated plexiform neurofibromas causing significant morbidity. 

An inoperable plexiform neurofibromas was defined as a plexiform neurofibroma that could not be completely surgically removed without risk for substantial morbidity due to encasement or close proximity to vital structures, invasiveness, or high vascularity.

The major efficacy outcome measure was confirmed overall response rate (ORR), defined as the percentage of patients with complete response (disappearance of the target plexiform neurofibroma) or partial response (≥20% reduction in plexiform neurofibroma volume). Responses were assessed by blinded independent central review using volumetric MRI analysis per Response Evaluation in Neurofibromatosis and Schwannomatosis criteria, modified to require confirmation of responses within 2 to 6 months during the 24-cycle treatment phase. 

Confirmed ORR was 41% for adults and 52% in the paediatric cohort.

The most common adverse reactions in adult patients were rashdiarrhoeanausea, musculoskeletal pain, vomiting, and fatigue. The most common grade 3 or 4 laboratory abnormality was increased creatine phosphokinase.

The most common adverse reactions in paediatric patients were rash, diarrhoea, musculoskeletal pain, abdominal pain, vomiting, headacheparonychialeft ventricular dysfunction, and nausea. The most common grade 3 or 4 laboratory abnormalities were decreased neutrophil count and increased creatine phosphokinase.

Mirdametinib can also cause left ventricular dysfunction and ocular toxicity including retinal vein occlusionretinal pigment epithelial detachment, and blurred vision. Mirdametinib should be withheld, dosage reduced or permanently discontinued based on the severity of adverse reactions.

Healthcare professionals should report all serious adverse events suspected to be associated with the use of any medicine and device to FDA'sMedWatch Reporting System or by calling 1-800-FDA-1088.

Reference: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-mirdametinib-adult-and-pediatric-patients-neurofibromatosis-type-1-who-have-symptomatic

SOURCE: US Food and Drug Administration




Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.

Wednesday, June 04, 2025

Eczema de manos endogeno, exogeno vs. psoriasis…la clinica manda

Abstract

Abstract: Background: Hand eczema and hand psoriasis are common skin conditions that may present with similar clinical features, making differentiation challenging.
Objective: This study aims to identify clinical characteristics that distinguish hand eczema from hand psoriasis.
Methods: A retrospective chart review was conducted on patients diagnosed with either condition at the Contact Dermatitis and the Psoriasis Clinic of the Department of Dermatology, Siriraj Hospital, Mahidol University—a national tertiary referral center in Thailand—from January 2015 to November 2022.
Results: A total of 398 patients with hand eczema and 140 with hand psoriasis were included. Exogenous (76.1%) and endogenous (23.9%) hand eczema showed similar lesion location and morphology. However, compared with hand psoriasis, endogenous hand eczema more commonly involved the palmar area, palmar side of digits, and finger pulps (P < 0.001). Conversely, hand psoriasis predominantly affected both sides of the wrist, the dorsal side of the hand, nail fold, and the nails (P < 0.001). Clinical manifestations such as papules, vesicles, scales, and fissures were more frequently observed in endogenous hand eczema, whereas hyperkeratotic plaques were more characteristic of hand psoriasis (P < 0.001). Itching was significantly more frequent in hand eczema (P < 0.001).
Conclusions: Symptoms, lesion locations, and morphology may provide valuable insights that enhance diagnostic accuracy in distinguishing between hand eczema and psoriasis.



Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.