Ossifying fasciitis of the proximal lower extremity

Ossifying fasciitis is a rare benign tumor of heterotopic bone formation within fascial tissue. We present a case of a 23-year-old female with a nontraumatic painful mass of the left proximal thigh identified as ossifying fasciitis, a lesion that must be considered in the differential diagnosis of soft tissue tumors.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Determination of aflatoxin biomarkers in excreta and ileal content of chickens

Aflatoxins are carcinogenic secondary metabolites frequently detected in food and feed stuff based on maize and other crops susceptible to infection with the fungal pathogen Aspergillus flavus. We investigated the metabolization of aflatoxins in chickens by analyzing excreta and ileal content and developed and validated a biomarker method for detection of aflatoxins and their metabolites in these matrices. Analysis of ileal content served to distinguish between urinary and fecal excretion combined in the excreta samples. During a 3-wk animal trial, one hundred sixty-eight 1-day-old chicks were randomly allocated to 24 pens with 7 chicks per pen and subjected to different feed regimens with: A) toxin-free feed, B) feed supplemented with 18 ng of total aflatoxins/g, and C) feed supplemented with 515 ng of total aflatoxins/g. Chicken excreta and ileal content were sampled after 7, 14, and 21 D. An analytical method based on liquid chromatography coupled to tandem mass spectrometry was validated for the determination of aflatoxin B1, B2, G1, G2, M1, P1, Q1, and aflatoxin B1-N7-guanine (AFB1-N7-Gua) in chicken's samples. Comparing chicken excreta, which contain urine and feces, to ileal content, which contains no urine, we explored the secretion pathway of aflatoxin metabolites. The AFB1-N7-Gua was only detected in excreta, whereas aflatoxin M1 (AFM1) was detected both in ileal content and excreta. Aflatoxin M1 was detected in excreta in concentrations 5 times higher than in ileal content, suggesting primary excretion via urine. Although chickens are relatively resistant to aflatoxins, contamination of feed can lead to adverse effects and thus economic losses in farming. Therefore, a biomarker method to estimate the exposure of chickens to aflatoxins can play an important role to monitor the animals' health.

Large-scale analysis of acquired chromosomal alterations in non-tumor samples from patients with cancer

Mosaicism, the presence of subpopulations of cells bearing somatic mutations, is associated with disease and aging and has been detected in diverse tissues, including apparently normal cells adjacent to tumors. To analyze mosaicism on a large scale, we surveyed haplotype-specific somatic copy number alterations (sCNAs) in 1,708 normal-appearing adjacent-to-tumor (NAT) tissue samples from 27 cancer sites and in 7,149 blood samples from The Cancer Genome Atlas. We find substantial variation across tissues in the rate, burden and types of sCNAs, including those spanning entire chromosome arms. We document matching sCNAs in the NAT tissue and the adjacent tumor, suggesting a shared clonal origin, as well as instances in which both NAT tissue and tumor tissue harbor a gain of the same oncogene arising in parallel from distinct parental haplotypes. These results shed light on pan-tissue mutations characteristic of field cancerization, the presence of oncogenic processes adjacent to cancer cells.

The oral Janus kinase/spleen tyrosine kinase inhibitor ASN002 demonstrates efficacy and improves associated systemic inflammation in patients with moderate-to-severe atopic dermatitis: results from a randomized double-blind placebo-controlled study

BACKGROUND

ASN002 is an oral dual inhibitor of Janus kinase and spleen tyrosine kinase, which are involved in the pathogenesis of atopic dermatitis (AD) through their regulatory role on T helper (Th)1, Th2 and Th17/Th22 pathways.

OBJECTIVES

The objectives of this study were to evaluate the efficacy, safety, pharmacokinetics and effects on systemic biomarkers of ASN002 in patients with moderate-to-severe AD. Methods A total of 36 patients with moderate-to-severe AD were randomized (3 : 1) to ASN002 or placebo in the phase Ib study. Three dosage cohorts were studied over a 28-day period (20 mg, 40 mg and 80 mg once daily).

