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Jaime is a freelance writer for The American Journal of Managed Care® (AJMC®), where she previously worked as an assistant editor.

She has a BA in print journalism from Penn State University. You can connect with Jaime on 

Articles

This analysis found that the 3000 patients with hemophilia had higher rates of pain, depression, and anxiety medication use.

Use of Pain, Depression, Anxiety Meds Higher Among Patients With Hemophilia

Former NBA star Magic Johnson has partnered with GSK to educate the public about this virus, specifically in seniors and those at high-risk for contracting a severe form of RSV.

 Raising Awareness About RSV in Older Adults

Mary is the associate editorial director for The American Journal of Managed Care® (AJMC®), The Center for Biosimilars®, and Evidence-Based Oncology™. She joined AJMC® in 2013 and oversees speaker recruitment and panel preparations for AJMC®'s premier annual oncology meeting, Patient-Centered Oncology Care®.

She has a BA in communications and philosophy from Loyola University New Orleans. You can connect with Mary on 

Based on promising results, the biotech IMV has moved into phase 2b trials with a cancer vaccine composed of survivin epitopes that uses the company’s proprietary delivery system to elicit persistent immune responses.

Delivery Matters: In Early Studies, DPX Technology Allows  Vaccines to Persist When Cancer Pushes Back 

Between 2019 and 2020, there were 97 reported shortages among sponsor-reported antiseizure medications in Australia, 93% of which were generic brands.

Shortages of Antiseizure Meds Continue, More Common Among Generics: Australian Report

The American Journal of Managed Care provides insights into the latest news and research in managed care across multimedia platforms.

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1rem

Compendium

 Dermatology compendium is a comprehensive resource for clinical news and expert insights for diseases related to the skin, hair, and nails.

The lower number needed to treat suggests that ruxolitinib cream may be more effective for patients with atopic dermatitis (AD), according to a poster presented at AMCP 2023.

Ruxolitinib Cream Has Lower Number Needed to Treat for AD Compared With Other Therapies

This year’s most-read articles on dermatology covered the first and only FDA-approved treatment for repigmentation in patients with vitiligo, as well as other therapies for the treatment of acne, hidradenitis suppurativa, and more.

Examining Clinical Characteristics of Hidradenitis Suppurativa in Older Adults

This American Academy of Dermatology (AAD) Annual Meeting covered a breakthrough therapy for the management of vitiligo, clinical and epidemiological differences of certain dermatologic diseases, and the role of dietary triggers on patient outcomes.

ICYMI: Highlights From the 2022 American Academy of Dermatology Meeting

Non-White patients with hidradenitis suppurativa reported longer delay in diagnosis than their White counterparts. In addition, Black patients did not receive dermatologic care as early in their disease course as other racial groups.

Racial Disparities Shown for Delayed Diagnosis, Dermatologic Care in Hidradenitis Suppurativa

Precision medicine is advancing quicker than ever before in 

, and this is of utmost importance for certain complex dermatologic conditions that have proven difficult to understand and manage, said Jason Ezra Hawkes, MD, MS, FAAD, board-certified dermatologist and associate professor of Dermatology at the University of California Davis in Sacramento.

What are your thoughts on the future of therapeutic innovation in dermatology?

I'm just excited about all of the therapies that are coming into dermatology. I think it's a very exciting time, where precision medicine is really starting to happen. We're talking about personalized therapies for certain types of diseases. And I think the immunology is really catching up to what we have in the clinic. And that's been in part due to huge research advances and technological advances where what we couldn't do 5 years ago, even a couple of years ago, we're starting to do today. So, it's a really exciting time.

We're advancing medicine quicker than we have in the past where research was primarily performed or done in silos. Small groups, studying things in their lab with groups of 8 to 20 people, but now we're in big medicine where large companies and organizations are looking at big data. They're coupling with machine learning and artificial intelligence.

So, I think we can start to tackle some of these really complex medical dermatologic conditions, and really start to tease out subtleties that we couldn't look at or understand what we were looking at with a small microscope, but now we've got the power to start to tease out how do the genetics really play a role with environment, etc. So, I just think this is the beginning of medicines that are going to be really targeted and highly effective, and it's just an exciting time to be in medical dermatology right now.

Videos

Jason Ezra Hawkes, MD, MS, FAAD, board-certified dermatologist and associate professor of Dermatology at the University of California Davis in Sacramento, spoke on the advancement in precision medicine within dermatology and what role genetics, research, and immunology can have for care management going forward.

