Background Genital warts caused by human papillomavirus are common sexually transmitted infections, with no single therapy providing consistent clearance. Garlic extract has antiviral and antiproliferative properties and may offer a low-cost treatment.Objective To compare the efficacy and safety of topical 5% garlic extract with 20% podophyllin solution in women with genital warts.Methods Seventy-four women were randomized to 5% garlic extract (n = 37) or 20% podophyllin (n = 37), applied weekly for four weeks. Wart size and count were assessed using marginal models (generalized estimating equations). The primary outcome was change in mean wart size and the secondary outcome was change in wart count.Results Mean wart size decreased from 1.61 ± 0.81 to 0.60 ± 0.82 mm with garlic extract and from 2.96 ± 7.99 to 0.62 ± 0.73 mm with podophyllin. The between-group p-value at final assessment was 0.756; group × time interaction p values were 0.329 for wart size and 0.583 for count. Among 35 and 37 participants analyzed, complete response occurred in 18 (51.4%) and 19 (51.4%), respectively; complete or partial response occurred in 23 (65.7%) and 25 (67.6%). Itching and burning occurred in 8 (21.6%) garlic-treated participants each.Conclusion Both treatments reduced wart size and count, with similar response rates. Four-week follow-up precluded assessment of durability and recurrence.
Background Janus kinase inhibitors (JAKis) are increasingly used in dermatology, yet their gastrointestinal safety profiles remain incompletely characterized in real-world practice. Although gastrointestinal adverse events (GIAEs) are generally mild, gastrointestinal perforation remains an important safety concern with JAKi treatment. This study aimed to characterize GIAEs associated with six oral JAKis and identify potential disproportionality signals in the US Food and Drug Administration Adverse Event Reporting System (FAERS).Methods GIAEs associated with abrocitinib, baricitinib, deucravacitinib, ritlecitinib, tofacitinib, and upadacitinib were evaluated. System Organ Class-level reports and patient characteristics were obtained from AERSMine, while Preferred Term-level disproportionality analyses were performed using OpenVigil 2.1. Reporting odds ratios (RORs) with 95% confidence intervals (CIs) were calculated; signals were considered positive when the lower 95% CI exceeded 1.Results Overall, 74,678 GIAE reports were identified, predominantly for tofacitinib and upadacitinib. Diarrhea, nausea, and vomiting were among the most frequently reported events. Positive signals included nausea and abdominal discomfort with abrocitinib, diarrhea with ritlecitinib, and diarrhea and abdominal discomfort with tofacitinib. The strongest signals predominantly involved gastrointestinal infections and perforation-related events.Conclusions This study highlights potential gastrointestinal safety concerns associated with JAKis. Further real-world observational studies are needed to clarify their clinical significance.
Objectives: The study aimed to understand disease and treatment differences between adult and pediatric patients with psoriasis and identify opportunities for optimization of care.Methods: Data were drawn from the Adelphi Real World Psoriasis Disease Specific ProgrammeTM, a cross-sectional survey of physicians, and their pediatric (aged 4–17) and adult (aged ≥18) patients with psoriasis in the United States from August 2018–April 2020.Results: Overall, 153 physicians reported data for 690 pediatric and 626 adult patients. Physicians reported that more pediatric patients were in remission (p < 0.001) and had a lower mean body surface area affected (p < 0.001) compared to adults. Physicians rated disease overall more severe in adult patients than pediatric (p < 0.001). Treatment patterns in pediatric and adult patients were significantly different (all p < 0.001), with topicals/phototherapy more commonly used in pediatric patients and conventional systemic and biologics more commonly used in adult patients throughout the treatment history.Conclusions: Overall, pediatric patients had significantly less severe disease than adults, but moderate/severe pediatric patients received fewer systemic therapies than in the adult moderate/severe cohort. Further research is needed to understand the use and effectiveness of biologics in the pediatric population, given the approval of newer biologics for pediatric use since the time of the survey.
Purpose Atopic dermatitis (AD) treatment has expanded considerably in recent years, yet insurance barriers such as prior authorization (PA) and step therapy continue to delay care.Materials and methods We conducted a 2025 (July–September) national survey through the National Eczema Association to assess prescription coverage delays and denials among insured US adults (18+) with AD and caregivers of pediatric patients (age 0–17).Results Among 543 respondents (60.6% with moderate-to-severe disease), 37.9% experienced at least one coverage delay or denial in the preceding 12 months. Rates were higher among those who had changed insurance (51.1%) versus those with stable coverage (33.1%). Coverage barriers were most common for targeted systemic therapies, though most affected prescriptions were non-biologic. PA was the leading barrier (56.8%), often resolving well beyond recommended timeframes, and step therapy affected 34.4% of those with issues, including forced re-failure of previously failed medications after insurance changes. Nearly one-third of respondents were unaware of their appeal rights. Coverage barriers led 15.7% to never initiate and 12.4% to discontinue prescribed treatment, often resulting in untreated disease.Conclusions Despite an expanding therapeutic landscape, prescription access barriers for AD remain pervasive, underscoring the need for policy reform and improved patient education on appeal rights.