RESULTS

ASN002 was superior to placebo for the proportion of patients achieving Eczema Area and Severity Index (EASI) 50 (20 mg 20%, P = 0·93; 40 mg 100%, P = 0·003; 80 mg 83%, P = 0·03; placebo 22%), EASI 75 (20 mg 0%, P = 0·27; 40 mg 71%, P = 0·06; 80 mg 33%, P = 0·65; placebo 22%) and in change from baseline in pruritus (20 mg -1·3 ± 2·1, P = 0·81; 40 mg -3·1 ± 2·7, P = 0·27; 80 mg -4·7 ± 2·1, P = 0·01; placebo -1·6 ± 1·8). Adverse events were generally mild and similar across all groups. ASN002 showed dose-dependent plasma exposure with low interpatient variability, significantly downregulated several serum biomarkers involved in Th1, Th2 and Th17/Th22 immunity, and decreased the atherosclerosis-associated biomarker E selectin/SELE.

CONCLUSIONS

In patients with moderate-to-severe AD, ASN002 showed strong efficacy with rapid onset of action and associated improvements in systemic inflammation.

Evaluation of encapsulated sodium butyrate with varying releasing times on growth performance and necrotic enteritis mitigation in broilers

This study was conducted to evaluate the effect of an encapsulated sodium butyrate (Na-B) with targeted releasing times on growth performance and mitigating the impact of necrotic enteritis in broilers. Two Na-B (30% of Na-B content) products, CMA (2 h releasing time) and CMP (3 to 4 h releasing time), were evaluated in a necrotic enteritis challenge model. The experiment consisted of 4 Na-B treatments (500 and 1,000 ppm of each product) plus 2 control (non-challenged and challenged). A total of 336 Cobb-Cobb male broilers were placed 8 birds per pen into 7 replicate battery cages. On day 14, birds from challenged treatments were orally gavaged with ∼5,000 oocysts of Eimeria maxima. On day 19, 20, and 21, the challenged birds received 1 mL of 108 cfu/mL Clostridium perfringens. Total pen body weight (BW) and feed weight were assessed on day 14, 21, and 28 for BW gain and mortality-adjusted feed conversion ratio (FCR). On day 21, 3 birds were randomly selected per pen and scored for intestinal lesions. The duodenum and jejunum tissue were collected on day 21 and 28 for quantifying intestinal histology. Results revealed that adding CMA at 500 ppm showed significantly higher cumulative BW gain (P < 0.05) compared to the challenged control from day 1 to 21. Adding CMA at 500 ppm also showed the equivalent cumulative FCR that was comparable to the non-challenged control on day 21. The CMA treatments and CMP at 1,000 ppm treatment showed equivalent BW gain compared to the non-challenge control after an additional 7 d post-challenge on day 28. Both products at 500 or 1,000 ppm had the significantly (P < 0.05) lower intestinal lesion scores compared to the challenged control. However, there was no difference in lesion scores among the Na-B treatments. The Na-B product targeted to release in the anterior intestinal tract shows the beneficial effects on BW gain and feed utilization efficiency in current challenge model. Adding encapsulated Na-B product has the potential to mitigate the impact of necrotic enteritis in broilers.

Long-term safety and efficacy of trifarotene 50 μg/g cream, a first-in-class RAR-γ selective topical retinoid, in patients with moderate facial and truncal acne

BACKGROUND

Treatment for both facial and truncal acne has not sufficiently been studied.

OBJECTIVES

To evaluate the long-term safety and efficacy of trifarotene in both facial and truncal acne.

METHODS

In a multicentre, open-label, 52-week study, patients with moderate facial and truncal acne received trifarotene 50 μg/g cream (trifarotene). Assessments included local tolerability, safety, investigator and physician's global assessments (IGA, PGA) and quality of life (QOL). A validated QOL questionnaire was completed by the patient at Baseline, Week 12, 26 and 52/ET.

