Tag Archives: eczema

MedShadow’s Top 10 Stories of 2018

What were the most popular stories we published in 2018? Our Top 10 includes two stories on drugs that have become popular among opioid abusers, as well as articles dealing with drug interactions, a controversial class of antibiotics and a first-person story on an herbal supplement that has come under attack from the FDA, among others. Here are excerpts of the stories with the highest readership.

1. Gabapentin’s Secret: The Drug Opioid Abuser’s Crave

By Ronni Gordon

For many people who take gabapentin – a drug prescribed to treat seizures and pain caused by shingles – side effects such as sedation can be a challenge, as those who take it off-label for neuropathic pain told MedShadow in the past.

But an increasing number of opioid abusers crave that side effect, reporting a calm feeling when combining gabapentin – developed by Pfizer under the brand name Neurontin – with opioids, muscle relaxants and anxiety medications. Some also get a marijuana-like high and an enhanced euphoria. But when overused or abused, it can cause significant organ or brain damage. Read more →

2. Managing Eczema: Are New Treatments Like Eucrisa Worth It?

By Madeline Vann

Eczema (atopic dermatitis) can feel like a moving target for people who live with it. They get control over one flare, only to have eczema redden and irritate another patch of skin. For some patients, changing their bathing and beauty habits along with a thick moisturizer and topical corticosteroid ointments are enough.

“Steroids are the mainstay of treating atopic dermatitis. They’ve been around for decades. They are generally inexpensive, and for the vast majority of patients, that’s how we start treatment,” explains dermatologist Amy Paller, MD, director of the Northwestern University Skin Disease Research Center in Chicago. American Academy of Dermatology (AAD) guidelines recommend using emollient moisturizers, lifestyle changes to avoid triggers, and corticosteroids at first. Read more →

3. How Imodium Became Appealing to Opioid Addicts

By Padma Nagappan

A sports injury from playing squash in high school lead to a herniated disc for Bob Johnson (name changed to protect his privacy), who was initially given codeine for his pain, and then bumped up to hydrocodone, which is more powerful and used to treat severe pain.

He stopped taking the drugs once he began recovering. All was well until he left for college in Philadelphia and started playing on the squash team — and his back began hurting again. He found it was easy to get access to drugs and began buying OxyContin (oxycodone) from a dealer. Read more → 

4. What is the Best Way to Treat Heat Rash?

By Dave Walker, RPh

Question: It’s summer and I’m going to be spending a lot of times outdoors. I’m susceptible to heat rash. What is the best treatment for it?

I remember anticipating summer vacation as a kid. We were always busy planning and participating in neighborhood sporting activities, biking, hiking, fishing and camping trips. The neighborhood moms always had a ready supply of Band-Aids, Bactine and antiseptic cream to take care of those expected and inevitable scratches, scrapes, cuts and insect bites along the way. Read more →

5. 4 Drugs That Interact with Anxiety Meds

By Christy Huff, MD

If you suffer from anxiety, panic disorder or insomnia, your doctor may have prescribed you a tranquilizer belonging to a class of drugs known as benzodiazepines.

Drugs such as Xanax (alprazolam), Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam) are some of the most-prescribed medicines – more than 133.4 million such prescriptions were filled in the US in 2014. As with any medication, drug interactions can occur if you take a benzo with another medication, and in certain cases, may be life-threatening. Read more → 

6. Why Aren’t Seniors Getting the Shingles Vaccine?

By Rita Colorito

Nearly 12 years after the FDA approved Zostavax, the first vaccine to prevent shingles in adults 60 and older, the vast majority of seniors still haven’t received it. Only 30.6% of adults age 60 and older reported getting the shingles vaccine, according to the latest CDC (Centers for Disease Control and Prevention) assessment of vaccine coverage.

Since it became available, Zostavax has faced numerous barriers in terms of getting seniors vaccinated, the assessment found. In October, the FDA approved a new shingles vaccine, Shingrix, for people age 50 and older. Less than a week later, the CDC’s Advisory Committee on Immunization Practices (ACIP) recommended Shingrix as the CDC’s preferred shingles vaccine for adults age 50 plus due to Shingrix’s better efficacy and fewer side effects compared to Zostavax. Read more → 

7. Floxed! The Painful, Life-Lasting Effects of Some Antibiotics

By Suzanne B. Robotti

Last week, we ran a news story on antibiotics causing “rare” damages to people. We had a very passionate response from more than 75 people who all claimed to be harmed by a particular type of antibiotics. More than 60,000 people have complained to the FDA about them. It begs the question, how unusual are these “rare” harms.