Dr Jason Ezra Hawkes: Exciting Innovations Shown for Precision Medicine, Research, and Technology in Dermatology

 (HS) is a difficult disease to manage for dermatologists, but advances continue to be made in clinical research regarding comprehension and treatment of the disease, said Jason Ezra Hawkes, MD, MS, FAAD, board-certified dermatologist and associate professor of Dermatology at the University of California Davis in Sacramento.

Can you speak on recent advances and unmet needs in HS care management?

HS is definitely a difficult condition to manage. When I kind of think about psoriasis being a little more straightforward than eczema, I think of eczema being more straightforward than HS. So, HS really has this heterogeneous presentation. Sometimes it's just in the groin, sometimes it's in the axilla, sometimes it's both. It can be atypical and just be on the buttocks. We see this range of primary skin lesions. So, papules, pustules, some have nodules;  we see prominent scarring.

So, this is really a very heterogeneous disease in presentation. And these are what we need to be taking on in the clinic and also in our clinical studies. We're just teasing out the pathogenesis of this condition. We’re starting to learn those patients who just get it in the axilla vs those that have prominent scarring. And we're starting to learn what that pathophysiology looks like.

There's some exciting advances happening in HS. We had big dramatic improvements in management when TNF [tumor necrosis factor] inhibitors were approved for this condition, but now we're starting to see studies that are quite advanced looking at the possible benefit of [interleukin] IL-17 blockade as a treatment strategy for HS.


There's been studies looking at the IL-1 signaling family and its role into HS’ development of disease around the hair follicle or the follicular unit. So, we're starting to tease out some subtleties that are going to open up the door. I think this will be the next big inflammatory condition that we learn to treat in dermatology. And as we do that, we're going to start taking biopsies of patients at different stages so that we can sort of better phenotype these groups early on, to have understanding about what therapies might be more effective in certain stages of disease. So, this is a really important disease that we tackle.

Jason Ezra Hawkes, MD, MS, FAAD, board-certified dermatologist and associate professor of Dermatology at the University of California Davis in Sacramento, spoke on challenges in the management of hidradenitis suppurativa (HS), as well as promising therapies in the pipeline that target specific pathways suggested to play a role in the pathogenesis and pathophysiology of the disease.

Dr Jason Ezra Hawkes Reviews Recent Advances, Unmet Needs in Management of Hidradenitis Suppurativa

There are several misconceptions regarding hidradenitis suppurativa (HS) that clinicians should address with a culturally sensitive approach, said Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected with HS.

Can you speak on misconceptions in the management of HS?

We understand fully that cigarette smoking and weight loss are very important topics. Cigarette smoking can kill you—it's been proven, it's very bad for you—and being overweight is indicative of being unhealthy and we get that, too. If I meet a doctor, and in the first 30 minutes, they tell me that I need to quit smoking and lose weight, I kind of tune them out.

We are working, as the patient community, to kind of help doctors understand that we have organized online and we know a lot of patients who are thin that have this disease. There are patients who have anorexia that have this disease. And again, I'm not saying that we shouldn't be trying to incorporate a healthy diet into our lifestyle, that smoking isn't horrible for you—it absolutely is—but maybe that can be a nudge in the second or third appointment and done gently.


This reputation that patients with HS have that we’re overweight smokers only leads into more of this stigma that we are doing this to ourselves. If it were as simple as that we would do this, but it's a little more complex than that.

Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected with hidradenitis suppurativa (HS), spoke on common stigmas regarding HS and how clinicians can improve consultation through a culturally sensitive approach.

Advocate Discusses Misconceptions, Culturally Sensitive Care for Hidradenitis Suppurativa

 (HS) have shown benefit with dietary strategies, but there remain gaps in clinical knowledge regarding the holistic management of the overall patient population, said Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected with hidradenitis suppurativa (HS),

Can you discuss holistic considerations for the management of HS and any gaps in knowledge here?

So, one of the pressing needs or one of the pressing topics with patients, and one of the things I forgot to mention in my 

, diet is a huge, huge topic amongst the HS patient community. So, at one point, when I had to leave the Humira [adalimumab] study and I was going to look at more holistic ways of treating this because I thought that was probably better to do with pregnancy, I had gone to a holistic doctor—a functional/integrative medicine doctor or something like that—and he sent me home with like $400 worth of medical supplements.

Paste for your GI [gastrointestinal] tract, it was an orange salve, pills, it all smelled horrible. He gave me this presentation with all of these little circles on what he thought was affecting the immune system and how this was to play. And I gave it an honest-to-god shot, but it just didn't work for me.