RESULTS

Of 453 patients enrolled, 342 (75.5%) completed the study. Trifarotene-related treatment-emergent adverse events (TEAEs) were reported in 12.6% of patients, and none was serious. Most related TEAEs were cutaneous and occurred during the first 3 months. Signs and symptoms of local tolerability were mostly mild or moderate and severe signs, and symptoms were reported for 2.2% to 7.1% of patients for the face and 2.5% to 5.4% for the trunk. Local irritation increased during the first week of treatment on the face and up to Weeks 2 to 4 on the trunk with both decreasing thereafter. At Week 12, IGA and PGA success rates were 26.6% and 38.6%, respectively. Success rates increased to 65.1% and 66.9%, respectively at Week 52. Overall success (both IGA and PGA success in the same patient) was 57.9% at Week 52. At Week 52 visit, 92/171 (53.8%) patients who had completed their assessments had scores from 0 to 1 (i.e. no effect of acne on their QOL) vs. 47/208 (22.6%) patients at Baseline visit.

CONCLUSION

In this 52-week study, trifarotene was safe, well tolerated and effective in moderate facial and truncal acne.

Current, future and potential use of mobile and wearable technologies and social media data in the ABCD study to increase understanding of contributors to child health

Mobile and wearable technologies and novel methods of data collection are innovating health-related research. These technologies and methods allow for multi-system level capture of data across environmental, physiological, behavioral, and psychological domains. In the Adolescent Brain Cognitive Development (ABCD) Study, there is great potential for harnessing the acceptability, accessibility, and functionality of mobile and social technologies for in-vivo data capture to precisely measure factors, and interactions between factors, that contribute to childhood and adolescent neurodevelopment and psychosocial and health outcomes. Here we discuss advances in mobile and wearable technologies and methods of analysis of geospatial, ecologic, social network and behavioral data. Incorporating these technologies into the ABCD study will allow for interdisciplinary research on the effects of place, social interactions, environment, and substance use on health and developmental outcomes in children and adolescents.

Influence of dietary inclusion of untreated or heat-treated Jatropha meal on productive and reproductive performances and biochemical blood parameters of laying Japanese quail

Jatropha meal (JM) has been characterized as a potential animal feedstuff due to its high crude protein content and high levels of essential amino acids. However, it contains anti-nutritive and toxic compounds that may hinder its use. The present study was conducted to evaluate the effects of a dietary inclusion of raw Jatropha meal (RJM) and heat-treated Jatropha meal on the growth and production of laying Japanese quail using productive, reproductive, and biochemical blood parameters. A total number of 180 mature Japanese quail at 2 months of age (120 females and 60 males) was randomly divided into 4 treatment groups: control (0% JM); 3.5% RJM; 3.5% JM heated in an oven at 100°C for 24 h (JM24); and 3.5% JM heated in oven at 100°C for 48 h (JM48). After 8 wk on treatment diets, the inclusion of RJM to quail diets reduced (P < 0.05) feed intake, feed efficiency, egg number, and egg mass compared with the control diet. There was no difference between the heat-treated Jatropha (JM24 and JM48) treatments and the control. Fertility and hatchability percentages were improved (P < 0.001) with JM24 and JM48 compared with the RJM group. Feeding of 3.5% RJM or JM24 in quail diets led to significant decrease (P < 0.05) in serum total protein, albumen, globulin, γ-glutamyl transpeptidase, total and HDL-cholesterol, immunoglobulin (IgG and IgM), and increased serum alanine transaminase (ALT) and creatinine along with the mortality rate when compared with birds fed JM48. In conclusion, heat treatment of JM is essential to eliminate its hepatotoxic and nephrotoxic effects and, when properly heat-treated, can be used in laying Japanese quail diets without detrimental effects on production, reproductive performance, and health status.

Evaluation of encapsulated sodium butyrate on growth performance, energy digestibility, gut development, and Salmonella colonization in broilers