The side effects and adverse events associated with Cipro, Levaquin and other fluoroquinolones (FQs) can be significant and life altering. Yet many people who have been damaged by fluoroquinolones complain that there are too few warnings. Many claim that doctors don’t believe that their new illnesses have come from the FQs. Worse, sometimes FQs are prescribed when other, less risky — and just as effective — antibiotics are available. Read more →

8. The FDA Has It Wrong on Kratom: How the Herb is Helping People Like Me

By Andrew Turner

Some may ask who are the consumers of kratom, an herb used to treat pain, depression and anxiety that has been the subject of controversy lately in the news. It’s complicated.

We can be anyone. We are your neighbor, the veteran in the supermarket, your college professor and even your best friend. There’s a lot of misconceptions about kratom, how it’s used to treat certain ailments and its potential for addiction. Read more →

9. Can An Opioid Addiction Drug Treat Autoimmune Disorders

By Deborah Lynn Blumberg

A slew of drugs, both new and old, are used to treat autoimmune disorders like multiple sclerosis (MS), lupus and Crohn’s disease. Most of them come with side effects, some of them serious. But research and experience from patients and doctors are mounting that a drug used to treat substance abuse, when used in lower doses, can effectively treat autoimmune conditions with few side effects.

The drug is naltrexone, which was first approved in the 1980s to treat heroin addiction. In recent years, it has been prescribed more and more at a low dose for patients with autoimmune disorders. But is this off-label use (yet to be approved by the FDA) safe and effective? Read more →

10. Pros and Cons: Prednisone

By Tori Rodriguez

If you visit the doctor from time to time for anything other than a routine checkup, it’s likely that at some point you’ve received a prescription for a type of drug called corticosteroids. These are among the most commonly prescribed medications in the US, and they are used in almost every medical specialty.

In a study published last year, researchers at the University of Michigan found that 1 in 5 American adults with commercial health insurance had been prescribed a corticosteroid at least once over a 3-year period. Read more →

Managing Eczema: Are New Treatments Like Eucrisa Worth It?

Eczema (atopic dermatitis) can feel like a moving target for people who live with it. They get control over one flare, only to have eczema redden and irritate another patch of skin. For some patients, changing their bathing and beauty habits along with a thick moisturizer and topical corticosteroid ointments are enough.

“Steroids are the mainstay of treating atopic dermatitis. They’ve been around for decades. They are generally inexpensive, and for the vast majority of patients, that’s how we start treatment,” explains dermatologist Amy Paller, MD, director of the Northwestern University Skin Disease Research Center in Chicago. American Academy of Dermatology (AAD) guidelines recommend using emollient moisturizers, lifestyle changes to avoid triggers, and corticosteroids at first.

However, some people with eczema find those first steps offer little relief. For these people, new eczema treatments offer renewed hope.

When Corticosteroids Aren’t Enough

Jennifer Merrill, a resident of western Maine, is among those for whom eczema remains a frustrating puzzle. She’s had eczema since childhood. The 40-year-old managed to reduce the eczema on her scalp by washing her hair less frequently and abstaining from hairspray – only to find that eczema moved to the skin around her lips, eyes, wrist and stomach. A dermatologist prescribed a number of different creams, including topical corticosteroids.

“The steroids started to work in the beginning, but quickly things went from bad to worse,” she recalls.

Dr. Paller acknowledges that corticosteroids aren’t good options for everyone.

“Sometimes we have patients who can’t just intermittently put on steroids, clear their skin up, and use moisturizers. They are more chronic,” she says.

A different dermatologist put Merrill on antibiotics and a nonsteroid prescription medication, Elidel (pimecrolimus).

“Things calmed down a bit, but I would get random flares. After about six months on antibiotics I went back, at which time she did a biopsy and the results were eczema,” she says. At that point, Merrill’s dermatologist gave her samples of a medication approved for use on eczema in 2016: Eucrisa (crisaborole).

“It has helped somewhat. Pretty much cleared up the patches on my wrist, has helped but not completely cleared my face, and has done nothing for my stomach. The area I need to use it the most now is around my lips. I’ve used it on my wrists and belly and felt no side effects, but when applied around my lips it burns and itches like crazy! After a few minutes it will go away, but those first few are torture,” she says.

People like Merrill find their eczema requires a menu of strategies, including the relatively new topical Eucrisa (crisaborole).

Eucrisa was approved by the FDA in 2016 for use on eczema in people over the age of 2. A thin layer is applied to the affected areas twice daily.

Eucrisa has been shown to improve eczema symptoms safely, according to a review of the research on the ointment published in the December 2017 issue of the American Journal of Clinical Dermatology. According to the review, a small number of people using Eucrisa experience some pain at the site.

“Topical steroids, while effective, have many side effects, especially when used long term,” says dermatologist Emma Guttman, MD, PhD, vice chair of the department of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. Side effects of corticosteroids include skin irritations and thinning of the skin.