Patients with HS are very curious about diet. We get asked that a lot and a lot of doctors get asked a lot about that, and there's all kinds of thoughts and theories. As general advice, we always say just try a basic elimination diet. Like if you think it's potatoes, just eliminate them first, but don't go full autoimmune paleo. I don't know if you ever heard of that. You can't drink coffee on it, and it's extremely restrictive. They talk about nightshade vegetables and stuff like that.


Some patients have had success with dairy and removing dairy out of their diet—I know that that's the case for acne as well. But it's all very individualized, and right now there's not one conclusive thing that kind of works on everybody. Like Humira has great success, but it doesn't work on everybody. And so that kind of tells me that the nail hasn't quite been hit on the head. But diet is something that patients with HS always seem to want to talk about.

Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected with hidradenitis suppurativa (HS), discusses current knowledge on the impact of diet and other holistic care strategies in the management of HS.

Advocate Speaks on Diet, Holistic Care in Hidradenitis Suppurativa

Greater understanding of the pathophysiology of and effective interventions for 

 (HS) is needed in the medical community to adequately manage the burden of symptoms and comorbidities, said Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected by HS.

As both a patient and advocate for HS, what do you think are the most pressing issues that should be addressed to improve the care and treatment of patients?

I mean, first and foremost, we need the medical community to know what this is, to understand it, and how to best treat it. Most of the patients right now that I know and speak to—if they don't know [HS] belongs in dermatology, they’re just going to urgent care and EDs [emergency departments] to get the abscess treated, and then when it comes back, they go.

So, there's been a big push, especially by the HS Foundation, to get the education out there to the emergency rooms, EDs, and urgent care [clinics] to let these doctors know better how to treat it, and then where to take the patient.

As far as needs go, we always need help with wound care. We need doctors to address the realistic possibility of all of the comorbidities that come along with HS, and then we need mental health care. There's so much that goes into getting to a diagnosis, and then it's almost luck of the draw on whether or not you're going to get a provider that can adequately treat this.

So, one example is when I didn't have the right insurance and couldn't be in the hands of a specialist, I worked with a dermatologist who was the nicest human being, I mean, just an overall great person, a knowledgeable doctor, passionate about what he was doing, but HS was not his specialty.


So, when I had asked him about surgery, I said to him: What do you think about it? He's like, you could try it. And I was like, well, do you know anyone? And he's like, no, you can just Google someone. He was a really nice human being, but I was like, what do you mean? Is it just a lottery? Do I just randomly pull someone?

Having a dermatologist that has networks [and can say:] I know a plastic or a general surgeon that can do good HS work. I know mental health care providers that specialize in chronic disease and can help. I know GI [gastrointestinal] doctors, because of all of the comorbidities; cardiac doctors, because we have a high rate of cardiac disease. 

And so we need an overall form of care, because this disease is so high maintenance, so it's hard to pinpoint just one need when there's quite a bit.

Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected by hidradenitis suppurativa (HS), discussed several pressing issues that warrant consideration to improve the care management of HS.

Advocate Addresses Unmet Needs in the Management of Hidradenitis Suppurativa

 (HS) can include surgeries to remove manifestations and ongoing therapeutic management with medications, said Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected by HS.

What treatments have worked and not worked for you in the management of HS?

I have had a total of 5 surgeries altogether, I had to think about it for a second. I've had 2 in each armpit and then one in the groin. The ones in my armpit have been successful so far. I had a procedure called a staged excision—I live by myself and wound care and postoperation recovery is kind of a concern of mine, because I have nobody else to take care of me and I have a crazy dog.

So, I have a dermatologist who's a specialist, and she came to me and said, both of your armpits are stage 3, and the disease is not really going to undo itself. There was a ton of scar tissue damage and she said, we could get it to stop, but if you do surgery and medicine, we're probably going to have a better pathway. So, I said to her, I live alone though and doing such a big procedure and all the wound care after is a big deal.

So, we did a staged excision, where it took 2 procedures to remove all of it from each of my arms. So, it was 2 each. She went in and got the bulk of it on the first and then went back in after it healed and got the rest of it. So, I had nice-sized surgery areas, but they weren't gaping and they were manageable for me to take at home. She left it to heal by a process called secondary intention, where there’s no stitches, there's no skin graft, there's no wound vac—it’s dressing changes and so that a nice healthy layer of scar tissue kind of builds up and prevents the disease from recurring.


Athena Gierbolini, president of Hope for HS, a nonprofit advocacy group for those affected by hidradenitis suppurativa (HS), spoke on the surgical and therapeutic interventions she’s had for the management of HS.