Two experiments were conducted to determine the effect of an encapsulated sodium butyrate (Na-B) with targeted releasing times on broiler performance, energy digestibility, intestinal morphology, and ceca Salmonella colonization. In experiment 1, 3 different Na-B products (CMA, CMP, and CMS) were evaluated following a challenge with a nalidixic acid-resistant Salmonella typhimurium (STNAR). Cobb-Cobb male birds were placed 8 per pen into 6 replicates for each treatment. Treatments included 6 Na-B treatments (500 and 1,000 ppm of each product) plus 2 control (non-challenged and challenged). Birds were orally gavaged with 0.1 mL of 107 cfu/mL STNAR on d 4. Ceca and ileal samples were collected on d 11. In experiment 2, CMA and CMP products were evaluated for a full grow-out period without an external challenge. Cobb-Cobb male birds were distributed among 45 floor pens with 24 birds per pen. Treatments included 4 product treatments (500 and 1,000 ppm of each product) plus one control. Feed intake and pen weight were obtained on d 14, 28, and 42. Experiment 1 showed that CMP at 1,000 ppm had the highest value for BW and BWG on d 4 (P = 0.07). Adding CMA and CMP at 500 ppm increased ileal digestibility energy (IDE) compared to the challenged control (P ≤ 0.05). The Salmonella recovery data indicated that the challenge had a significant but mild impact, since it did not affect the performance variables but did result in a significant increase in log10 cfu/g cecal material between the non-challenged and challenged control (1.42 vs 3.72). Experiment 2 showed that both products improved the villus height in the duodenum on d 21 (P = 0.08) and IDE on d 42, relative to the control (P ≤ 0.05). This study demonstrates that Na-B has the potential to improve growth in broilers at an early age. The beneficial effects on intestinal morphology and IDE are affected not only by dosage level, but also by the product's releasing time.

Algorithms for Identification of Nearly-Coincident Events in Calorimetric Sensors

For experiments with high arrival rates, reliable identification of nearly-coincident events can be crucial. For calorimetric measurements to directly measure the neutrino mass such as HOLMES, unidentified pulse pile-ups are expected to be a leading source of experimental error. Although Wiener filtering can be used to recognize pile-up, it suffers errors due to pulse-shape variation from detector nonlinearity, readout dependence on sub-sample arrival times, and stability issues from the ill-posed deconvolution problem of recovering Dirac delta-functions from smooth data. Due to these factors, we have developed a processing method that exploits singular value decomposition to (1) separate single-pulse records from piled-up records in training data and (2) construct a model of single-pulse records that accounts for varying pulse shape with amplitude, arrival time, and baseline level, suitable for detecting nearly-coincident events. We show that the resulting processing advances can reduce the required performance specifications of the detectors and readout system or, equivalently, enable larger sensor arrays and better constraints on the neutrino mass.

Evaluation of Anatomical and Functional Hip Joint Center Methods: The Effects of Activity Type, Gender, and Proximal Reference Segment

Accurate hip joint center (HJC) location is critical when studying hip joint biomechanics. The HJC is often determined from anatomical methods, but functional methods are becoming increasingly popular. Several studies have examined these methods using simulations and in vivo gait data, but none has studied high-range of motion activities, such a chair rise, nor has HJC prediction been compared between males and females. Furthermore, anterior superior iliac spine (ASIS) marker visibility during chair rise can be problematic, requiring a sacral cluster as an alternative proximal segment; but functional HJC has not been explored using this approach. For this study, the quality of HJC measurement was based on the joint gap error (JGE), which is the difference in global HJC between proximal and distal reference segments. The aims of the present study were to: (1) determine if JGE varies between pelvic and sacral referenced HJC for functional and anatomical methods, (2) investigate which functional calibration motion results in the lowest JGE and if the JGE varies depending on movement type (gait versus chair rise) and gender, and (3) assess whether the functional HJC calibration results in lower JGE than commonly used anatomical approaches and if it varies with movement type and gender. Data were collected on 39 healthy adults (19 males and 20 females) aged 14–50 yr old. Participants performed four hip “calibration” tests (arc, cross, star, and star-arc), as well as gait and chair rise (activities of daily living (ADL)). Two common anatomical methods were used to estimate HJC and were compared to HJC computed using a published functional method with the calibration motions above, when using pelvis or sacral cluster as the proximal reference. For ADL trials, functional methods resulted in lower JGE (12–19 mm) compared to anatomical methods (13–34 mm). It was also found that women had significantly higher JGE compared to men and JGE was significantly higher for chair rise compared to gait, across all methods. JGE for sacrum referenced HJC was consistently higher than for the pelvis, but only by 2.5 mm. The results indicate that dynamic hip range of movement and gender are significant factors in HJC quality. The findings also suggest that a rigid sacral cluster for HJC estimation is an acceptable alternative for relying solely on traditional pelvis markers.