“Many patients prefer to use a nonsteroid cream. Other nonsteroid creams such as Protopic (tacrolimus) and Elidel (pimecrolimus) currently have a black-box warning.”

The FDA requires Protopic and Elidel to carry a black-box warning letting consumers know there might be an increased risk of cancer associated with their use. Eucrisa does not have a black-box warning.

The Benefits of Eucrisa

“Eucrisa is indicated for mild to moderate eczema,” explains dermatologist Holly Gunn, MD, assistant professor in the department of dermatology at the University of Alabama School of Medicine in Birmingham. It is essentially an anti-inflammatory that targets a specific enzyme in the eczema which is causing inflammation. “Some patients love it and others say it didn’t work.”

Gunn says that she particularly likes Eucrisa for delicate skin, such as the skin on the face or close to the eyes, which might be further aggravated by steroid creams. Paller agrees that Eucrisa is promising for areas of delicate skin, and adds that the ointment seems to be effective for hand and foot eczema as well.

But, they say, each person’s skin will respond differently to treatment, so what works for one person might not work for the next. “We put Eucrisa, Elidel and Protopic in the same category,” she says, listing the other nonsteroidal options for eczema treatment.

The Drawbacks of Eucrisa

People who use Eucrisa may find that they feel a burning or stinging at the site, says Paller. Some people can continue to use the ointment and find the unpleasant sensations go away – while others might have to switch to another option, she says. There’s currently no standard recommendation on how to reduce the burning sensations. In some situations, using a corticosteroid ointment to reduce the inflammation and then using another ointment, such as Eucrisa, might help.

The biggest drawback to Eucrisa is its cost. However, says Gunn, it’s possible that you can use Eucrisa sparingly, either to give yourself a break from topical steroids or only on specific parts of your body.

“Typically, insurance companies like us to try less-expensive treatments first,” points out Gunn. So you might have to try other topical treatments before you can try Eucrisa. A 60-gram tube of Eucrisa runs approximately $600, while topical corticosteroids cost half that for a brand-name product, and a quarter as much for a generic. Check with your insurance provider to find out what your copays could be.

Overall, atopic dermatitis is estimated to cost the country $5 billion dollars annually. This annual cost includes the cost of treatment and hospitalization, as well as the cost of lost work and productivity, according to an article published in Advances in Experimental Medicine and Biology in 2017. The most cost-effective strategy for eczema management is the preventative use of moisturizer, according to the February 2017 issue of JAMA Pediatrics.

Paller points out that the arrival of newer eczema treatments such as Eucrisa, Elidel and Protopic is just the tip of the iceberg – she expects researchers in future years to develop more treatments based on increasingly nuanced understanding of how eczema works.

Quick Hits: FDA Approves New Drugs for Multiple Sclerosis, Eczema and Warning About Heart Drug

The FDA approved Ocrevus (ocrelizumab) as the first-ever drug to treat primary progressive multiple sclerosis (PPMS), a serious form of the disease. Ocrevus, a biologic, intravenous infusion, was also approved for relapsing forms of MS. Ocrevus, which is only given twice a year, can cause serious infusion-related reactions. These reactions include, but are not limited to, itchy skin, rash, hives, skin redness, flushing, low blood pressure, fever, tiredness, dizziness, headache, throat irritation, shortness of breath, swelling of the throat, nausea and fast heartbeat. Additionally, Ocrevus may increase the risk for cancer, particularly breast cancer. Upper respiratory tract infection was the most common side effect of the biologic seen in the clinical trials for relapsing forms of MS. The list price of Ocrevus is $65,000 per year. Posted March 29, 2017. Via FDA.

The FDA approved Dupixent (dupilumab) to treat adults with moderate to severe eczema. The biologic is intended for patients whose eczema is not adequately controlled by topical therapies. Possible side effects associated with Dupixent include serious allergic reactions and eye problems, such as pink eye and inflammation of the cornea (keratitis). If patients experience new or worsening eye symptoms such as redness, itching, pain or visual changes, they should consult their doctor immediately. The most common side effects include injection site reactions; cold sores in the mouth or on the lips; and eye and eyelid inflammation, including redness, swelling and itching. Dupixent has a list price of $37,000 per year. Posted March 28, 2017. Via FDA.

The heart drug digoxin may increase the risk of death in people with a common heart rhythm disorder. Researchers strongly advise that those patients avoid this medication. Data was analyzed from nearly 18,000 atrial fibrillation patients in an international stroke prevention trial, including about 32% who were on digoxin at the start of the trial and nearly 7% who started taking the drug at some point during the trial. There was no significant association between digoxin use and death risk among patients who were already taking digoxin; however, the risk of death was related to digoxin concentration in the blood. In addition, the risk of death was substantially higher in patients who began digoxin after the start of the study. Posted March 22, 2017. Via HealthDay.