Yeast cell wall and live yeast products and their combination in broiler diets formulated with weekly ingredient variations

A 6-week broiler study was conducted to evaluate whether subjecting the intestinal microflora of broilers to the effect of weekly variations in feed ingredients could be ameliorated by the inclusion of yeast-derived feed additives: a yeast cell wall extract (YCW), live yeast culture (LY) or their combination (YCW + LY). Recent changes in ingredient prices have motivated producers to formulate diets not necessarily based primarily on corn and soya bean meal. Intestinal microflora in birds can vary significantly based on the ingredient composition of their diet, and the make-up of the flora can influence overall bird performance. Within the three nutrient phases of this study, birds were fed either a traditional corn-soya ingredient profile or a variable-ingredient regimen, which had weekly changes in the ingredient composition. There were consistent ameliorative effects of the yeast treatments in both the corn-soya and the variable-ingredient groups throughout all 6 weeks, with the YCW + LY combination showing a reduced effect when compared to either product fed alone. The effectiveness of YCW and LY on ameliorating the effects of weekly ingredient variations appeared most effective during the starter and grower phases, but was less significant during the sixth week.

HOLMES: The electron capture decay of [Formula: see text]Ho to measure the electron neutrino mass with sub-eV sensitivity

The European Research Council has recently funded HOLMES, a new experiment to directly measure the neutrino mass. HOLMES will perform a calorimetric measurement of the energy released in the decay of [Formula: see text]Ho. The calorimetric measurement eliminates systematic uncertainties arising from the use of external beta sources, as in experiments with beta spectrometers. This measurement was proposed in 1982 by A. De Rujula and M. Lusignoli, but only recently the detector technological progress allowed to design a sensitive experiment. HOLMES will deploy a large array of low temperature microcalorimeters with implanted [Formula: see text]Ho nuclei. The resulting mass sensitivity will be as low as 0.4 eV. HOLMES will be an important step forward in the direct neutrino mass measurement with a calorimetric approach as an alternative to spectrometry. It will also establish the potential of this approach to extend the sensitivity down to 0.1 eV. We outline here the project with its technical challenges and perspectives.

Treatment of facial erythema in patients with rosacea with topical brimonidine tartrate: correlation of patient satisfaction with standard clinical endpoints of improvement of facial erythema

BACKGROUND

Once-daily brimonidine tartrate (BT) 0.5% gel was shown to provide significantly greater efficacy vs. vehicle for the treatment of facial erythema in patients with rosacea.

OBJECTIVES

To demonstrate that patient satisfaction with overall appearance is correlated with reduction in facial erythema, as measured by clinician and patient assessments.

METHODS

Data from two identical phase III, multicentre, randomized, controlled trials of moderate facial erythema of rosacea (study A: n = 260; study B: n = 293) with topical BT 0.5% compared to vehicle gel once-daily for 4 weeks were analysed. Correlations of Patient's Assessment of Appearance (PAA) with Clinician's Erythema Assessment (CEA) and Patient's Self-Assessment (PSA) of erythema were evaluated by calculation of gamma statistics.

RESULTS

PAA correlated with CEA post-application on Days 1, 15 and 29 for the intent-to-treat population and provided a median gamma value of 0.57 (min = 0.28, max = 0.61). PAA and PSA was also highly correlated post-application on Days 1, 15 and 29; with a median gamma value of 0.87 (min = 0.66, max = 0.89). Subjects who achieved a clinically meaningful improvement in both CEA and PSA scales were more likely to report satisfaction with the overall appearance of their skin (P < 0.001).

CONCLUSIONS

Both one- and two-grade improvements in facial erythema assessed by subjects (PSA) and clinicians (CEA) correlate well with PAA, a patient-centered representation of meaningful change.

Large-aperture wide-bandwidth antireflection-coated silicon lenses for millimeter wavelengths

The increasing scale of cryogenic detector arrays for submillimeter and millimeter wavelength astrophysics has led to the need for large aperture, high index of refraction, low loss, cryogenic refracting optics. Silicon with n=3.4, low loss, and high thermal conductivity is a nearly optimal material for these purposes but requires an antireflection (AR) coating with broad bandwidth, low loss, low reflectance, and a matched coefficient of thermal expansion. We present an AR coating for curved silicon optics comprised of subwavelength features cut into the lens surface with a custom three-axis silicon dicing saw. These features constitute a metamaterial that behaves as a simple dielectric coating. We have fabricated silicon lenses as large as 33.4 cm in diameter with micromachined layers optimized for use between 125 and 165 GHz. Our design reduces average reflections to a few tenths of a percent for angles of incidence up to 30° with low cross polarization. We describe the design, tolerance, manufacture, and measurements of these coatings and present measurements of the optical properties of silicon at millimeter wavelengths at cryogenic and room temperatures. This coating and lens fabrication approach is applicable from centimeter to submillimeter wavelengths and can be used to fabricate coatings with greater than octave bandwidth.

Impact of dose hot spots on spinal cord tolerance following stereotactic body radiotherapy: a generalized biological effective dose analysis

The purpose of this study was to investigate the effects of high-dose inhomogeneous irradiation to small volumes of spinal cord with a new generalized biological effective dose (gBED) analysis for spine stereotactic body radiotherapy (SBRT). The gBED was applied to spinal cord dosimetric data (contoured per the thecal sac) at specified volumes for a cohort of five patients with radiation-induced myelopathy (RM) and compared to nineteen patients without RM post-SBRT. The spinal cord gBED was calculated and normalized to a conventional 2-Gy equivalent dose fraction scheme (α/β = 2 Gy for late toxicity). Differences between the conventional BED and those gBED calculations by accounting for small-volume dosing within the spinal cord was observed. Statistically significant differences in the mean gBED between the RM group and the non-RM group was observed both at the maximum point volume (gBED of 66 Gy vs. 37 Gy (p = 0.01), respectively) and at the 0.1 cm(3) volume (gBED of 53 Gy vs. 28 Gy (p = 0.01), respectively). No significant difference at the 0.1 cm(3) volume was observed based on the mean BED comparisons. No significant differences were observed at the larger 1 cm(3), 2 cm(3) or 5 cm(3) volumes for either BED or gBED comparisons. We conclude that differences in dose hot spots characteristics within small inhomogenously irradiated volumes of spinal cord can affect spinal cord tolerance following SBRT treatments.

Once-daily topical brimonidine tartrate gel 0·5% is a novel treatment for moderate to severe facial erythema of rosacea: results of two multicentre, randomized and vehicle-controlled studies

BACKGROUND

Erythema of rosacea is thought to result from abnormal cutaneous vasomotor activity. Brimonidine tartrate (BT) is a highly selective α(2) -adrenergic receptor agonist with vasoconstrictive activity.

OBJECTIVE

To determine the optimal concentration and dose regimen of topical BT gel for the treatment of erythema of rosacea and to evaluate its efficacy and safety.

METHODS

In study A, 122 subjects were randomized to receive a single application of BT 0·07%, 0·18%, 0·5% or vehicle. In study B (4-week treatment and 4-week follow-up), 269 subjects were randomized to receive BT 0·5% once daily, BT 0·18% once daily, vehicle once daily, BT 0·18% twice daily or vehicle twice daily. Evaluations included Clinician's Erythema Assessment (CEA), Patient's Self-Assessment (PSA), Chroma Meter measurements and adverse events.

RESULTS

In study A, a single application of topical BT gel reduced facial erythema in a dose-dependent fashion. A significant difference between BT 0·5% and vehicle in Chroma Meter redness value was observed from 30min to 12h after application. In study B, BT 0·5% once daily had a statistically superior success profile (defined as a two-grade improvement on both CEA and PSA over 12h) compared with vehicle once daily on days 1, 15 and 29 (all P<0·001). No tachyphylaxis, rebound of erythema or aggravation of other disease signs (telangiectasia, inflammatory lesions) was observed. All regimens were safe and well tolerated with similarly low incidence of adverse events.

CONCLUSIONS

Once-daily BT gel 0·5% is well tolerated and provides significantly greater efficacy than vehicle gel for the treatment of moderate to severe erythema of rosacea.